NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

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NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders – Step-by-Step Guide

The first step before starting to write the NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders Instructions

In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.  

Possible topics covered in this Knowledge Check include:

  • Ulcers
  • Hepatitis markers
  • After HP shots
  • Gastroesophageal Reflux Disease
  • Pancreatitis
  • Liver failure—acute and chronic
  • Gall bladder disease
  • Inflammatory bowel disease
  • Diverticulitis
  • Jaundice
  • Bilirubin
  • Gastrointestinal bleed – upper and lower
  • Hepatic encephalopathy
  • Intra-abdominal infections (e.g., appendicitis)
  • Renal blood flow
  • Glomerular filtration rate
  • Kidney stones
  • Infections – urinary tract infections, pyelonephritis
  • Acute kidney injury
  • Renal failure – acute and chronic

Concepts of Gastrointestinal and Hepatobiliary Disorders Questions

Scenario 1: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating. Have a look at NURS 6501 Week 6 Knowledge Check: Endocrine Disorders.

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis, 

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain 

Family Hx-non contributary  

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.  

Breath test in the office revealed + urease. 

The healthcare provider suspects the client has peptic ulcer disease.

Questions:

1.     Explain what contributed to the development from this patient’s history of PUD?

Scenario 1B: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating.  

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis, 

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain 

Family Hx-non contributary  

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters.  

Breath test in the office revealed + urease. 

The healthcare provider suspects the client has peptic ulcer disease.

Question:

1.     What is the pathophysiology of PUD/ formation of peptic ulcers? 

Scenario 2: Gastroesophageal Reflux Disease (GERD)

A 44-year-old morbidly obese female comes to the clinic complaining of  “burning in my chest and a funny taste in my mouth”. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea. 

PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2) 

FH:non contributary   

Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn 

SH: 20 PPY of smoking, ETOH rarely, denies vaping    

Diagnoses: Gastroesophageal reflux disease (GERD). 

Question:

1.     If the client asks what causes GERD how would you explain this as a provider?

Scenario 3: Upper GI Bleed

A 64-year-old male presents the clinic with complaints of passing dark, tarry, stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed.

Question:

1.     What are the variables here that contribute to an upper GI bleed? 

Scenario 4: Diverticulitis

A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning.

Diagnosis is lower GI bleed secondary to diverticulitis.

Question:

1.     What can cause diverticulitis in the lower GI tract? 

NURS 6501 Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders Example Approach

Explain what contributed to the development of this patient’s history of PUD.

PUD is distinguished by a breach in the mucosa that extends to the submucosa or deeper layers. PUD primarily affects gastric and duodenal mucosa. Peptic ulcer disease originates from an array of etiologies. However, the most common etiologies include NSAID use, alcohol, and H. pylori (McCance & Huether, 2019). In the case scenario, the patient apparently has all these predominant etiologies. For instance, her urease test is positive, which points to H. pylori, and she uses ibuprofen, an NSAID. She also takes wine. Additional risk factors for her PUD development include smoking and emotional stress following a pending divorce.

What is the pathophysiology of PUD/ formation of peptic ulcers? 

Peptic ulcer disease stems from an imbalance between gastric mucosa’s destructive and protective factors. Protective factors include GI mucus, bicarbonate, mucosal blood flow, tight intercellular junctions, cell renewal and restitution, and prostaglandins E, F, and I (McCance & Huether, 2019). Gastrointestinal mucosa, for instance, protects against mucosal damage, lubricates against friction, and controls the diffusion of hydrogen ions.  

On the other hand, aggressive factors include acid, pepsin, bile, pancreatic enzymes, and H. pylori. With the destruction of the mucosal layer, the bicarbonate production is decreased, resulting in enhanced susceptibility of the deep layers to acidity (McCance & Huether, 2019). Several factors alter this balance, including NSAIDs, H. pylori, alcohol, steroids, psychological stress, and genetic factors.

 If the client asks what causes GERD, how would you explain this as a provider?

GERD is a condition that develops following the backflow of stomach contents into the esophagus. The exact cause related to the development of GERD is unknown. However, it is stipulated that GERD stems from a multifactorial etiology. For instance, motor abnormalities, esophageal dysmotility, impaired tone of the lower esophageal sphincter, delayed gastric emptying, and transient lower esophageal sphincter relaxation have been identified (Clarrett & Hachem, 2018).

Additionally, anatomical factors such as hiatal hernia and an increase in intraabdominal pressure, as in the case of obesity, predispose to GERD. Other risk factors correlated with GERD symptoms include smoking, alcohol consumption, pregnancy, age greater than 50 years, connective tissue disorders, low socioeconomic status, and drugs such as anticholinergics, benzodiazepines, and calcium channel blockers (Clarrett & Hachem, 2018).

What are the variables here that contribute to an upper GI bleed?

Upper GI bleeding implies gastrointestinal bleeding that originates proximal to the ligament of Treitz. According to McCance and Huether (2019), upper GI bleeding accounts for 70 to 80% of all gastrointestinal bleeding. In the scenario presented, variables that contribute to the diagnosis of an upper GI bleed include age, passing dark tarry stools, history of antiacids, and mid-epigastric pain for several weeks. An age greater than 60 years increases the risk of gastrointestinal bleeding, while the passage of black tarry stool predominantly originates from upper GI bleeding. Finally, antiacid use and mid-epigastric pain are associated with peptic ulcer disease, the most common cause of upper GI bleeding.

What can cause diverticulitis in the lower GI tract? 

Diverticula refer to sac-like protrusions in the colonic wall (Strate & Morris, 2019). These outpouchings are a consequence of the weakness of the outer muscle layer of the colonic wall. Diverticulitis refers to the inflammation or infection of these sac-like protrusions. The distinct cause of diverticulitis is unclear. However, several factors contribute to the risk of diverticulitis, including increased pressure from constipation, abdominal obesity, and smoking (Strate & Morris, 2019). Similarly, diet plays a significant role in the development of diverticulitis, particularly high-fat, red meat, and low-fiber diets (Strate & Morris, 2019). Finally, exposure to drugs such as opioids, steroids, and NSAIDs increases the risk of diverticulitis.

References

Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal reflux disease (GERD). Missouri Medicine, 115(3), 214–218. https://www.ncbi.nlm.nih.gov/pubmed/30228725

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298.e1. https://doi.org/10.1053/j.gastro.2018.12.033