N512-19A Module Six: Disorders of the Digestive System Across the Life Span

Discussion 6

Luv Taub, a 32-year-old, married Hmong woman, presents to her primary care Nurse Practitioner complaining of a persistent burning sensation in her chest and upper abdomen. N512-19A Module Six: Disorders of the Digestive System Across the Life Span. The symptoms are worse at night while she is lying down and after meals. She enjoys many years of cooking and eating “hot and spicy foods” common in her culture. She has tried drinking hot cocoa to help her sleep. She is a smoker and frequently relies on benzodiazepines for insomnia. She notes a sour taste in her mouth every morning. Physical examination is normal.

In this discussion:

Discuss this patient’s likely diagnosis. Why do you support this “likely” diagnosis?
Describe the pathophysiology of this disorder.
Discuss a plan of care for this patient.
What is the anticipated prognosis for this patient? What lifestyle factors might alter her short- and long-term outcomes?

Include citations from the text or the external literature in your discussions. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

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Example Approach For Discussion 6

Mrs. Taub has presented complaints that could be considered having acid reflux. Acid reflux is also known as heart burn. The common signs and symptoms are persistent burning sensation in chest and epigastric area, worse at night while lying down, after meals. Hot and spicy foods, milk, and fried foods can cause increase risk of acid reflux.

This is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining. When having episodes of acid reflux or heartburn more than twice a week may indicate gastroesophageal reflux disease (GERD). GERD refers to backflow of gastric or duodenal contents or both into the esophagus and past the lower esophageal sphincter (LES), without associated belching or vomiting (Rebar, Heimgartner, & Gersch, 2019). Symptoms include burning pain in the chest that usually occurs after eating and worsens when lying down (Hammer & McPhee, 2019).

When educating Mrs. Taub on her care plan for acid reflux, I would start with a bland diet until she has this episode under control. I would also suggest anti-acid medication for her to take once a day in the morning prior to first meal. No eating at least two hours before bedtime.

Acid reflux can be treatable with medication and diet control. Relief from lifestyle changes and over-the-counter medications is usually temporary. Prescription medication may be needed or even possibly surgery in more severe cases. The prognosis is good to moderate in most cases. GERD is a chronic disease with relapsing episodes. The less of episodes the better the outcome.

References

Rebar, C., Heimgartner, N., & Gersch, C. (2019). Pathophysiology Made Incredibly Easy (6th ed.). Wolters Kluwer.

Hammer, G., & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed). McGraw-Hill

290 words

Hi Helen,

Good post. nice and to the point. I would agree that probably educating the patient would be beneficial as in the case with a new onset of any disease. thank you..

33 words

Dear Helen,
Nice post. I believe that L.T. is probably experiencing gastroesophageal reflux disease. We do not know how many episodes she is currently experiencing, however, so I would think that would be one of the questions I would ask during her initial physical exam. According to Cherney (2019), if you experience at least two episodes per week, you are most likely experiencing GERD. I also found that there are a few herbal remedies that other patients have tried and have expressed that they seem to have worked for them (Cherney, 2019). The herbals include, slippery elm, marshmallow, licorice, and chamomile (Cherney, 2019). Lifestyle modifications and herbal remedies are often worth a shot prior to being placed on long-term medications.Reference

Cherney, K. (2019). 8 home remedies for acid reflux/GERD. Retrieved from https://www.healthline.com/health/gerd/home-remedies

141 words

Assignment 3

The purpose of this paper is to address the following clinical scenario with the use of your textbook, external credible literature, and/or reliable electronic sources. Use the guide below to draft your paper and review the rubric to ensure you have met the assignment criteria. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).

James Alvarez is a 52 y.o., recently divorced, Latino male; new patient who arrives at the community health clinic for an appointment with a primary care Nurse Practitioner. His chief complaint of abdominal pain and vomiting, fatigue, and weight loss. He notes that although he has experienced overall weight loss, his stomach “looks huge.” As his history is taken, he notes no alcohol use. In speaking with him, the Nurse Practitioner notices a yellow tinge to the whites of his eyes. During examination, the Nurse Practitioner notes organomegaly in the right upper quadrant.

