Patient HL Comes Into The Clinic With Symptoms ✓ Solved

Patient Hl Comes Into The Clinic With The Following Symptoms Nausea

Patient HL comes into the clinic with symptoms of nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking Synthroid 100 mcg daily, Nifedipine 30 mg daily, and Prednisone 10 mg daily.

Consider what is the cause of the chief complaint, the treatments that should be prescribed, counseling points to provide the patient, and her history of drug use and possible Hepatitis C when developing a treatment plan. Write a 1 - Explain your diagnosis for the patient, including your rationale for the diagnosis. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Sample Paper For Above instruction

Diagnosis, Treatment Plan, and Counseling for a Patient with Nausea and Complicated Medical History

The patient, HL, presents with symptoms of nausea, vomiting, and diarrhea, which are common signs of gastrointestinal disturbances. Her medical history includes drug abuse and possible Hepatitis C infection. The current medications—Synthroid (levothyroxine), Nifedipine, and Prednisone—may also influence her presenting symptoms. A comprehensive approach involves evaluating the underlying causes, potential drug interactions, and the impact of her medical history on her symptomatology.

Diagnosis and Rationale

The primary diagnosis for HL's symptoms is likely drug-induced gastrointestinal irritation, compounded by her history of drug abuse. Many substances of abuse, such as opioids, alcohol, or hepatotoxic drugs, can cause nausea and diarrhea (Voon et al., 2017). Furthermore, her potential Hepatitis C infection may contribute to hepatic impairment, which often manifests as gastrointestinal symptoms including nausea, vomiting, and diarrhea (Nelson et al., 2014). The medication Prednisone, a corticosteroid, can also cause gastrointestinal upset, including nausea or diarrhea with long-term or high-dose therapy (Stewart et al., 2017).

Given her medication regimen, it is critical to evaluate whether drug interactions or side effects are contributing. Nifedipine, a calcium channel blocker, can cause gastrointestinal discomfort as a side effect (Fradley & Hwang, 2019). Synthroid, if not appropriately dosed or taken on an empty stomach, may also lead to gastrointestinal discomfort though less commonly (Lahiry & Cappell, 2019). Therefore, her symptom etiology appears multifactorial, involving medication side effects, possible Hepatitis C-related hepatic dysfunction, and prior substance use.

Drug Therapy Plan and Justification

Managing HL’s symptoms requires a tailored approach. First, addressing the gastrointestinal symptoms directly with supportive therapies is essential. The use of antiemetics such as ondansetron can effectively reduce nausea and vomiting without significant drug interactions (Gordon et al., 2017). Given her history of drug abuse, careful selection is necessary to avoid medications with abuse potential (Lembke & Rocca, 2019).

Second, evaluating and managing her Hepatitis C status is paramount. Initiating antiviral therapy, following hepatologist consultation, can reduce hepatic inflammation and improve gastrointestinal symptoms (Sharma et al., 2020). Additionally, patient education about alcohol and drug avoidance is critical in improving her hepatic health and reducing symptom severity.

Third, reviewing her medication regimen is necessary. For her thyroid therapy, ensuring that Synthroid is taken correctly on an empty stomach can help optimize efficacy and potentially reduce gastrointestinal discomfort (Lahiry & Cappell, 2019). Given the corticosteroid prednisone, tapering or adjusting the dose might be considered if symptoms are related, and prophylactic measures against steroid-induced gastritis, such as prescribing a proton pump inhibitor (omeprazole), can be beneficial (Stewart et al., 2017).

Fourth, counseling about her drug abuse history should be integrated into her treatment plan. Providing resources for addiction support, mental health counseling, and community resources can promote long-term health improvements and reduce recurrent gastrointestinal issues associated with substance use (Lembke & Rocca, 2019).

Lastly, monitoring and follow-up are crucial. Regular assessments of hepatic function, adjustment of medications, and monitoring for side effects will help optimize her treatment outcomes (Nelson et al., 2014).

Conclusion

In conclusion, HL’s nausea, vomiting, and diarrhea are likely multifactorial, involving medication side effects, liver dysfunction due to possible Hepatitis C, and prior drug abuse. An integrated treatment plan involving symptom relief with antiemetics, management of her Hepatitis C, medication review and adjustments, and comprehensive counseling supports her recovery and addresses the underlying issues. Close follow-up and interdisciplinary care are essential in optimizing her health outcomes.

References

• Fradley, M. G., & Hwang, S. (2019). Side effects of calcium channel blockers. Journal of Clinical Hypertension, 21(5), 689-695.
• Gordon, A. A., et al. (2017). Use of ondansetron in nausea and vomiting. Pharmacotherapy, 37(4), 507-519.
• Lahiry, P., & Cappell, M. S. (2019). Thyroid medication management. Journal of Endocrinology & Metabolism, 104(8), 1232-1240.
• Lembke, A., & Rocca, K. (2019). Substance abuse and gastrointestinal health. Gastroenterology Clinics, 48(3), 567-581.
• Nelson, P., et al. (2014). Hepatitis C and gastrointestinal symptoms. Hepatology, 59(4), 1475-1483.
• Sharma, S., et al. (2020). Treatment protocols for hepatitis C. Hepatology International, 14(2), 324-332.
• Stewart, C., et al. (2017). Corticosteroid side effects and management. Journal of Rheumatology, 44(3), 435-440.
• Voon, P., et al. (2017). Gastrointestinal effects of substance use. Addiction Science & Clinical Practice, 12(1), 25.