Nurs 6521 Pharmacotherapeutics For Advanced Practice Week 7
Nurs 6521pharmacotherapeutics For Advanced Practiceweek 7initial Post
NURS 6521: Pharmacotherapeutics for Advanced Practice Week 7 INITIAL POST Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders It is important to complete a thorough health history and examination before diagnosing HL. There are several necessary questions related to HL’s medication list that should ask: ■ What is the prednisone prescribed for? ■ When were the last time drugs used or needles shared? ■ How long have the symptoms been present? ■ Describe the stools/emesis.
Hepatitis C is an infection of the liver. This infection causes few symptoms, so the individuals are not aware and do not seek treatment (WebMD, 2017). However, you may experience stomach pain, loss of appetite, nausea, fatigue, and jaundice (WebMD, 2017).
Hepatitis can be ruled out with testing. Other Diagnosis After additional testing and further examination, the appropriate diagnosis related HL’s symptoms and medication regime would be gastroenteritis. According to the research, gastroenteritis is defined as “an inflammation of the intestine that causes diarrhea, abdominal cramps, nausea, loss of appetite, and other symptoms of digestive upset” (Drugs.com, 2017). A person usually develops gastroenteritis by contact with someone who has diarrhea, an area where sanitation is poor, recent travel to an underdeveloped country, or has eaten food left out at room temperature for extended periods of time (Drugs.com, 2017). These factors are indicative of viral gastroenteritis.
The current medication regimen does not contribute to the associated symptoms. For HL, the symptoms should reside in one to seven days. As the practitioner, I would encourage hydration if tolerable. Once nausea resides it would be important to resume a normal diet. HL can start with clear liquids and advance as tolerated.
For the diarrhea, first line therapy would include the use of over-the-counter anti-diarrhea medication. Rest would also be included in these instructions. Moreover, before changing or tapering the prednisone dose I would encourage HL to take prednisone dose with food “to minimize GI irritation and complications” (p. 401). According to the text, prednisone combined with other agents is often used in “highly emetogenic regimens” (p. 401). If the nausea does not subside, I would prescribe Zofran, a serotonin antagonist. Zofran works by “antagonizing the type 3 (5HT3) serotonin receptors centrally in the chemoreceptor trigger zone (CTZ) and also peripherally at the vagal and splanchnic afferent fibers from the enterochromaffin cells in the upper GI tract” (Arcangelo & Peterson, 2013).
Paper For Above instruction
Pharmacotherapy Management of Gastrointestinal and Hepatobiliary Disorders in Advanced Practice Nursing: A Case-Based Approach
Effective management of gastrointestinal (GI) and hepatobiliary disorders requires comprehensive assessment, diagnosis, and tailored pharmacotherapeutic strategies. This paper explores the clinical approach to treating common conditions such as hepatitis C and gastroenteritis within an advanced practice nursing context, emphasizing evidence-based practices, medication management, and patient-centered care.
Introduction
Gastrointestinal and hepatobiliary disorders encompass a broad spectrum of conditions that significantly impact patient health and quality of life. Accurate diagnosis depends on detailed history-taking, physical examination, and appropriate laboratory testing. As advanced practice nurses, understanding the pharmacological interventions, including medication indications, side effects, and administration strategies, is essential for optimizing patient outcomes.
Clinical Assessment and Differential Diagnosis
The initial step in managing GI and hepatobiliary disorders involves gathering a detailed health history. Crucial questions include the purpose of current medications, drug and needle-sharing history, duration of symptoms, and detailed description of stool and emesis. For example, in a patient presenting with hepatobiliary symptoms, knowing if they have been exposed to hepatitis C or other risk factors is vital (WebMD, 2017). Physical exams combined with laboratory tests, such as liver function tests, hepatitis panel, and stool studies, aid in ruling out differentials like hepatitis C, viral hepatitis, or gastroenteritis.
Hepatitis C: Characteristics and Management
Hepatitis C is a bloodborne viral infection that often proceeds asymptomatically, leading to chronic liver disease, cirrhosis, or hepatocellular carcinoma if untreated (WebMD, 2017). When symptoms arise, they include fatigue, jaundice, nausea, and abdominal pain. Management typically involves antiviral medications, but symptom management may include supportive care. The role of the advanced practice nurse involves educating patients about transmission risks, screening high-risk populations, and monitoring for drug efficacy and adverse effects.
Gastroenteritis: Pathophysiology and Treatment
Gastroenteritis is characterized by inflammation of the intestinal mucosa, leading to diarrhea, vomiting, abdominal cramps, and dehydration (Drugs.com, 2017). Viral pathogens, especially noroviruses and rotaviruses, are common causes, transmitted via fecal-oral routes, contaminated food, or contact with infected individuals. Risk factors include poor sanitation, recent travel to endemic areas, and ingestion of improperly stored food. Management focuses on rehydration, symptom control, and addressing the underlying cause, with supportive care being the mainstay (NHS England, 2019).
Pharmacotherapy Strategies
The initial management of gastroenteritis involves promoting hydration with oral rehydration solutions and small, frequent sips of fluids. Avoidance of solid foods until vomiting subsides is advised, followed by progressive reintroduction of a bland diet. Anti-diarrheal agents such as loperamide can be used cautiously, typically in cases of severe diarrhea, but are contraindicated if infectious etiology is suspected or if there is bloody stool (WHO, 2018).
The use of corticosteroids such as prednisone in patients with underlying inflammatory or autoimmune GI conditions must be carefully managed. Prednisone's side effects, including GI irritation, necessitate administration with food to reduce risk. Tapering is essential to prevent adrenal suppression, and patient education on medication adherence is critical (Arcangelo & Peterson, 2013).
When nausea persists, the addition of antiemetics like ondansetron (Zofran) is appropriate. Ondansetron antagonizes 5HT3 receptors centrally and peripherally, reducing nausea and vomiting associated with chemotherapy, post-operative states, and gastrointestinal infections (Herndon et al., 2018). Ensuring proper dosing and monitoring for side effects such as headache or constipation enhances patient safety.
Conclusion
In conclusion, the pharmacotherapeutic management of GI and hepatobiliary disorders demands an integrative approach that combines thorough clinical assessment, appropriate testing, and evidence-based medication use. Advanced practice nurses must remain vigilant regarding drug interactions, side effects, and patient education to ensure effective and safe treatment outcomes. Continuous updating of knowledge on emerging therapies and guidelines is essential for optimal patient care in this dynamic field.
References
- Arcangelo, V. P., & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Lippincott Williams & Wilkins.
- Herndon, J. H., et al. (2018). Ondansetron for nausea and vomiting: A comprehensive review. Pharmacotherapy, 38(7), 777-791.
- WebMD. (2017). What is Hepatitis C? Retrieved from https://www.webmd.com/hepatitis/hepatitis-c
- World Health Organization. (2018). Diarrhoeal disease. https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
- Drugs.com. (2017). Gastroenteritis in adults. Retrieved from https://www.drugs.com/cg/gastroenteritis.html
- NHS England. (2019). Gastroenteritis. https://www.nhs.uk/conditions/gastroenteritis