NURS-6501 Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders Essay

NURS-6501 Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders Essay

Week 5 Concepts

Question 1: Explain what contributed to the development from this patient’s history of PUD

Peptic ulcer disease (PUD) is a common condition and, in most cases, presents with epigastric pain or burning and postprandial bloating or belching (Lanas & Chan, 2017). This patient presents with symptoms of PUD. From the patient’s history, various factors might have contributed to the development of the condition. The patient’s social history indicates that the patient might have developed the condition from social behaviors. The patient drinks one to two glasses of wine on a daily basis and currently has 35 pack-year of smoking. Both consumptions of alcohol and smoking are all risk factors for developing PUD (Lanas & Chan, 2017). The patient is also on ibuprofen, a nonsteroidal anti-inflammatory drug for pain, which has been shown to be a risk factor for developing the condition.

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Question two: What is the pathophysiology of PUD/ formation of peptic ulcers? 

PUD is characterized by the gastrointestinal tract inner lining discontinuation because of pepsin or the secretion of gastric acid. The mechanism of PUD comes due to an imbalance between the gastric mucosal destructive and protective factors. Various risk factors predispose the formation of the condition. Some of them include genetic factors, H. pylori infection, use of NSAIDs, smoking, regular alcohol drinking, and the presence of other conditions such as lung, kidney, or liver disease (Lanas & Chan, 2017). When the condition occurs, it implies that the mucosa has a defect that goes into the muscularis mucosa, and when the damage occurs to the superficial mucosal layer, then the inner layer becomes vulnerable to acid attack. In addition, the mucosal cells’ ability to produce bicarbonate is greatly reduced.

Question 3: If the Client asks what causes GERD, how would you explain this to a provider?

Patients sometimes need to know how some conditions arise or come. It is, therefore, the responsibility of the provider to explain as clear as possible in a language that the client can understand. Therefore as a provider, I would avoid technical, medical terms and vocabularies that are meant for professionals. I would tell the client that GERD results when the contents of the stomach leak backward into the food pipe. When a person eats, the food goes from the throat into the stomach while passing through the esophagus (Richter& Rubenstein, 2018). The food is prevented from going back by the lower esophageal sphincter. However, when the sphincter fails to close all the way, then the stomach contents may flow back into the esophagus, causing GERD.

Question 4: What are the variables here that contribute to an Upper GI bleeding

Upper gastrointestinal bleeding usually comes when upon the inflammation or injury of the upper digestive tract. The bleeds can occur in the duodenum, stomach, or esophagus (Wilkins et al., 2020). For this patient, various variables could have contributed to an upper GI bleeding. One of the variables is epigastric pain. Epigastric pain could be an indication of peptic ulcer disease, which is one of the causes of upper GI bleeding. The patient also indicates passing dark tarry stools. This could point to esophageal varices, which is one of the causes of upper GI bleeding.

Question 5: What can cause diverticulitis in the lower GI tract?

Diverticulitis is a condition that results when the pouches start protruding outward from the colon walls, get infected and become inflamed. One of the causes of diverticulitis in the lower GI tract is the giving way by the weak spots in the colon muscle outside layer, which allows the inner layer to squeeze through, hence protruding (Young-Fadok, 2018). The 54-year old patient has presented with symptoms that can be associated with diverticulitis.

References

Lanas, A., & Chan, F. K. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613-624. https://doi.org/10.1016/S0140-6736(16)32404-7.

Richter, J. E., & Rubenstein, J. H. (2018). Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology, 154(2), 267-276. https://doi.org/10.1053/j.gastro.2017.07.045.

Wilkins, T., Wheeler, B., & Carpenter, M. (2020). Upper gastrointestinal bleeding in adults: evaluation and management. American family physician, 101(5), 294-300. https://www.aafp.org/afp/2020/0301/p294.html.

Young-Fadok, T. M. (2018). Diverticulitis. New England Journal of Medicine, 379(17), 1635-1642. https://doi.org/10.1056/NEJMcp1800468

NURS-6501
Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders. Due on 1/2/22.
Knowledge Check: Gastrointestinal and Hepatobiliary Disorders
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