Case Study For Appropriate Diagnosis Of Cholecystitis Discussion

Case Study For Appropriate Diagnosis Of Cholecystitis Discussion

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Case Study

The study presents patient DC’s case, which involves a 46-year-old female. The patient has a 24-hour RUQ pain history which began one year after dinner with her family. The main symptoms presented include vomiting and nausea. In that regard, the paper will assess the patient’s diagnosis, appropriate drug therapy, and drug therapy recommendation justification.

The Patient Diagnosis

The primary diagnosis of patient DC is cholecystitis. According to Gallaher and Charles (2022), cholecystitis refers to gallbladder inflammation, with the main symptoms being vomiting, nausea, and abdomen tenderness similar to thee case study patient. Consequently, cholecystitis symptoms begin once an individual takes a meal, particularly a fatty or large one for the patient, and the pain begins after consuming a large dinner with her family. Also, when comparing the cholecystitis pain to that of biliary colic, which may be a differential diagnosis is that in biliary colic, the pain lasts for a few hours (Veronica et al., 2019)Case Study For Appropriate Diagnosis Of Cholecystitis Discussion. Another fact to consider that ascertains cholecystitis is her elevated leukocyte count at 13000, /mm³, which is usually consistent with chronic or acute cholecystitis. In addition, nausea and vomiting may be attributed to medication such as Lisinopril 10 mg daily, essential for the patient to control her hypertension state. Hence, during drug therapy, there is a need to evaluate if the medication needs to be reduced. Also, considering that the patient is taking HCTZ 25 mg daily, essential to treat high blood pressure, its side effects include stomach pains which may cause minimal abdominal tenderness. Hence, there will be a need to ensure that further examination is conducted to identify the main cause of these issues.

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Appropriate Drug Therapy

The main aim of pharmacotherapy in treating diseases includes reducing morbidity and preventing complications. According to Vagholkar (2020), antiemetics and analgesics are the most effective drug therapy that may be appropriate for a cholecystitis patient. However, it will also be essential first to withdraw HCTZ 25 mg daily since it plays a similar role to Lisinopril 10mg daily considering that it exposes the patient to more adverse effects.

Drug Therapy Justification

Antiemetics like prochlorperazine 5 to 10 mg will be appropriate for patient DC which will be essential in relieving vomiting and nausea (Eakin et al., 2020). Acetamophine will also be effective for the patient since it will help relieve pain episodes with doses not exceeding 4 g/24 hr. Considerably, the withdrawal of HCTZ 25mg daily will help assess the patient’s severity of abdominal pain, vomiting, and nausea since they are part of its side effects (Itoh et al., 2019). However, if the condition persists, the patient will have to undergo laparoscopic cholecystectomy since it is a preferred treatment for individuals with a projected longer life expectancy considering that the patient’s bilirubin level is at 0.8 mg/dL, thus indicating she has a longer life expectancy (Vagholkar, 2020)Case Study For Appropriate Diagnosis Of Cholecystitis Discussion.

Conclusion

The paper assessed a case study for a 46-year-old patient suspected of having cholecystitis. The main areas evaluated include appropriate diagnosis and its rationale and appropriate diagnosis and its justification.

References

Eakin, C. M., Norton, T. J., Monk, B. J., & Chase, D. M. (2020). Management of nausea and vomiting from poly(ADP-ribose) polymerase inhibitor therapy for advanced ovarian cancer. Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2020.08.016

Gallaher, J. R., & Charles, A. (2022). Acute Cholecystitis: A Review. JAMA, 327(10), 965–975. https://doi.org/10.1001/jama.2022.2350

Itoh, A., Hirano, K., Tanaka, N., Yoshioka, I., Shibuya, K., Watanabe, T., Kimura, N., Sugano, K., Okumura, T., & Fujii, T. (2019). Intravenous scheduled administration of acetaminophen in analgesia after pancreatectomy. HPB, 21, S450–S451. https://doi.org/10.1016/j.hpb.2019.10.2228

Vagholkar, Dr. K. (2020). Acute cholecystitis: Severity assessment and management. International Journal of Surgery Science, 4(2), 299–302. https://doi.org/10.33545/surgery.2020.v4.i2e.433

Veronica, B., Francesca, C., Luigi, L., De Gaetano, A. M., & Riccardo, M. (2019). Imaging of Biliary Colic and Cholecystitis. Pain Imaging, 229–245. https://doi.org/10.1007/978-3-319-99822-0_13

Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Case:

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain.  She states the pain started about 1 hour after a large dinner she had with her family.  She has had nausea and on instance of vomiting before presentation Case Study For Appropriate Diagnosis Of Cholecystitis Discussion.

Allergies:

• Latex
• Codeine
• Amoxicillin

PE:

• Eyes: EOMI
• HENT: Normal
• GI: Nondistended, minimal tenderness
• Skin: Warm and dry
• Neuro: Alert and Oriented
• Psych: b Appropriate mood

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Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom Case Study For Appropriate Diagnosis Of Cholecystitis Discussion.

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

• Review the case study assigned by your Instructor for this Assignment
• Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
• Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
• Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples Case Study For Appropriate Diagnosis Of Cholecystitis Discussion.

RESOURCES

Required Readings

• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
  • Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597)
  • Chapter 65, “Laxatives” (pp. 598–604)
  • Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
  • Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
    

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• Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver DiseasesLinks to an external site.. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder. Case Study For Appropriate Diagnosis Of Cholecystitis Discussion

RUBRIC:

NURS_6521_Week4_Assignment_Rubric

 Case Study For Appropriate Diagnosis Of Cholecystitis Discussion