NURS 6541 Week 9 Journal – Gastrointestinal Disorders
NURS 6541 Week 9 Journal – Gastrointestinal Disorders
Gastrointestinal Disorders
During this practicum, I had the opportunity to see a 7-year-old male patient previously diagnosed with encopresis. Now, the child was in the office for a 6 month..
Paper details:
To prepare for NURS 6541 Week 9 Journal – Gastrointestinal Disorders:
•Review this week’s media presentations and Part 12 of the Buttaro et al. text in the Learning Resources.
•Select one of the three case studies listed above. Reflect on the provided patient information including history and physical exams.
•Think about a differential diagnosis. Consider the role the patient history and physical exam played in diagnosis.
•Reflect on potential treatment options based on your diagnosis.
In primary care settings, patients often present with abdominal pain. Although this is frequently a sign of a gastrointestinal (GI) disorder, abdominal pain could also be the result of other systemic disorders, making this type of pain difficult to assess. While abdominal pain is most common, many other GI symptoms also overlap multiple disorders, further increasing the difficulty in diagnosing and treating patients. This makes provider-patient communication essential. You must be able to formulate questions that will prompt the patient to provide the necessary information, as this will guide your assessment and diagnosis. For this Discussion, consider potential diagnoses for the patients in the following case studies
2.an explanation of the differential diagnosis for the patient in the case study that you selected.
3.Describe the role the patient history and physical exam played in the diagnosis.
4. Then, suggest potential treatment options based on your patient diagnosis.
NURS 6541 Week 9 Journal – Gastrointestinal Disorders Case Study 3:
A 52-year-old male presents to the office for a routine physical. The review of symptoms reveals anorexia, heartburn, and weight loss over the past 6 months. The heartburn is long standing, occurring most days during the week. He takes TUMS or Rolaids to relieve the discomfort. The patient describes occasional use of ibuprofen for back pain, but denies other medications including herbals. He has no known allergies. He was adopted so does not know his family history. Social history reveals that, although he stopped smoking ten years ago, he smoked for 20 years. He occasionally consumes alcohol on the weekends only. The only positive physical exam finding for this patient was slight epigastric tenderness. The remainder of his exam was negative and the rectal exam was negative for blood
Resources
Learning Resources for NURS 6541 Week 9 Journal – Gastrointestinal Disorders
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media players below
Required Resources for NURS 6541 Week 9 Journal – Gastrointestinal Disorders
Readings
• Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby. Part 12, “Evaluation and Management of Gastrointestinal Disorders” (pp. 612–722)
This part examines the pathophysiology and clinical presentation of several GI disorders. It also describes diagnostic criteria, differential diagnosis, and management methods for GI disorders.
Part 20, “Evaluation and Management of Infectious Disease” Chapter 234, “Infectious Diarrhea” (pp. 1263–1271)
This chapter describes characteristics of three types of infectious diarrhea and identifies the pathophysiology, clinical presentation, treatment options, and possible causes of the disorder.
www.waldenu.edu
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Building a Health History
Since the first meeting with any patient sets the tone for a successful patient provider collaboration and partnership I would ensure the clinical atmosphere was physically unencumbered and with a comfortable atmosphere. My client is a 76-year-old African-American male with disabilities living in an urban setting. I would first introduce myself with an extended hand and ask my patient how he would like to be addressed (Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W., 2015). As an active listener and in consideration of my patient’s age, gender, and ethnicity, I would formulate my questions in a respectful, nonjudgmental, and open-ended manner. I would begin with the patient’s explanation as to the reason for his visit or his chief complaint. I would then gather the patient’s current and past medical history, family history, psychological history, social history, review of systems, and then physical examination (Sullivan, D. D., 2012).
Explanation of Techniques Utilized
It is important that there are no physical obstacles between the patient and me, for the purpose of good eye contact and so he will know that I am actively listening to his concerns. A comfortable and uncluttered atmosphere will help the patient to relax and feel at ease (Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W., 2015). The formulation of my questions would give my patient the latitude and room for explanation. NURS 6541 Week 9 Journal – Gastrointestinal Disorders
Risk Assessment Instruments Their Justify the Applicability
The risk assessment tools that I would utilize are the TACE assessment tool and the geriatric functional assessment tool (functional impairment, gait instability, cognitive impairment, and major depressive illness). The TACE questionnaire will give me an indication of what additional labs I will need to order and additional patient education to be completed (Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W., 2015). Since my patient is in the geriatric age group, he is at increased risk for physical and cognitive impairment. Approximately 75% of persons over the age of 75 have decreased functional impairment and are at greater risk for falls, injury, illness, hospitalization, and nursing home placement. Although cognitive impairment for age 65 and older is roughly, only about 3%, cognitive testing it should not be ruled out because this often goes undiagnosed and must be ruled out and patients with suspected cognitive impairment should be screened for delirium and depression (University of Michigan Medical School, 2003)
Provide At Least Five Targeted Questions
1.Do you live with
2.How often do you forget to take your medication
3.How has this problem effected your everyday life
4.How often do you leave your home weekly
5.Are there stairs in your home
6.How many times have you fallen in the last 12 months
7.Do you have close family or friends
8.What other concerns do you have. NURS 6541 Week 9 Journal – Gastrointestinal Disorders
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to
physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.
University of Michigan Medical School. (2003). Geriatric functional assessment. Retrieved from
http://www.med.umich.edu/lrc/coursepages/m1/HGD/GeriatricFunctionalAssess.pdf
NURS 6541 Week 10 SOAP
CHIEF COMPLAINT: Sore throat
SUBJECTIVE
OBJECTIVE
ASSESSMENT: (Primary diagnosis)
DIFFERENTIAL DIAGNOSIS:
PLAN:
REFLECTION NOTES:
Practicum – Journal Entry
Reflect on your Practicum experience and the patients you have seen and the disorders that you have diagnosed and treated. Review your Journal Entry that you submitted in Week 1.
By Day 7 of Week 10, write a Journal Entry that includes responses to the following:
Explain what most excited and/or concerned you throughout your pediatric clinical experience.
Discuss how your personal definition of family and family roles has changed or stayed the same.
How has your understanding of family and family roles influenced your assessment of children and their families?
Explain how your understanding of culture (both the culture of the provider and that of the child and his or her family) has changed and how it may have influenced the assessments you conducted during your practicum.
Assess how you did with accomplishing the goals and objectives you developed in Week 1 for the Practicum experience.
Based on your Practicum experience, refine your existing goals and/or develop new goals for your continued education and professional practice. Be sure to consider the NAPNAP Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice Found in the Week 1 Learning Resources.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the following naming convention: “WK10Assgn+lastname+first initial”.
Click the Week 1 Assignment link.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.
Click on the Submit button to complete your submission.
