Case Study: The client with IBS

 
Case overview:
Irritable bowel syndrome (IBS) is one of the most common GI conditions.
Approximately 12% of adults in the United States report classic symptoms of IBS
(Hadley & Gardner, 2005). IBS accounts for 3.5 million office visits and is a
leading
cause of workforce absenteeism (Harmon, 2007). It occurs more commonly in
women than in men, and the cause remains unknown (Hasler, 2007).
Although no anatomic or biochemical abnormalities have been found that
account for its common symptoms, various factors are associated with the
syndrome: heredity, psychological stress or conditions such as depression and
anxiety, a diet high in fat and stimulating or irritating foods, alcohol consumption,
and smoking. The diagnosis is made only after tests confirm the absence of
structural or other disorders (Hasler, 2007).
Reference: Hinkle, J., & Cheever, K. (2017) Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing. (14th ed.) Philadelphia: Lippincott Williams and
Wilkins. 
 
 
Case Scenario : Patient Melissa
1. Click the YouTube link below and watch the entire video so you have the
necessary information to plan your nursing care management. Analyze  the scenario
carefully without  assuming  any facts not present  in the case scenario. You may refer
to your textbooks  and lecture notes  for additional  references.
https://www.youtube.com/watch?v=bJLRcHSNUls

What Triggers Irritable Bowel Syndrome?

2. Diagnosis* 
To diagnose the patient's  condition, the doctors have ordered several tests to
determine the cause including:
2.1 Blood Test: CBC
2.2 Stool Culture
2.3 Magnetic resonance imaging (MRI)
2.4 CT scan
2.5 Colonoscopy
2.6  Intestinal endoscopy
3.  Medical Intervention*
The  patient  was  diagnosed  with  IBS-D  (Diarrhea  Predominant  IBS)  . She was
prescribed  Alosetron  (0.5 mg BID for 4 weeks), and she  experienced  relief of her 
IBS-D  symptoms.  However,  she  had  to  stop  the  medication  after  it  was
voluntarily  withdrawn  from the market. She was later restarted  on alosetron  when it 
was  re-released ,  and  she  experienced improvement of her gastrointestinal
symptoms. Other medications includes Rifaximin  (Xifaxan) 550  mg PO q8hr  for 14 
days  (decrease  bacterial  overgrowth and diarrhea)  and  Pregabalin  (Lyrica)  75 mg
BID for 7 days for abdominal  pain.  She  also tried using over-the-counter and 
prescription antidiarrheal agents (Loperamide HCl (Lomotil)  2mg,  Initially  2 tab  w/
subsequent  dose  of 1  tab  after each loose  stool) with little  relief of her symptoms.
She was  subsequently  prescribed  a low dose  of
Amitriptyline  (Elavil 25 mg OD HS), a tricyclic agent,  for her bowel symptoms, but the
drug caused  sedation  and a dry mouth. 
Using the format below, develop a drug study for the meds prescribed for the patient
before and during her hospital admission