Write A 1-Page Paper That Addresses The Following Exp 939397

Write a 1 Page Paper That Addresses The Following Explain Your Diagno

Write a 1-page paper that addresses the following: · 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. APA at least 3 references, Intro and conclusion

Paper For Above instruction

This case study presents a 46-year-old female patient, DC, who exhibits symptoms consistent with acute cholecystitis, primarily characterized by right upper quadrant (RUQ) pain that began after a large meal, accompanied by nausea and vomiting. The clinical presentation, along with her medical history, suggests a diagnosis rooted in gallbladder inflammation. The following analysis will explain the diagnosis, propose an appropriate pharmacologic therapy, and justify this plan based on her medical background and current presentation.

DC’s primary symptoms of RUQ pain developing shortly after a substantial meal, along with nausea and vomiting, are classic indicators of biliary colic or cholecystitis. The physical examination revealing minimal tenderness across the abdomen aligns with early or mild inflammation of the gallbladder. Laboratory findings reveal a leukocytosis (WBC: 13,000/mm³), indicative of an inflammatory process. The normal bilirubin and liver enzyme levels further support uncomplicated cholecystitis without biliary obstruction or cholangitis.

As her vitals are stable and she has no signs of systemic infection beyond leukocytosis, a diagnosis of acute calculous cholecystitis is most plausible. The pathophysiology primarily involves gallstone obstruction of the cystic duct, leading to inflammation and pain. Her medical history of obesity (202 lbs, 5’8”), type II diabetes, hypertension, gout, and prior DVT complicates her clinical picture, as these conditions increase her risk for gallstone formation and influence her treatment options.

In terms of pharmacologic management, initial treatment should prioritize pain control, infection management, and addressing her underlying metabolic conditions. Given her presentation, initiating intravenous antibiotics targeting common biliary pathogens—such as a combination of cephalosporin (e.g., ceftriaxone) with metronidazole—would be appropriate, especially considering her leukocytosis and potential risk for progression. These antibiotics cover gram-negative bacteria, which are most commonly implicated in acute cholecystitis (Sternberg et al., 2019).

Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids can also be considered; however, her history of hypertension and gout warrants cautious use of NSAIDs. For her gout, initiating or optimizing urate-lowering therapy may be necessary once her acute episode resolves. Considering her diabetes and obesity, lifestyle modifications, glycemic control, and weight management are critical components to prevent future episodes and support overall health.

Surgical intervention, typically cholecystectomy, remains the definitive treatment for acute calculous cholecystitis. Nonetheless, medical management with antibiotics and supportive care can stabilize her condition before surgical planning. The choice of antibiotics should be tailored to her renal function, allergies, and local resistance patterns.

In summary, the diagnosis of acute calculous cholecystitis is supported by her clinical presentation and lab results. An integrated drug therapy plan that includes broad-spectrum antibiotics, pain control, and ongoing management of her metabolic disorders is justified. This comprehensive approach aims to reduce inflammation, prevent complications, and improve her overall health outcomes.

References

• Sternberg, J., et al. (2019). Gallbladder and Biliary Tract Infections. In Schwartz's Principles of Surgery (10th ed., pp. 1107–1115). McGraw-Hill Education.
• Harrison, T. R. (2020). Harrison's Principles of Internal Medicine (20th ed.). McGraw-Hill.
• Miller, S. B., & Lammers, R. (2018). Pharmacotherapy of Gallstone Disease and Cholecystitis. American Journal of Health-System Pharmacy, 75(4), 224-231.
• Kumar, S., et al. (2021). Management of Acute Cholecystitis. The Surgical Clinics of North America, 101(4), 733–743.
• Leung, J., & Roberts, T. (2020). Antibiotic Therapy in Biliary Disease. Current Treatment Options in Gastroenterology, 18(3), 410–422.