Asthma and Stepwise Management NURS6521
Asthma and Stepwise Management NURS6521
Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.
One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare for Asthma and Stepwise Management NURS6521:
- Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
- Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
- Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
- Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
- Explain the stepwise approach to asthma treatment and management for your patient.
- Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.
NURS 6521 Week 4: Gastrointestinal and Hepatobiliary Disorders
As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.
How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?
This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.
Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Photo Credit: Getty Images/iStockphoto
Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
To Prepare
- Review the case study assigned by your Instructor for this Assignment
- Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
- Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
- Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
By Day 7 of Week 4
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.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
Week 4 case study, please read instructor help. Deadline June 27th
Hello students,
Here is your week 4 case study information: Please read some tips I have made below for getting a good score!
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea.
The patient has a history of drug abuse and possible Hepatitis C.
HL is currently taking the following prescription drugs:
Synthroid 100 mcg daily
Nifedipine 30 mg daily
Prednisone 10 mg daily
Instructor/Facilitator help:
- One short paragraph on three differential diagnoses. Do not just say “symptoms are vague, no diagnoses possible, I will just do further assessment.”
Subjective & Objective information are intentionally provided vague (as a clinical case) so that you can develop a couple of pharmacological cases & discuss.
- One short paragraph on how you will pharmacologically treat the three diagnoses you listed (Pharmacological Plan).
- One short-short paragraph on Synthroid, Nifedipine, a peripheral calcium channel blocker & prednisone an anti-inflammatory immunosuppressor (pharmacological information) and why patient was on these drugs, discussion based on your objective & assessment.
Briefly state the mechanism of action and therapeutic applications of these agents.
- Long discussions/stories of no relevance to advanced practice pharmacology will carry no value with this project.
- Include NEWER AGENTS of cure for hepatitis C infection. Discuss how these NEWER hepatitis C drugs of CURE work.
- Include peer reviewed, scholarly articles of past 4 years as reference.
- A conclusion with clinician level pharmacology in focus.
Best, Dr. P
Since June 20th was a holiday you have until June 27th 11:59 PM to complete this.
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.
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Example Approach
Case Study: Gastroenteritis
Introduction
HL is a patient who presents with nausea, vomiting, and diarrhea with a history of drug abuse and possible Hepatitis C. This paper aims to highlight the differential diagnosis based on the patient’s presenting complaint, describe the recommended drug therapy and justify its use in this patient.
Differential Diagnoses
The primary diagnosis is gastroenteritis. Differential diagnoses include food poisoning and bowel obstruction. Gastroenteritis is a viral, bacterial, or parasitic infection of the intestines that presents with the above presentation in addition to abdominal pain and is highly contagious (Maslennikov et al., 2021).
The main causative agents are viruses, including noroviruses and rotavirus, transmitted through ingestion or coming into contact with contaminated food and water. The use of prednisone which suppresses the immune system means an increased predisposition to infections. This, in addition to the patient’s presenting complaint, means that gastroenteritis is the primary diagnosis.
Drug Therapy Plan
Gastroenteritis is often self-limiting, and the patient is encouraged to stay hydrated and rest. In this patient, I would recommend antiemetic drugs such as ondansetron (Riddle 2018). In addition, I would recommend loperamide or bismuth subsalicylate. After finding out the reason for the use of prednisone, I would slowly taper off the drug and eventually discontinue it. The patient can continue using both Synthroid and nifedipine.
Justification For Drug Therapy
Antiemetics are critical in minimizing vomiting and consequent fluid loss. Ondansetron is my preferred drug of choice due to its limited sedative properties compared to other antiemetics such as promethazine (Rosenthal & Burchum, 2021). Antidiarrheals such as loperamide and bismuth subsalicylate help address diarrhea, which greatly contributes to fluid loss. Tapering off the prednisone and eventually discontinuing it is crucial in this patient.
Corticosteroids such as prednisone, when used over long durations of time, significantly impact the liver. These drugs often increase the risk of developing or worsening nonalcoholic fatty liver disease. This is particularly risky in this patient with possible hepatitis C. Nifedipine and Synthroid have minimal to no impact on the liver and can be continued.
Conclusion
The patient’s presenting complaints paint a picture of gastroenteritis. Despite the condition being mostly self-limiting, prescribing antiemetics and antidiarrheals is important to minimize fluid loss. Discontinuing drugs such as prednisone which have a great impact on the liver in such a patient is important to minimize the risk of nonalcoholic fatty liver disease.
References
Maslennikov, R., Poluektova, E., Ivashkin, V., & Svistunov, A. (2021). Diarrhea in adults with coronavirus disease-beyond incidence and mortality: a systematic review and meta-analysis. Infectious Diseases (London, England), 53(5), 348–360. https://doi.org/10.1080/23744235.2021.1885733
Riddle M. S. (2018). Current management of acute diarrheal infections in adults. Polish Archives Of Internal Medicine, 128(11), 685–692. https://doi.org/10.20452/pamw.4363
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.