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For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation.<\/strong><\/p>\n<\/p>\n Support with 1\u00a0journal no older than 5 years.<\/p>\n Week 7: DISCUSSION QUESTION IN DISCUSSION BOARD<\/strong><\/p>\n Gastroenterology-Motility Case Study<\/strong><\/p>\n ACC\/AHA Guidelines<\/strong><\/p>\n Chief complaint:<\/strong> \u201c I have chronic constipation, incomplete defecation and abdominal bloating\u201d for past 2 years.\u00a0<\/p>\n M.C. a 46-year-old hispanic female presents to the GI-Motility clinic for complaint of chronic constipation, incomplete defecation and abdominal bloating. She has pmhx of DM-type 2, IBS-Constipation, Tubular Adenoma.<\/p>\n She also indicates that she has noticed that her symptoms are worsening for past 3 months. She has associated her symptoms with abdominal bloating, straining and incomplete defecation.<\/p>\n She has tried Miralax one packet po daily for at least 8 weeks and it has not relieved her symptoms.<\/p>\n Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.<\/p>\n<\/p>\n Diabetes Mellitus, type 2<\/p>\n Constipation, chronic-IBS<\/p>\n<\/p>\n \u00a0Penicillin<\/p>\n<\/p>\n She receives an annual flu shot. Last flu shot was this year<\/p>\n<\/p>\n High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.<\/p>\n<\/p>\n Both parents are alive. Father has history of DM type 2, Tinea Pedis.<\/p>\n mother alive and has history of atopic (sample nursing essay examples by the best nursing assignment writing service) dermatitis, tinea corporis and tinea pedis.<\/p>\n<\/p>\n Constitutional: Negative for fever. Negative for chills.<\/p>\n Respiratory: No Shortness of breath. No Orthopnea<\/p>\n Cardiovascular: + 1 pitting leg edema. + Varicose veins.<\/p>\n Skin: + rash crusted white in feet and inter-digit in feet.<\/p>\n Psychiatric: No anxiety. No depression.<\/p>\n Physical examination:<\/strong><\/p>\n Vital Signs<\/strong><\/p>\n Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110\/70 T 98.0 po P 80 R 22, non-labored<\/p>\n HEENT<\/strong>: Normocephalic\/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.<\/p>\n NECK<\/strong>: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.<\/p>\n LUNGS<\/strong>: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.<\/p>\n HEART<\/strong>: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.<\/p>\n ABDOMEN<\/strong>: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.<\/p>\n GENITOURINARY<\/strong>: No CVA tenderness bilaterally. GU exam deferred.<\/p>\n MUSCULOSKELETAL<\/strong>: Slow gait but steady. No Kyphosis.<\/p>\n SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes.<\/strong><\/p>\n PSYCH<\/strong>: Normal affect. Cooperative.<\/p>\n Labs day of visit<\/strong>:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST\/ALT normal. TSH 3.7 normal, glucose 98 normal<\/p>\n<\/p>\n<\/p>\n<\/p>\n Small intestine bacterial overgrowth (SIBO)<\/strong><\/p>\n Plan:<\/strong> Medications:<\/strong><\/p>\n Miralax one packet po daily for at least 8 weeks.<\/strong><\/p>\n Plan: Tests<\/strong><\/p>\n Anorectal Manometry with rectal sensation\/tone compliance test to evaluate if patient has dyssynergic defecation. If test positive then will consider ordering sessions of Biofeedback bowel retraining program to correct cause of incomplete defecation.<\/strong><\/p>\n Labs:\u00a0<\/strong>No new labs are needed. \u00a0<\/p>\n Referrals<\/strong>: may refer based on effect of medication therapy given for 2 weeks.<\/p>\n Follow up<\/strong>: return to office in 8 weeks to reevaluate her symptoms.<\/p>\n Questions: As an NP student, needs to determine the medications for constipation.<\/strong><\/p>\n<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":" \u00a0 For the following Case Study, as follow is Discussion Question: As an NP student, needs to determine the medications for constipation. 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