N512 Assignment 3 Disorders of the Digestive System Across the Life Span

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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). N512 Assignment 3 Disorders of the Digestive System Across the Life Span

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

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 – N512 Assignment 3 Disorders of the Digestive System Across the Life Span

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 Assignment 3 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. N512 Assignment 3 Disorders of the Digestive System Across the Life Span	Adequate references	Minimal use of appropriate references	Poor use and/or selection of references not relevant	/5
Total					/100

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. 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.

Example Discussion Solution

The symptoms indicated that Luv Taub is suffering from Gastroesophageal reflux disease (GERD). Gastroesophageal reflux disease is a medical condition that causes frequent acidic flux. The reflux occurs when the acid from the stomach moves up into the esophagus, causing a burning sensation in the stomach and chest. Symptoms of GERD include a sour taste in the back of mouth, regurgitation, difficulty swelling, and bloating (Kabadi etal., 2017). Most common causes of GERD include connective tissue disorder, obesity and pregnancy. The GERD may cause chronic inflammation in esophagus which can lead to several complications.

In gastroesophageal reflux disease, the stomach acid flows back to the esophagus and this backwash can irritate the lining of esophagus and cause burning effect in upper stomach and chest. The weakness of lower esophageal sphincter allows the stomach acid to flow back to the esophagus and it frequently occur at night in lying position. Taste and smell abnormalities are common in GERD patients. The backwash of acid also causes bad breath which results in sour taste in mouth (Kabadi etal., 2017). In Ms. Luv Taub’s case, these symptoms are common which supports this likely diagnosis that the patient is suffering from GERD. N512 Assignment 3 Disorders of the Digestive System Across the Life Span

The Pathophysiologic Mechanism of Gastroesophageal reflux disease is due to the abnormal amount of gastric acid to enter the esophagus; the acid burn causes mucosal damage. When the mucosal damage occurs in the esophagus, a vicious cycle continues to maintain and accentuate the GERD. More acidic flux and decreased clearance of acid can prolong contact of the acid with the esophageal mucosa (Tack, & Pandolfino, 2018). Gastroesophageal reflux disease can be treated via medication at an earlier stage, proton pump inhibitors are one of the common pharmaceutical treatments for GERD (Patil, Dalal, & Maydeo, 2020). Several other pharmaceuticals that can be used in GERD include H2 blocker, Prokinetics, Erythromycin, and Antacids.

The plan of care after discharge is based on the living arrangement and social supports. The patient should eat moderate amount of food and avoid overeating. Patients should avoid eating 2 to 3 hours before sleep. The patient should sleep at a slight angle with the head slightly elevated. The patient should avoid certain food that may become a reason for GERD which include spicy food, chocolate, coffee, and oily diet (Newberry, & Lynch, 2019).

The anticipated prognosis for the patient indicates that the patient may suffer from Esophagitis, Esophageal stricture, and Barrett’s esophagus. The esophagitis is the inflammation of the esophagus that commonly occurs in GERD. Another prognosis is the esophageal stricture, a condition in which the esophagus becomes narrow and the patient may face difficulty in swallowing. Barrett’s esophagus is the condition in which the cell lining of the esophagus can change similar to the intestinal cell.

The patient should alter her lifestyle for the better outcome. The risk factor of GERD is associated with obesity, eating large meal, spicy food, beverage like coffee, and medication. Lifestyle change such as eating healthy food and avoid spicy foods may reduce the risk of Gastroesophageal reflux disease. Avoid eating before sleeping may also play a positive role to reduce acidity in the stomach. The sleep pattern of the patient should be altered to avoid the abnormal amount of gastric acid to enter the esophagus (Tack, & Pandolfino, 2018). The patient should sleep at a slight angle with the head slightly elevated.

References

Kabadi, A., Saadi, M., Schey, R., & Parkman, H. (2017). Taste and Smell Disturbances in Patients with Gastroparesis and Gastroesophageal Reflux Disease. Journal Of Neurogastroenterology And Motility, 23(3), 370-377. doi: 10.5056/jnm16132

Newberry, C., & Lynch, K. (2019). The role of diet in the development and management of gastroesophageal reflux disease: Why we feel the burn. Journal of Thoracic Disease, 11(Suppl 12), S1594.

Patil, G., Dalal, A., & Maydeo, A. (2020). Feasibility and outcomes of anti‐reflux mucosectomy for proton pump inhibitor dependent gastroesophageal reflux disease: First Indian study (with video). Digestive Endoscopy, 32(5), 745-752.

Tack, J., & Pandolfino, J. E. (2018). Pathophysiology of gastroesophageal reflux disease. Gastroenterology, 154(2), 277-288. N512 Assignment 3 Disorders of the Digestive System Across the Life Span

N512 Assignment 3 Disorders of the Digestive System Across the Life Span