Cheap essays, research papers, dissertations.Sample Answer for GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501 Included After Question
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
Ulcers
Hepatitis markers
After HP shots
Gastroesophageal Reflux Disease
Pancreatitis
Liver failure—acute and chronic
Gall bladder disease
Inflammatory bowel disease
Diverticulitis
Jaundice
Bilirubin
Gastrointestinal bleed – upper and lower
Hepatic encephalopathy
Intra-abdominal infections (e.g., appendicitis)
Renal blood flow
Glomerular filtration rate
Kidney stones
Infections – urinary tract infections, pyelonephritis
Acute kidney injury
Renal failure – acute and chronic
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 5
Complete the Knowledge Check By Day 7 of Week 5.
A Sample Answer For the Assignment: GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501
Title: GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501
The case study concerns a 46-year-old female with reports of RUQ pain for the past 24 hours. The pain began an hour after having a large dinner. She also experienced nausea and one vomiting episode prior to the presentation. The purpose of this paper is to discuss the likely diagnosis and treatment plan.
Diagnosis
The likely diagnosis for this patient is Acute cholecystitis. This is a gallbladder inflammation that progresses over hours due to a gallstone obstructing the cystic duct. Gallaher & Charles (2022) explain that the classic presentation of Acute cholecystitis includes acute RUQ pain, fever, nausea, and vomiting associated with eating and physical exam findings of RUQ tenderness. Acute cholecystitis manifests with a high WBC count indicating inflammation (Bridges et al., 2018). In addition, serum levels of aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase may be increased, pointing to abnormalities in liver function in persons with severe biliary obstruction (Doherty et al., 2022). Direct and indirect serum bilirubin levels are also increased. Acute cholecystitis is the selected diagnosis owing to postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels.
Drug Therapy
Drug therapy will include antibiotics with IV Ceftriaxone 2 g once daily and IV metronidazole 500 mg every 8 hours. These antibiotics have adequate coverage against the most common pathogens (Gallaher & Charles, 2022). An antiemetic like Prochlorperazine IV 2.5 mg every 4 hours will be administered to alleviate nausea and prevent fluid and electrolyte disorders caused by vomiting. Oxycodone/acetaminophen 1 tablet orally every 6 hours will be prescribed for pain control.
Conclusion
Positive findings of postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels indicate likely Acute cholecystitis. When a gallstone impacts the cystic duct and continuously obstructs it, it results in acute inflammation causing cholecystitis. Drug therapy will include antibiotics with Ceftriaxone and Metronidazole, antiemetic with Prochlorperazine, and Oxycodone/acetaminophen for pain relief.
GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501
References
Bridges, F., Gibbs, J., Melamed, J., Cussatti, E., & White, S. (2018). Clinically diagnosed cholecystitis: a case series. Journal of surgical case reports, 2018(2), rjy031. https://doi.org/10.1093/jscr/rjy031
Doherty, G., Manktelow, M., Skelly, B., Gillespie, P., Bjourson, A. J., & Watterson, S. (2022). The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease. Medicina, 58(3), 388. https://doi.org/10.3390/medicina58030388
Gallaher, J. R., & Charles, A. (2022). Acute Cholecystitis: A Review. JAMA, 327(10), 965–975. https://doi.org/10.1001/jama.2022.2350
A Sample Answer 2 For the Assignment: GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501
Title: GASTROINTESTINAL AND HEPATOBILIARY DISORDERS MODULE 3 NURS 6501
Question 1
4 out of 4 points
Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed + urease.
The healthcare provider suspects the client has peptic ulcer disease.
Questions:
1. Explain what contributed to the development from this patient’s history of PUD?
Selected Answer:
PUD is ulceration in the mucosal lining of the lower esophagus, stomach, and or duodenum. This patient has several risk factors contributing to the development of peptic ulcer disease. including, Patient’s age of 65, Daily use of NSAIDs for osteoarthritis pain, High stress due to a pending divorce, working, and managing 2 homes. The patient smokes and drinks Alcohol daily. Coffee consumption may be another causative factor for PUD. Also, her positive breath test for urease indicates the presence of H. pylori infection.
