Posted: January 18th, 2023

Module 3: Gastrointestinal and Hepatobiliary Systems

NURS 6521: Advanced Pharmacology
Gastrointestinal and Hepatobiliary Systems
The gastrointestinal (GI) system is responsible for the digestion and absorption of nutrients from food, and the elimination of waste products. It includes the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus. The hepatobiliary system, which is closely related to the GI system, includes the liver, gallbladder, and biliary tree. Together, these systems play a crucial role in maintaining overall health and wellness.
The liver is responsible for a variety of metabolic functions, including the synthesis and metabolism of glucose, lipids, and proteins. It also detoxifies harmful substances, such as drugs and alcohol, and produces bile, which is necessary for the digestion of fats. The gallbladder stores and concentrates bile, releasing it into the small intestine as needed for digestion. The biliary tree, which includes the bile ducts and ducts connecting the liver, gallbladder, and small intestine, plays a key role in the transport and excretion of bile.
Problems or disorders in the gastrointestinal and hepatobiliary systems can lead to a variety of symptoms, including abdominal pain, nausea, vomiting, diarrhea, constipation, jaundice, and other issues. Examples of common GI and hepatobiliary conditions include:
Gastroesophageal reflux disease (GERD)
Peptic ulcer disease
Inflammatory bowel disease (IBD)
Irritable bowel syndrome (IBS)
Gastrointestinal bleeding
liver diseases such as hepatitis, cirrhosis, fatty liver disease
gallstones
Cancer of the liver, bile ducts, or pancreas
Treatment for these conditions typically involves a combination of medications, diet and lifestyle changes, and in some cases, surgery. Medications used to treat gastrointestinal and hepatobiliary disorders include antacids, proton pump inhibitors, antispasmodics, antibiotics, antidiarrheals, and other classes of drugs depending on the condition.
It’s important to consult a healthcare provider if you experience any symptoms that may be related to the gastrointestinal or hepatobiliary system, so they can make a proper diagnosis and develop an appropriate treatment plan.
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Module 3: Gastrointestinal and Hepatobiliary Systems
Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap, making diagnosis and treatment challenging. For example, symptoms such as vomiting, constipation, and bloating are non-specific and could also be the result of underlying medical history or current prescription drug use. As an advanced practice nurse, you could be potentially responsible for providing care to a patient who may present with non-specific symptoms related to the gastrointestinal and hepatobiliary systems.

How would you proceed to care for this patient? What type of drug therapy might you recommend, not knowing current medical history or prescription drug use? Are there certain drugs you should avoid in ensuring a drug-drug interaction does not occur? These are the types of questions that may guide you in your role as an advanced practice nurse.

What’s Happening This Module?
Module 3: Gastrointestinal and Hepatobiliary Systemsis a 1-week module, Week 4 of the course. In this module, you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You also develop a drug therapy plan based on patient history and diagnosis.

What do I have to do? When do I have to do it?
Review your Learning Resources. NURS 6521: Advanced Pharmacology Days 1-7, Week 4
Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Submit your Assignment by Day 7 of Week 4.
Go to the Week’s Content
Week 4

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.

Learning Objectives
Students will:

Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
Justify drug therapy plans based on patient history and diagnosis
Learning Resources
Required Readings (click to expand/reduce)
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. NURS 6521: Advanced Pharmacology
By Day 7 of Week 4
Ace my homework – 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 School 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.
-STUSY NOTES-
General information on how an advanced practice nurse would approach the patient with gastrointestinal and hepatobiliary symptoms, and design an appropriate drug therapy plan.
The diagnosis for the patient would begin with a thorough assessment of the patient’s symptoms, medical history, and any drugs currently prescribed. Based on this information, the advanced practice nurse would work to rule out any possible causes of the patient’s symptoms that are not related to the gastrointestinal or hepatobiliary system, such as pregnancy or psychological disorders. The advanced practice nurse would also consider any risk factors for gastrointestinal or hepatobiliary disorders, such as a history of alcohol use, medications that may cause liver or gastrointestinal problems, or a family history of gastrointestinal cancer.
Once the underlying cause of the patient’s symptoms is identified, the advanced practice nurse would then be able to design an appropriate drug therapy plan. For example, if the patient is found to have a gastrointestinal disorder such as inflammatory bowel disease, the advanced practice nurse may recommend medications such as sulfasalazine or mesalamine to reduce inflammation in the gut, as well as medications to control diarrhea and pain.
If the patient is found to have a hepatobiliary disorder such as hepatitis, the advanced practice nurse may recommend antiviral medications such as entecavir or tenofovir to reduce inflammation in the liver, as well as medications to control symptoms such as jaundice and fatigue.
The advanced practice nurse would also consider the patient’s overall health and any other medications the patient is currently taking to ensure that the drug therapy plan is safe and effective. Additionally, the nurse would discuss any potential side effects of the drugs prescribed, and monitor the patient for response, adherence, and adverse effects related to the prescribed medications.
In addition to drug therapy, the nurse would also stress the importance of lifestyle modification such as healthy diet, exercise, and avoiding drugs and alcohol as appropriate. Monitoring of vital signs, regular lab tests and frequent follow up would be a important aspect of care.
An advanced practice nurse would approach a patient with gastrointestinal and hepatobiliary symptoms by thoroughly assessing the patient’s symptoms, medical history, and drugs currently prescribed, and work to rule out any possible causes of the patient’s symptoms that are not related to the gastrointestinal or hepatobiliary system. Once the underlying cause of the patient’s symptoms is identified, the advanced practice nurse would then be able to design an appropriate drug therapy plan and make recommendations for lifestyle changes that may also help improve the patient’s symptoms and overall health.
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