Description
Reflection: Address the following questions:
Which diagnostic tests did you select for this client? Using the estimated national average cost for each diagnostic test from a website such as MD saveLinks to an external site. calculate the total cost for diagnostic testing for this client if she was uninsured. How might this information change your decision to order diagnostic tests for the client? Would lack of insurance change your management plan? Why or why not?
How would you alter your management plan for this client if she was experiencing food insecurity or lack of housing?
Include the following components:
write 150-300 words in a Microsoft Word document
demonstrate clinical judgment appropriate to the virtual patient scenario
cite at least one relevant scholarly source as defined by program expectations
communicate with minimal errors in English grammar, spelling, syntax, and punctuation
Diagnostic Test:
Tissue glutaminase antibody (IgA-tTG)
C Reactive Protein
Capsule endoscopy
Colon biopsy
Colonoscopy
Complete blood count
CMP
CT abdomen
CTA abdomen
ESR
Sigmoidoscopy
Vitamin B12
Medications:
Antispasmodic Medication:
Prescription: Hyoscyamine (e.g., Levsin) 0.125 mg orally three times daily before meals.
Instructions: Take as directed for abdominal pain and cramping.
Probiotics:
Over-the-Counter Recommendation: Align Probiotic Supplement.
Instructions: Take one capsule daily to help regulate gut flora.
Fiber Supplement:
Over-the-Counter Recommendation: Metamucil (psyllium husk) 1 tablespoon daily.
Instructions: Mix with water and consume to alleviate constipation.
Anti-Diarrheal Medication:
Prescription: Loperamide (Imodium) 2 mg as needed for diarrhea.
Instructions: Take one tablet after loose stools, up to three times a day.
Consults/Referrals:
Nutritional Counseling:
Referral: Registered Dietitian with experience in managing IBS.
Rationale: Dietary modifications are crucial in managing IBS symptoms.
Psychological Support:
Referral: Behavioral therapist or psychologist.
Rationale: Cognitive-behavioral therapy (CBT) can help manage stress and improve coping mechanisms.
Client Education:
Dietary Modifications:
Educate on a low-FODMAP diet to identify trigger foods.
Emphasize the importance of regular, well-balanced meals.
Lifestyle Modifications:
Stress management techniques, such as deep breathing exercises and mindfulness.
Regular exercise to promote bowel regularity.
Medication Adherence:
Provide clear instructions on the proper use of prescribed medications.
Discuss potential side effects and when to seek medical attention.
Follow-up:
Schedule a follow-up appointment in 4 weeks to assess treatment effectiveness and make adjustments if necessary.
If symptoms worsen or new symptoms arise, encourage the patient to contact the clinic for an earlier appointment.
References:
Ford, A. C., Lacy, B. E., Talley, N. J., et al. (2017). Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: Systematic review and meta-analysis. The American Journal of Gastroenterology, 109(9), 1350–1365. doi:10.1038/ajg.2014.148