Chronic use of ibuprofen suppresses mucosal prostaglandin synthesis which in turn results in decreased bicarbonate secretion and mucin production. The bicarbonate is a buffer against HCl, and mucin is a component of the gut barrier. Subsequently, the secretion of HCl is increased. The interaction of NSAIDS and H. Pylori can contribute to the pathogenesis of peptic ulcers as both disrupt the integrity of the mucosa. This exposes submucosal areas to gastric secretions and autodigestion, causing erosion and ulceration
Correct Answer:
Stress secondary to divorce and financial situation, cigarette smoking, alcohol consumption, use of NSAIDS, excess coffee consumption, +H Pylori test
Response Feedback:
[None Given]
· Question 2
4 out of 4 points
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Scenario 1: Peptic Ulcer
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.
PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain
Family Hx-non contributary
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.
Breath test in the office revealed + urease.
The healthcare provider suspects the client has peptic ulcer disease.
Question:
1. What is the pathophysiology of PUD/ formation of peptic ulcers?
Selected Answer:
The two major types of peptic ulcers are duodenal ulcers and gastric ulcers. Both are predominately caused by H. pylori and NSAID usage. The pathophysiology of both is similar, however, in duodenal ulcers, acid and pepsin concentrations in the duodenum penetrate the mucosal barrier and lead to ulceration. In the case of gastric ulcers, duodenal reflux of bile precipitates ulcer formation by limiting the mucosa’s ability to secrete a protective layer of mucus. The pyloric sphincter may fail to respond properly allowing reflux of bile and pancreatic enzymes to damage the gastric mucosa. The damaged mucosal barrier permits hydrogen ions to diffuse into the mucosa. Here they disrupt permeability and cellular structure. A vicious cycle is then established as the damaged mucosa liberates histamine. This stimulates the increase of acid and pepsinogen production, blood flow, and capillary permeability. The disrupted mucosa becomes edematous and loses plasma proteins. The destruction of small vessels causes bleeding. Thus, the pathophysiology of the various peptic ulcer formation has similar beginnings and can diverge from there to follow a couple of different pathways. Initially: 1. Causative factors: H. pylori, bile salts, NSAIDS, alcohol, ischemia 2. Damaged mucosal barrier 3. Decreased function of mucosal cells, decreased quality of mucus, loss of tight junctions between cells 4. Back-diffusion of acid into gastric mucosa which leads to A. Conversion of pepsinogen to pepsin. This leads to further mucosal erosion, destruction of blood vessels, and bleeding. Resulting in ulceration. B. Formation and liberation of histamine. This leads to local vasodilation and results in increased capillary permeability, loss of plasma proteins, mucosal edema, and loss of plasma into the gastric lumen. This formation and liberation of histamine also increase acid secretion leading to both ulceration and muscle spasms. it should be also be noted that H. pylori which thrive in the presence of increased acidity also leads to mucosal injury, and thereby, ulceration.
High-risk for PUD include alcoholics, patients on extensive NSAIDs, and those with chronic renal failure. PUD has been strongly linked to infection with Helicobacter pylori. This bacterium is responsible for the destruction of protective mechanisms in the stomach and duodenum leading to damage by stomach acid that would otherwise not be a problem. These ulcers are found more commonly in the duodenum than in the stomach, although both locations present equal incidences of bleeding.
Correct Answer:
Chronic use of NSAIDS causes suppresses of mucosal prostaglandin and direct irritative topical effect. High gastrin level and excessive gastric acid production often seen in Zollinger-Ellison syndrome which can caused by gastrinoma. Smoking impairs healing by vasoconstriction. H Pylori causes gastritis and interferes with mucosa
Response Feedback:
[None Given]
· Question 3
4 out of 4 points
Scenario 2: Gastroesophageal Reflux Disease (GERD)
A 44-year-old morbidly obese female comes to the clinic complaining of “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.
PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2)
FH:non contributary
Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn
SH: 20 PPY of smoking, ETOH rarely, denies vaping
Diagnoses: Gastroesophageal reflux disease (GERD).
