As an advanced practice nurse (APN), it is common to see people with gastrointestinal (GI) disorders. For the purpose of this discussion, I will evaluate the case study #2 and give a differential diagnosis with an explanation. I will discuss how the physical examination and patient history plays a role in the diagnosis and provide examples of treatments based on the diagnosis.
Mr BW was a 74-year-old man who had a fall due to a new onset of seizures, which resulted, to a direct impact of his head on the ground while at home. While at the hospital, MR BW underwent a CT and MRI brain scan and showed a haematoma, which resulted to commencing of the patient on Keppra and Bezodiapenes. Moreover, Mr BW also developed a sudden onset of pleuretic chest pain, which was confirmed by CTPA as a small pleural effusion on the left lungs; while there was also pulmonary embolism on both upper and lower lobes of the left lung. Due to the development of a provoked pulmonary embolism, patient commenced on Clexane injection. In September 2015, an elective open abdominoperineal resection was performed on Mr BW, which resulted to prolonged stay in the hospital due to delayed wound healing.
The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or
Irritable Bowel Syndrome (IBS) is a long-term or recurrent medical disorder of gastrointestinal functioning. IBS usually affects both the small intestine and large intestine, as well as the motor function and sensation of the bowel. Disturbances in these areas of the body cause symptoms such as intermittent abdominal discomfort or pain, a change in bowel habits, bloating, and a sense of gaseousness.
The American Journal of Health-System Pharmacy finds that approximately 5-15% of the world population are affected by irritable bowel syndrome (IBS). What is irritable bowel syndrome? It is interpreted as a disorder of the gastrointestinal system that spawns changes in bowel function (chronic diarrhea, constipation, or abdominal pain) (Roberts, 2013). Severity depends upon the cause; food intolerances worsen the clinical presentations (Roberts, 2013). Those who are affected by IBS present with manifestations such as anorexia, abdominal bloating, and nausea with meals or passing stool. The disease is speculated to be a psychosomatic disorder that is aroused by stress, but is identified as an
The next topic discusses the significant challenges facing the Crohn’s and Colitis Foundation of America today and in the near future. One of the major challenges of the organization is finding ways to help with the insurance and financial burdens for the IBD patients. In 2004, there were 1.1 million hospital and healthcare visits for Crohn’s disease and 716,000 for Ulcerative Colitis, as well as 4 million prescriptions written for both these diseases (Crohn’s and Colitis, 2012). Unfortunately, the annual financial burden of IBD in the United States is more than 31 billion dollars, which demonstrates how expensive the physician visits, hospital stays, and medications are for IBD patients. For example, studies have estimated the annual direct
Irritable bowel syndrome is a very common condition that effects a lot of people throughout the world. While it isn’t a particularly dangerous condition, it is generally very long term, requiring treatment for many years, sometimes even for the duration of the patients life. It isn’t widely known what causes irritable bowel syndrome, but there are several factors that seem to make the symptoms worse for those that suffer from this condition; diet, stress and exercise. While there are medication that help manage the symptoms of irritable bowel syndrome, most people with this condition find that managing their diet, keeping stress under control and getting a reasonable amount of exercise is a good way to keep their large intestine happier than
Medication: Different types of medications are effective treatments for IBS. Taking antidepressants can help treat depression but can also treat abdominal pain. Antispasmodic medicines can be used to reduce abdominal pain. Laxatives are helpful treatments for constipation.
Between 5 to 10% of the population has Irritable bowel syndrome, a common disease that occurs when your large intestine contracts slower or faster than normal (Erlich, 2014). Present at any age range, irritable bowel syndrome is very common; but, between the ages of 20 to 39, it can affect up to twice as many women as men. This pressing disease is often associated with stress or dietary restrictions and causes symptoms such as cramping, abdominal pain, gas, bloating, diarrhea, and constipation. Such indicators are presumably uncomfortable as IBS is a long-term chronic condition
(Waterloo, Ontario) The holiday season has arrived and with it comes the risk of food contamination and illness. Sadly, some individuals struggle with blood in stool and other symptoms associated with diarrhea all year long, rather than just after eating bad food. In fact, experts estimate 900,000 individuals are hospitalized for this common condition every year, with 5,000 deaths being attributed to diarrhea. Although this is a topic many don't like to discuss, the importance of doing so has never been greater, as seen by these statistics.
Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) tract disorder that tends to go into remission and relapse. Pain and/or discomfort in different parts of the abdomen is associated with changes in bowel patterns (1). While the specific cause of IBS is still unknown, some believe that gut-brain axis disorders are
Irritable bowel syndrome (IBS) was once known as having a spastic colon. A gastrointestinal disorder which often changes from constipation for a while then diarrhea for a time. This is not always the case though. Some people who have IBS can suffer only from constipation which is chronic in nature. Other people with this syndrome have chronic diarrhea. When you suffer from this it matters not what your symptoms to it are, what matters is the cause. With different symptoms different treatments are used to provide some relief. Let us consider the symptoms of constipation due to Irritable Bowel Syndrome.
Irritable bowel syndrome (IBS) is a functional GI disorder (FGID) characterized by abdominal pain in association with altered bowel habits in the absence of any identifiable structural or biochemical abnormalities. It is a very common disorder that can have a profound negative impact on a patient’s quality of life and constitutes a considerable social and economic burden on society. Extensive research over the last few decades has led to a better understanding of this complex syndrome and improvements in treatment. After a brief review of the clinical manifestations and diagnosis of IBS, the current understanding of the complex physiological mechanisms contributing to the syndrome will be addressed. The remainder of this paper will focus
Patients with other abdominal anomalies may have an increased risk for intestinal atresia. For example, children with gastroschisis may also have intestinal atresia, and they should be examined for it (Bauman & Nanagas, 2015). The authors described a case of a neonatal child who was immediately diagnosed and treated for gastroschisis. However, the patient never had a bowel movement after surgical correction. By the fourth week without a bowel movement, an exploratory laparotomy was performed, and the child was diagnosed with intestinal atresia. Unfortunately, about 8 centimeters of small bowel was resected due to ill-appearance, but bowel to bowel anastomosis was performed. Interestingly, the patient still did not have a bowel movement, and
No. The records showed that the veteran had ileocolonic Crohn's disease diagnosed by Colonoscopy in September 2014. He was started Remicade infusion on 11/20/2014. It was then discontinued due to Infliximab-related infusion reaction. Humira was started on April 16, 2015.