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.

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. 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.

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

• Synthroid 100 mcg daily
• Nifedipine 30 mg daily
• Prednisone 10 mg daily

To Prepare

• Review the case study
• 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.

In a 2-page  address 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.

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)

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 Diseases. 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.

Assessment#4

Develop a 2–page training strategies summary. And annotated agenda for a training session. That will prepare a role group to succeed in implementing your proposed organizational policy and practice guidelines.

Training and educating those within an organization who are responsible for implementing. And working with changes in organizational policy is a critical step in ensuring that prescribed changes have their intended benefit. A leader in a health care profession must be able to apply effective leadership, management. And educational strategies to ensure that colleagues. And subordinates will be prepared to do the work that is asked of them.

 

Supporting Evidence

Cite 2–4 external sources to support your strategies for working with the group you have identified and generating their buy-in, as well as for your approach to the training session, activities, and materials.

Market Strategies To Target Personal Goods

In their personal lives, people routinely purchase goods or services. At times, they “need” or “want” something new; or it is time to replace/replenish an existing product. Whether they need to purchase groceries, buy gas for the car, or stretch a bit to get that exciting new toy, their investment in “goods” is ongoing. Similarly, they utilize the services that companies provide to enrich, replenish, fulfill, maintain, or enhance their lives. Describe how a marketer could develop differing marketing strategies to target your personal use of goods or services. Provide a real-world example of a marketer who does this. Include links to relevant marketing pieces to illustrate your example. In replies to peers, discuss the effectiveness of marketers in targeting to personal use in the examples provided.

Reading literature, and especially epic literature, is like looking through a window at the culture from which it emerged. Based on your reading of this ancient text, write an essay in which you discuss what The Epic of Gilgamesh reveals about the values – the moral ideas and standards of behavior – of ancient Sumerians. What ideas were important to the Sumerians? did they expect of their rulers?  values did they want their heroes to embody?  kind of gods did they have faith in? Use specific examples from the epic to support your argument.

Please write about 2-3 double-spaced pages (no less, no more, unless you would like to write more).

SUBMIT AS A REGULAR ASSIGNMENT. PLEASE MAKE SURE YOU DO NOT WRITE OR PASTE ON COMMENT-COLUMN. SUBMIT AS ATTACHMENT.

This assignment requires you to be particularly observant of the values of the world of Gilgamesh. This entails characteristics of human behavior as manifested in the characters’ decisions, actions and interactions. The introduction to the Epic in your book would be of great help to you, as much as the notes and video(s) you have received.

Part of this assignment is also to answer questions relevant to our course and the first epic you are reading, such as,

-What does it mean to be ancient? To be epic? To be distant from our time?

-What does it mean to be a man or a woman in the civilization of ancient Sumeria?

-To be mortal or immortal?

-How is gender perceived in that culture?

-How do people live, love and fight?

-What do their cities and homes look like?

-Which are the Sumerians’ eating habits?

-How do they dress?

-How do they worship?

-Are there temples of worship?

-What is the religion of the Sumerians and how is it manifested in the epic?

-Do they believe in dreams and their interpretations (oneiromancy)?

-Do they believe in friendship?

All the above are crucial questions whose answers reveal the complex identity of the Sumerian culture, as much as any culture. Be curious and investigative. You don’t have to answer all of the above questions. These are examples that will help you direct your interest and curiosity. Choose a few and follow the traces that will lead to the discussion of your topic

.

All observations are to be drawn from the poem, the introduction by Sandars, the various notes/essays and the video you have received. Please do not use random online references (spark notes, Wikipedia etc.) that will render your analysis off topic. This is not a social science course. All your conclusions about the Sumerian civilization should be drawn from your knowledge of the Epic of Gilgamesh and the related readings about it.

You may, of course, look up your own sources, but make sure your analysis remains within the context of the epic poem and you don’t generalize or fall into the trap of synopsizing the story of the poem. This paper is NOT about the story of King Gilgamesh, but rather about the people he is ruling -who are they and what kind of an impression do we get of them through this poem?