Case studyGastrointestinal pathophysiology

Herzing NU 636 Unit 5 Assignment Case Study Inflammatory Bowel Disease

Six questions about a prescription, and the numbers in the case decide whether outpatient prescribing is appropriate at all. Grade the flare before you answer any of them.

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Last reviewed · August 25, 2026

Written by

Maren Caldwell

MSN, RN, CNE

Medical-surgical nursing, pharmacology and NCLEX preparation

Reviewed by

Dr. Tessa Redmond

DNP, RN, CNE

Evidence-based practice and clinical education

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Interpret the task
Assignment instructions
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Proposed outline
Research plan
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Final review

Grade the flare before you reach for a drug

The six questions all assume a prescription, and the objective data are there to test whether you check first. Ten small-volume bloody stools a day, a temperature of 100.1, a white count of 14,000, a haemoglobin of 11.9, potassium of 3.3 and a sitting-to-standing drop from 116/70 to 100/66 are a severity picture, not background colour. Established severity indices for ulcerative colitis use exactly these variables, stool frequency, rectal bleeding, temperature, pulse and haemoglobin, and this combination sits at least at the moderate to severe end. The orthostatic change and the hypokalaemia indicate volume and electrolyte losses that need addressing regardless of which agent you choose, so a strong answer says what it would do about those before it says what it would prescribe. That sequence also protects you from the trap in the question set, which is that all six questions presuppose an answer to a question they never ask.

Then the prescribing question has a shape. Ulcerative colitis is treated by disease extent and severity, so say which you are assuming and why, and be explicit that a patient who has been off maintenance therapy for years is presenting with a flare rather than a new diagnosis. Two things in her current regimen deserve comment: an oral contraceptive matters in active inflammatory bowel disease because of thromboembolic risk, and the recently started fibre supplement is plausibly worsening symptoms during an acute flare. The pharmacogenetic question the brief asks is not decorative either, since thiopurine metabolism testing before starting azathioprine is the standard example and it belongs in the answer if your plan reaches that far. Effectiveness evaluation should name the specific things you would recheck and when, and education should include the symptoms that mean she stops waiting and comes back. Feeling better is not an evaluation; stool frequency, bleeding, inflammatory markers and potassium are.

Likely learning objectives

Grade flare severity from the objective data before prescribing.
Address volume and electrolyte losses alongside anti-inflammatory therapy.
Review existing medicines and supplements for contribution to the presentation.
Apply pharmacogenetic testing where the drug class requires it.

Assignment instructions

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Review every instruction before using the planning guidance that follows.

Case Study Mrs. Z is a 34-year-old female who come in with a complaint of diarrhea accompanied by abdominal pain. Onset of the symptom was about 4 days ago. She reports thinking she is running a fever but has not taken her temperature. She concerned that she is starting to feel weak. When asked how about the characteristics and the number of bowel movements a day, she reports increased number of BMs over the last few months. In the last few days she reports averaging about 10 small volume watery stools with varying amounts of blood daily. She denies recent travel and reportedly has not been on any antibiotics in the past few weeks. In reviewing her record, you notice that her health history is positive for history of ulcerative colitis. She has not been on any medications for this over the last few years as she had not been symptomatic. Mrs. Z is on an oral contraceptive. She takes slippery elm capsules and has for the last several years. She reports that she has been taking 2 to 3 doses of Benefiber prebiotic fiber for the last couple days. Objective data: BP 116/70 sitting, 100/66 standing; P 92; Temp 100.1 Herzing NU 636 Unit 5 Assignment Case Study Inflammatory Bowel Disease Abdomen – active bowel sounds all 4 quadrants, mild tenderness with palpation Otherwise her exam is unremarkable for pertinent positives or negatives. Labs – WBC 14,000; Hgb 11.9; Hct 35.7; Sodium 133; Potassium 3.3 What pharmacologic therapy would you prescribe for Mrs. Z? How will you evaluate the effectiveness of this therapy? What patient education would you provide for Mrs. Z relative to the pharmacologic agent you prescribed? Are there any pharmacogenetic considerations related to what you prescribed for the patient? Are there any alternative therapies or over-the-counter agents that might be of value to Mrs. Z? What, if any, lifestyle changes would you recommend? Instructions: Please prepare and submit a paper 3-4 pages [total] in length (not including APA format) answering the questions below. Please support your position with examples.

Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS 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 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.

What the case study asks

01A 3-4 page paper answering all six case questions, with examples supporting your position.
02The pharmacologic therapy you would prescribe for Mrs Z.
03How you would evaluate the effectiveness of that therapy.
04The patient education you would provide relative to the agent prescribed.
05Any pharmacogenetic considerations related to what you prescribed.
06Any alternative therapies or over-the-counter agents that might be of value.
07Any lifestyle changes you would recommend.