NURS 6512 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
NURS 6512 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
The case study depicts a 46-year-old female patient with a chief complaint of RUQ pain for the last 24 hours. The RUQ pain began an hour after dinner, and she had nausea and vomiting x1 before the pain started. The abdomen is non-distended but has mild tenderness. Lab results revealed a high WBC count and Direct bilirubin. The purpose of this paper is to discuss the patient’s diagnosis and treatment plan.
Diagnosis
Hepatitis A is the identified diagnosis for this case. It is caused by the hepatitis A virus (HAV) transmitted via the fecal-oral route through person-to-person contact and ingesting contaminated food or water. The classical presentation in adults includes anorexia, RUQ pain, jaundice, and hyperbilirubinemia (Abutaleb & Kottilil, 2020). Hepatitis A is the presumptive diagnosis based on pertinent positive symptoms of nausea, vomiting, RUQ pain, abdominal tenderness, and high direct bilirubin levels. Besides, an elevated WBC count indicates an underlying infection.
Drug Therapy Plan
Treatment of Hepatitis A is usually supportive. I would recommend Acetaminophen 500 mg per oral twice daily to relieve pain. Pain relief is important to promote quality patient care in the acute phase of Hepatitis A (Ntouva et al., 2019). In addition, I would recommend Metoclopramide 10 mg PRN. Metoclopramide is an antiemetic and will be important to alleviate nausea and vomiting. In addition, inactivated Hepatitis A vaccine will be administered for active immunization against diseases associated with HAV (Ntouva et al., 2019).
Conclusion
The patient presented with symptoms consistent with Hepatitis A, such as nausea, RUQ pain, mild abdominal tenderness, hyperbilirubinemia, and an elevated WBC count. Hepatitis A could be due to transmission of HAV from contaminated food or water. The treatment plan will include supportive measures such as pain control and alleviating nausea and vomiting using an analgesic and antiemetic.
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References
Abutaleb, A., & Kottilil, S. (2020). Hepatitis A: Epidemiology, Natural History, Unusual Clinical Manifestations, and Prevention. Gastroenterology clinics of North America, 49(2), 191–199. https://doi.org/10.1016/j.gtc.2020.01.002
Ntouva, A., Sibal, B., Balogun, K., Mandal, S., & Harding, N. (2019). Hepatitis A in primary care: working in partnership for diagnosis, management, and prevention of outbreaks. The British journal of general practice : the journal of the Royal College of General Practitioners, 69(687), 521–522. https://doi.org/10.3399/bjgp19X705965
