Many patient symptoms can be tied to multiple disorders, which may lead to misdiagnoses. For instance, consider two digestive disorders of the gastrointestinal tract—inflammatory bowel disease and irritable bowel syndrome. These two disorders are commonly confused because they present similar symptoms. As an advanced practice nurse, you must know the differences to properly diagnose and treat the disorders. How does the pathophysiology of inflammatory bowel disease compare to the pathophysiology of irritable bowel syndrome? How do treatments for the two disorders compare?

To Prepare

• Review      Chapter 36 in the Huether and McCance text and Chapter 13 in the McPhee      and Hammer text.
• Identify      the pathophysiological mechanisms of inflammatory bowel disease and      irritable bowel syndrome. Think about similarities and differences between      the disorders.
• Consider      common treatments for inflammatory bowel disease and irritable bowel      syndrome. Reflect on whether treatments for one disorder would work for      the other disorder.
• Select      one of the following patient factors: genetics, gender, ethnicity, age, or      behavior. Reflect on how the factor you selected might impact the      pathophysiology of and treatments for each disorder.

Post an explanation of the pathophysiological mechanisms of inflammatory bowel disorder and irritable bowel syndrome, including similarities and differences. Then describe common treatments, addressing whether treatments for one disorder would work for the other disorder. Finally, explain how the patient factor you selected might impact the pathophysiology of and treatments for each disorder.

Required Readings

**Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 35, “Structure and      Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

• Chapter 36, “Alterations of      Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

• Chapter 37, “Alterations of      Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.

**Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

• Chapter 13,      “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

• Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

• Chapter 15, “Disorders of      the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.

**de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

– This work should have Introduction and Conclusion

– It should have at least 3 current references (Year 2013 and up)

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

 

Go to the following website by clicking on the provided link, http://www.countyhealthrankings.org/ 

– select a county and a state (this may be the county/state in which you reside, attend school, or plan to live and work). 

After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions in a few short sentences as part of your discussion.

1-Select one area in need of improvement and list the general statistics pertaining to the specific problem.

2-How does the creation of the community health center program help to address this public health problem. 

3-What can you as a nurse practitioner do to influence policy innovation to resolve the problem?

APA style. 2 references (less than 5-7 years). 250 words. 

  

Select a state health policy reform innovation and describe the rationale, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. Summarize the findings in a 1-2-page, single-spaced memo.

A few examples of state innovations include Vermont’s single payer system, Massachusetts’ health reforms and Kentucky’s Medicaid healthcare program.

Important: Rationale/Adoption, Funding Structure, Impact on Healthcare, APA Format, 3 References.

  

 

Discussion Prompt

Initial Post: Describe the physiology of blood pressure control. Causes of Primary Hypertension may include overactivity of the SNS; overactivity of the RAAS; alterations in other neurohumoral mediators of blood volume and vasomotor tone such as ANP, BNP, and adrenomedullin; inflammation; a complex interaction involving insulin resistance and endothelial function; and obesity-related hormonal changes

Select 3 of the above potential causes and explain the pathophysiologic mechanisms of primary hypertension.

In this module, you will finalize the completion of the full assessment of your own community.  

Defining the Community

Your community should be within a specifically designated geographic location.

One must clearly delineate the following dimensions before starting the process of community assessment:

• Describe the population that is being assessed?

• What is/are the race(s) of this population within the community?

• Are there boundaries of this group? If so, what are they?

• Does this community exist within a certain city or county?

• Are there general characteristics that separate this group from others?

• Education levels, birth/death rates, age of deaths, insured/uninsured?

• Where is this group located geographically…? Urban/rural?

• Why is a community assessment being performed? What purpose will it serve?

• How will information for the community assessment be collected?

Assessment

After the community has been defined, the next phase is assessment. The following items describe several resources and methods that can be used to gather and generate data. These items serve as a starting point for data collection. This is not an all-inclusive list of resources and methods that may be used when a community assessment is conducted.

The time frame for completion of the assessment may influence which methods are used. Nonetheless, these items should be reviewed to determine what information will be useful to collect about the community that is being assessed. It is not necessary to use all of these resources and methods; however, use of a variety of methods is helpful when one is exploring the needs of a community.

Data Gathering (collecting information that already exists)

Your submission should be a minimum of 2000 words (maximum 2500 words) in length and should completely answer the proposed questions as listed under “Define the community.” You should have a minimum of three (3) references.

APA formatting is required and all responses should be combined into a single document for submission. 

Demographics of the Community

• When demographic data are collected, it is useful to collect data from a variety of levels so comparisons can be made.
• If the population that is being assessed is located within a specific setting, it may be best to contact that agency to retrieve specific information about that population.
• The following resources provide a broad overview of the demographics of a city, county, or state:
• American Fact Finder—Find population, housing, and economic and geographic data for your city based on U.S. Census data
• State and County Quick Facts—Easy access to facts about people, business, and geography, based on U.S. Census data
• Obtain information about a specific city or county on these useful websites:
  • www.epodunk.com and www.city-data.com

Information from Government Agencies

• Healthy People 2020—this resource is published by the U.S. Department of Health and Human Services. It identifies health improvement goals and objectives for the country to be reached by the year 2020
• National Center for Health Statistics—this agency is part of the Centers for Disease Control and Prevention; this website provides statistical information about the health of Americans
  • National Vital Statistics System
• Centers for Disease Control and Prevention (CDC)—The CDC website contains a large amount of information related to the health of the American population. The search engine within this website can be used to find relevant information
• Federal agencies with statistical programs
• Every state in the United States has its own specific health improvement plan and goals that are based on the Healthy People 2020 document. This information may be available on the state health department website.
• State and local health departments provide information related to vital statistics for the community.

Other Data Sources

• America’s Health Rankings—this website provides information about various health indicators for each state  
• Other relevant data sources may be found by conducting an Internet search related to the topic that is being examined through the community assessment.

After data are collected from various sources, it is important to review the information and to identify assets and areas for improvement in the community by comparing local data (if available) versus state and national data. This will facilitate organization of the information that has already been obtained and will provide direction for the next step of the process.