Please use the following headings/subheadings as a guide to draft your paper:

Introduction (including purpose statement)
What would be your priority diagnosis for Mr. Alvarez?
Identify the organ and describe the pathophysiological processes, which may have caused the organomegaly.
Develop a comprehensive and holistic plan of care for this patient based on James’ diagnosis.
Conclusion. N512-19A Module Six: Disorders of the Digestive System Across the Life Span

1. Within your description, place in bold font the key pathophysiological concepts (terms).

1. Include recommendations for follow-up with the Nurse Practitioner.
2. Incorporate a population-based component to Mr. Alvarez’ plan of care.

In regards to APA format, please use the following as a guide:

Include a cover page and running head (this is not part of the 4-5 page limit)
Include transitions in your paper (i.e. headings or subheadings)
Use in-text references throughout the paper
Use double space, 12 point Times New Roman font
Spelling, grammar, and organization are appropriate
Include a reference list (this is not part of the 4-5 page limit)
Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. ANA)

Assignment 3 Rubric

Assignment 3 Rubric

Competency

20 Points

12 Points

6 Points

0 Points

Points Earned

Nursing Application and Analysis of Content with Connection to Expert Nurse Level Knowledge Base

Establishes very high level of nursing knowledge application and analysis to assignment that equates to the expert practice nurse knowledge base.

Briefly describes application to nursing knowledge or that knowledge is not of an expert nurse but more than a novice nurse base knowledge.

Level of nursing knowledge is of a novice nurse with little application or support to expert nurse practice.

Does not include established nursing knowledge base and/or does not apply this to current clinical practice.

/20

Teaching Considerations

Evidence of intentional inclusion of patient and family teaching considerations which is sensitive to diversity, demographics and education level as necessary for the assignment. These are well supported in the literature and demonstrate clear positive impact on compliance with excellent patient outcomes.

Moderate attempt to demonstrate patient and family inclusion in teaching approaches. Some consideration given to sensitive factors which would positively impact patient receptivity and implementation for impact on patient outcomes.

Little demonstration of awareness and inclusion of patient and family sensitive teaching considerations. Impact on outcomes is not clearly addressed but can be inferred.

No attempt to demonstrate sensitive approach to patient and family teaching considerations. Impact on outcomes is not addressed. N512-19A Module Six: Disorders of the Digestive System Across the Life Span

/20

Critical thinking

Pathophysiology content and integration with current best practice standards (supported by the scholarly literature) are used to construct critical examination and application of concepts and content.

Connection between pathophysiology knowledge and current best practices is stated but now well supported with scholarly sources and/or weakly used to construct examination and application of concepts and constructs.

Integration of pathophysiology and current best practice standards are anecdotal and not supported by the literature or are outdated based on current best practice standards. Little attempt to apply knowledge in examination and application to concepts and constructs.

No attempt to integrate pathophysiology and current best practice standards in examination and application to constructs and concepts with no support from relevant, scholarly literature.

/20

Scholarly, evidence based, current standards of practice, Sources: 3-5+

Current, relevant and authoritative scholarly sources are used to support content. Demonstrates current, evidence-based standards of practice. Minimum of 3-5+ sources.

Moderate inclusion of current, relevant and authoritative scholarly sources are used to support content. Demonstrates occasional current, evidence-based standards of practice.

Little attempt to include current, relevant and authoritative scholarly sources are used to support content. Or, information is purely anecdotal or not current, evidence-based practice knowledge.

No attempt to use current, relevant and authoritative scholarly sources to support content. Does not demonstrate current, evidence-based standards of practice.

/20

Competency

5 Points

3 Points

1 Point

0 Point

Points Earned

Organization

Organization excellent, ideas clear and arranged logically, transitions smooth, no flaws in logic.

