Gastrointestinal Tract: Disorders of Motility Case Diagnosis

Gastrointestinal Tract: Disorders of Motility

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 up—she does not heave

or act unwell—but 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 didn’t 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 adults—adults 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

Review this week’s media presentation on the gastrointestinal system.

Review Chapter 35 in the Huether and McCance text. Identify the normal

pathophysiology of gastric acid stimulation and production.

Review Chapter 37 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

week’s 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 Maps—Dementia, 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 2 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.

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