NURS 6501N
Jamie is a 3-month-old female who presents with her mother for evaluation of throwing up. Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and overall seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle she seems to be a very healthy happy infant. A more precise history suggests that Jamie does not exactly throw upshe does not heave or act unwellbut rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didnt appear to help at all and now Mom is very concerned.
Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility prompting them to change formulas rather than seeking medical care. As in the case study above GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adultsadults may present with symptoms that have various potential causes. When evaluating patients it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD) peptic ulcer disease (PUD) and gastritis.
To prepare: INCLUDE 2 CURRENT OUTSIDE RESOURCES PLUS THE ONES BELOW:
Review this weeks media presentation on the gastrointestinal system.
Review Chapter 33 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.
Review Chapter 35 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD) peptic ulcer disease (PUD) and gastritis. Think about how these disorders are similar and different.
Select a patient factor different from the one you selected in this weeks Discussion: genetics gender ethnicity age or behavior. Consider how the factor you selected might impact the pathophysiology of GERD PUD and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.
Review the Mind MapsDementia Endocarditis and Gastro-oesophageal Reflux Disease (GERD) media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.
To complete:
Write a 3-page paper that addresses the following:
Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD PUD and gastritis disorders.
Explain how the factor you selected might impact the pathophysiology of GERD PUD and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Construct a mind map for gastritis. Include the epidemiology pathophysiology and clinical presentation as well as the diagnosis and treatment you explained in your paper.
REFERENCES
Huether S. E. & McCance K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis MO: Mosby.
Chapter 33 Structure and Function of the Digestive System
Chapter 35 Alterations of Digestive Function in Children.
Media
Zimbron J. (2008). Mind mapsDementia endocarditis and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/
Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.
This media provides examples of mind maps for dementia endocarditis and gastro-oesophageal reflux disease (GERD
Media
Laureate Education Inc. (Executive Producer). (2012c). The gastrointestinal system. Baltimore MD: Author