Question:
1. If the client asks what causes GERD how would you explain this as a provider?
Selected Answer:
GERD is caused by frequent acid reflux; the reflux of acid and pepsin or bile salts from the stomach to the esophagus. This, in turn, causes esophagitis, or inflammation and irritation of the esophagus. To break it down even more, when you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter or LES) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again. If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed. I would then explain to the patient the risk factors that increase a person’s susceptibility to developing GERD, as well as factors that can aggravate acid reflux as follows:
Conditions that can increase your risk of GERD include Obesity, Bulging of the top of the stomach up into the diaphragm (hiatal hernia), Drugs or chemicals that relax the lower esophageal sphincter, (such as anti-cholinergic, nitrates, calcium channel blockers, nicotine), Pregnancy, and Connective tissue disorders, such as scleroderma, Delayed stomach emptying.
Factors that can aggravate acid reflux include Smoking, Eating large meals, eating late at night, Eating certain foods (triggers) such as fatty or fried foods, drinking certain beverages, such as alcohol or coffee, and Taking certain medications, such as NSAIDs or aspirins.
Correct Answer:
GERD manifestations result directly from gastric acid reflux into the esophagus. Pyrosis, the classic symptom, is a substernal burning sensation typically described as heartburn. It may be accompanied by regurgitation, particularly in someone who has recently eaten. The lower esophageal sphincter (LES) relaxes due to certain medications (calcium channel blockers), hiatal hernia, and obesity allows stomach contents to enter the lower esophagus causing inflammation and possibly erosion of the esophagus.
Response Feedback:
[None Given]
Grading Rubric
Performance Category
100% or highest level of performance
100%
16 points
Very good or high level of performance
88%
14 points
Acceptable level of performance
81%
13 points
Inadequate demonstration of expectations
68%
11 points
Deficient level of performance
56%
9 points
Failing level
of performance
55% or less
0 points
Total Points Possible= 50
16 Points
14 Points
13 Points
11 Points
9 Points
0 Points
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics.
Presentation of information was exceptional and included all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in one of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in two of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
16 Points
14 Points
13 Points
11 Points
9 Points
0 Points
Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations
Presentation of information was exceptional and included all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements
Applies principles, knowledge and information and scholarly resources to the required topic.
Applies facts, principles or concepts learned scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
10 Points
9 Points
6 Points
0 Points
Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count)
The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)
Responses are substantive and relate to the topic.
Demonstrated all of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 3 of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 2 of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
8 Points
7 Points
6 Points
5 Points
4 Points
0 Points
Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing.
The source of information is the APA Manual 6th Edition
Error is defined to be a unique APA error. Same type of error is only counted as one error.
The following was present:
0-3 errors in APA format
AND
Responses have 0-3 grammatical, spelling or punctuation errors
AND
Writing style is generally clear, focused on topic,and facilitates communication.
The following was present:
4-6 errors in APA format.
AND/OR
Responses have 4-5 grammatical, spelling or punctuation errors
AND/OR
Writing style is somewhat focused on topic.
The following was present:
7-9 errors in APA format.
AND/OR
Responses have 6-7 grammatical, spelling or punctuation errors
AND/OR
Writing style is slightly focused on topic making discussion difficult to understand.
The following was present:
10- 12 errors in APA format
AND/OR
Responses have 8-9 grammatical, spelling and punctuation errors
AND/OR
Writing style is not focused on topic, making discussion difficult to understand.
The following was present:
13 – 15 errors in APA format
AND/OR
Responses have 8-10 grammatical, spelling or punctuation errors
AND/OR
Writing style is not focused on topic, making discussion difficult to understand.
AND/OR
The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.
The following was present:
16 to greater errors in APA format.
AND/OR
Responses have more than 10 grammatical, spelling or punctuation errors.
AND/OR
Writing style does not facilitate communication
0 Points Deducted
5 Points Lost
Participation
Requirements
Demonstrated the following:
Initial, peer, and faculty postings were made on 3 separate days
Failed to demonstrate the following:
Initial, peer, and faculty postings were made on 3 separate days
0 Points Lost
5 Points Lost
Due Date Requirements
Demonstrated all of the following:
The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.
Demonstrates one or less of the following.
The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.
