Gastrointestinal and Hepatobiliary System
Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap making diagnosis and treatment challenging. Consider the case of a 21-year-old female who is rushed to the hospital by her roommate. The patient is not conscious enough to describe her symptoms or medical history to the health care provider. However, the roommate is able to share that the patient has experienced abdominal pain for the past three days, as well as vomiting, constipation, and bloating. After unsuccessful attempts at contacting the patient’s family, the roommate decided to bring her in for care. At this point, medical history and currently prescribed drugs are unknown. However, this patient requires treatment for symptoms that could be the result of various underlying disorders. As an advanced practice nurse, you could potentially be responsible for this patient’s care. How would you proceed to care for this patient? What type of drug therapy would you recommend not knowing if she is currently taking other prescribed drugs? Are there certain drugs you should avoid in order to prevent a drug-drug interaction?
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 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.
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
• Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. With these thoughts in mind: