Gastroenteritis Paper Assignment

Gastroenteritis Paper Assignment

Gastroenteritis Paper Assignment

Response 1


The purpose of this paper is to define Gastroenteritis and its involvement in the health and wellness of patient Baby K. Baby K is 14 months of age and presents with vomiting, diarrhea, and severe abdominal pain. On assessment it is noted that the patient ingested improperly stored milk custard. Staphylococcus aureus is suspected.Gastroenteritis effects both the gastric mucosa of the stomach and the intestines in the inflammatory process causing each to appear red, inflamed, and edematous (Hubert & VanMeter, 2018). Anorexia, nausea, vomiting, and diarrhea are present with Gastroenteritis and vary in severity. Anorexia, or loss of appetite, often precedes nausea which is stimulated by inflammation or irritation of the digestive tract. The sensation of nausea often is paired with increase sweating and salivation. It is said that the increase in salivation helps lubricate the esophagus before vomiting occurs. Vomiting, or emesis, is the forceful expulsion of stomach and sometimes intestinal contents to include stomach acids and ingested materials. Diarrhea is an excessive number of frequent stools that are usually thin consistency. The loss of fluids in the stool can contribute to dehydration, electrolyte imbalances, acidosis, and malnutrition. Diarrhea is typically associated with nausea and vomiting with inflammation and irritation is present in the digestive tract (Hubert & VanMeter, 2018).

Causative Factors

Multiple causative agents exist for acute onset of Gastroenteritis, but most causes are of infectious etiology. A foodborne infection typically manifests as a combination of nausea, vomiting, diarrhea, and abdominal discomfort. If a foodborne illness is suspected, identifying the particular food exposure and timing of symptoms can be informative in determining the pathogen. Foodborne pathogens such as Staphylococcus aureus cause illness within hours of ingestion whereas other pathogens may take up to seven days to show symptoms (LaRocque & Harris, 2019).Patient Baby K presents with vomiting, diarrhea, and severe abdominal pain. It is believed that the patient ingested poorly kept custard. The suspicion of Staphylococcus aureus is plausible because foods not cooked after handling such as custards, pastries, and sandwiches are highly susceptible to be contaminated with Staph (CDC, 2020). As mentioned, the incubation period is 2-4 hours on average and manifests as sudden severe nausea, vomiting, abdominal cramps, and diarrhea (Hubert & VanMeter, 2018). Knowing that baby K ingested custard and the time in which the food was ingested will help solidify Staphylococcus aureus as a causative agent.


The APRN working in pediatrics will often come in contact with patients experiencing gastrointestinal upset such as with Gastroenteritis like baby K due to the increase risk of hypovolemia (dehydration) in infants and children. This increased risk is due to the higher prevalence of Gastroenteritis in children versus adults, the infant’s higher volume of insensible losses, and the infant’s inability to communicate their need for increased fluids (Somers, 2020). Severe nausea, vomiting, and diarrhea need to be corrected quickly to avoid severe dehydration and other clinical complications associated with extreme fluid loss. Signs of dehydration in an infant can be measured as mild, moderate, or severe and will need to be determined as part of the initial assessment plan. Signs of dehydration that will need to be assessed for severity will include pulse, systolic blood pressure, rate of respirations, buccal mucosa, anterior fontanelle (if age appropriate), eyes, skin turgor and temperature, urine output, and systemic signs such as activity level, increased thirst, and tear production (Somers, 2020).

Fluid Replacement

Assessment of volume depletion aids in determining the appropriate route to rehydrate and replenish volume. Laboratory testing will include serum sodium, serum potassium, serum bicarbonate, and urine concentration levels. Hypernatremia levels may be present due to insensible water losses causing greater loss of fluids than sodium often found in infants; however, diarrhea cause by gastroenteritis may lead to isonatremia as fluid and sodium are normally lost equally. Infants with gastroenteritis will commonly experience hypokalemia due to the loss of potassium in the diarrheal stool as well as a low serum bicarbonate concentration for the same reason. A higher urine concentration is present in hypovolemic patients due to most fluid loss taking place through the gastrointestinal tract (Somers, 2020).Whether the rehydration takes place as oral rehydration therapy (ORT) or via intravenous (IV) therapy (depending on severity), the electrolytes will need to be replaced. More severe cases will require 2-step IV therapy for fluid replenishment. The first step is to increase volume alone through the use of isotonic solution or 0.9% normal saline. This therapy is more rapid to increase volume. It is recommended that isotonic solution is used for fluid replacement in infants and children with hypovolemia due to Gastroenteritis that have normal sodium levels. The second step of rehydration will be to focus on volume and on electrolytes and may be done via IV or ORT. Hypertonic solutions will be more appropriate for patients with lower serum levels and should be given at a slower rate as to avoid rebound effects. If ORT is being used, fluids such as Pedialyte are recommended for use until the patient can return to normal volume and electrolyte status (Somers, 2020).

Response 2

Hepatitis B and Cirrhosis

Hepatitis is the inflammation of the liver which can be idiopathic such as with a fatty liver, local infection due to viral hepatitis, an infection at various locations within the body, or can be caused by chemicals or drug toxicity. The effects of hepatitis on the body varies, and can result in mild or severe inflammation and necrosis. Mild inflammation impairs hepatocyte function and severe inflammation may lead to obstruction of blood and bile flow in the liver, causing an impairment of liver cell function (Hubert and VanMeter, 2018). The case study that will be discussed is J.B., a 35 year old with chronic hepatitis B for nine years, with an unknown origin of acute infection.

Purpose Statement

There are several types of hepatitis, including Hepatitis A, B, C, D, and E. Hepatitis can also be caused by chemical exposure at the workplace, such as carbon tetrachloride, toluence, or ethanol or from drug toxicity, including large amounts of acetaminophen, halothane, phenothiazines, and tetracycline. Exposure to these chemicals and drugs can cause inflammation and necrosis of the liver (Hubert and VanMeter, 2018). The purpose of this case study is to discuss the pathophysiology, signs and symptoms, and treatment recommendations for hepatitis B.

Pathophysiology of acute hepatitis B infection

Hepatitis B is a double-stranded DNA virus, and the whole virion is referred to as Sane particle, consisting of two core antigens, HBcAg and HBeAG, and one surface antigen, HBsAg. The antigens cause a stimulation of the antibody production in the body which is useful for diagnosing and managing the virus. The incubation period of hepatitis B is about two months, but individuals can be asymptomatic and still remain contagious, which is referred to as a carrier state. There is a lag time of development of symptoms or serum markers which prevents detection of the virus, but it can still be transmitted to others. Hepatitis can be transferred by contact with infected blood such as during a blood transfusion, body secretions, and intravenous drug use, sexual contact, and hemodialysis, passage to the fetus during pregnancy, tattooing, and body piercing. Health care providers are at an increased risk of contracting hepatitis B from treating infected patients (Hubert and VanMeter, 2018).

Treatment measures

At the time of exposure, there are no recommendations for treatment for the virus. Individuals are treated for their symptoms, but usually medications are not initiated for the infection. There is no cure for hepatitis B, but there are treatment options for the symptoms to assist with protecting the liver. Individuals are encouraged to refrain from alcohol and tobacco and certain hepatotoxic medications, and to see their health care provider regularly or liver specialist. Medications that are used to treat hepatitis B are immune modulators to boost the immune system and antivirals to stop the replication of the virus in order to reduce inflammation and damage to the liver (Hepatitis B Foundation, 2020). Treatment with medications is not generally implemented until there are signs of acute liver disease. Regular monitoring and evaluation of the individual is pertinent in the form of physical exams, blood tests, and imaging studies to manage the virus.

Signs of the preicteric and icteric stages of acute hepatitis B infection

During the preicteric or prodromal stage, the liver becomes inflamed, liver enzymes become elevated, and the individual may report right upper quadrant abdominal pain. The stage is characterized by a gradual onset of anorexia, malaise, and fatigue. During the icteric stage, the individual may experience liver tenderness and jaundice, dark-colored urine and lighter-colored stools, nausea and vomiting, and pruritus (Samji, 2017).

Please respond to the above 2 responses with atleast 2 APA references


You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.


Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.




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