Organization good; ideas usually clear and arranged in acceptable sequence; transitions usually smooth, good support

Organization minimally effective; problems in approach, sequence, support and transitions

Organization does not meet requirements

Grammar

Grammar, punctuation, mechanics, and usage correct and idiomatic, consistent with Standard American English

Grammar, punctuation, mechanics, and usage good mostly consistent with Standard American English; errors do not interfere with meaning or understanding

Grammar, punctuation, mechanics and usage distracting and often interfere with meaning or understanding

Grammar, punctuation, mechanics, and usage interfere with understanding

APA Format

Demonstrates competent use of mechanics and APA

Minimal APA errors

Many APA errors

Complete lack of understanding

References

References are relevant, scholarly, authoritative and contemporary

Adequate references

Minimal use of appropriate references

Poor use and/or selection of references not relevant

Total

/100

Competency	20 Points	12 Points	6 Points	0 Points	Points Earned
Nursing Application and Analysis of Content with Connection to Expert Nurse Level Knowledge Base	Establishes very high level of nursing knowledge application and analysis to assignment that equates to the expert practice nurse knowledge base. N512-19A Module Six: Disorders of the Digestive System Across the Life Span	Briefly describes application to nursing knowledge or that knowledge is not of an expert nurse but more than a novice nurse base knowledge.	Level of nursing knowledge is of a novice nurse with little application or support to expert nurse practice.	Does not include established nursing knowledge base and/or does not apply this to current clinical practice.	/20
Teaching Considerations	Evidence of intentional inclusion of patient and family teaching considerations which is sensitive to diversity, demographics and education level as necessary for the assignment. These are well supported in the literature and demonstrate clear positive impact on compliance with excellent patient outcomes.	Moderate attempt to demonstrate patient and family inclusion in teaching approaches. Some consideration given to sensitive factors which would positively impact patient receptivity and implementation for impact on patient outcomes.	Little demonstration of awareness and inclusion of patient and family sensitive teaching considerations. Impact on outcomes is not clearly addressed but can be inferred.	No attempt to demonstrate sensitive approach to patient and family teaching considerations. Impact on outcomes is not addressed.	/20
Critical thinking	Pathophysiology content and integration with current best practice standards (supported by the scholarly literature) are used to construct critical examination and application of concepts and content.	Connection between pathophysiology knowledge and current best practices is stated but now well supported with scholarly sources and/or weakly used to construct examination and application of concepts and constructs.	Integration of pathophysiology and current best practice standards are anecdotal and not supported by the literature or are outdated based on current best practice standards. Little attempt to apply knowledge in examination and application to concepts and constructs.	No attempt to integrate pathophysiology and current best practice standards in examination and application to constructs and concepts with no support from relevant, scholarly literature.	/20
Scholarly, evidence based, current standards of practice, Sources: 3-5+	Current, relevant and authoritative scholarly sources are used to support content. Demonstrates current, evidence-based standards of practice. Minimum of 3-5+ sources.	Moderate inclusion of current, relevant and authoritative scholarly sources are used to support content. Demonstrates occasional current, evidence-based standards of practice.	Little attempt to include current, relevant and authoritative scholarly sources are used to support content. Or, information is purely anecdotal or not current, evidence-based practice knowledge.	No attempt to use current, relevant and authoritative scholarly sources to support content. Does not demonstrate current, evidence-based standards of practice.	/20
Competency	5 Points	3 Points	1 Point	0 Point	Points Earned
Organization	Organization excellent, ideas clear and arranged logically, transitions smooth, no flaws in logic.	Organization good; ideas usually clear and arranged in acceptable sequence; transitions usually smooth, good support	Organization minimally effective; problems in approach, sequence, support and transitions	Organization does not meet requirements	/5
Grammar	Grammar, punctuation, mechanics, and usage correct and idiomatic, consistent with Standard American English	Grammar, punctuation, mechanics, and usage good mostly consistent with Standard American English; errors do not interfere with meaning or understanding	Grammar, punctuation, mechanics and usage distracting and often interfere with meaning or understanding	Grammar, punctuation, mechanics, and usage interfere with understanding	/5
APA Format	Demonstrates competent use of mechanics and APA	Minimal APA errors	Many APA errors	Complete lack of understanding	/5
References	References are relevant, scholarly, authoritative and contemporary	Adequate references	Minimal use of appropriate references	Poor use and/or selection of references not relevant N512-19A Module Six: Disorders of the Digestive System Across the Life Span	/5
Total					/100

N512-19A Module Six: Disorders of the Digestive System Across the Life Span