Scribd Logo
Upload

Welcome to Scribd!

  • 34 views

    Week 4. Course Task 1

    Uploaded by

    DE LEON, CRONICA FAY G.
    V.A., a 55-year-old man, was admitted to the hospital with acute pancreatitis as evidenced by abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. Laboratory results showed increased amylase, lipase, glucose, and white blood cells along with decreased calcium, consistent with pancreatic inflammation and infection. The patient was placed on NPO status and given an NG tube and IV fluids to rest the pancreas. Morphine and pantoprazole were administered for pain and to reduce gastric acid secretion. The priority nursing diagnosis was acute pain and collaborative issues included potential for sepsis and fluid/electrolyte imbalance.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Week 4. Course Task 1

    Uploaded by

    DE LEON, CRONICA FAY G.
    34 views3 pages
    V.A., a 55-year-old man, was admitted to the hospital with acute pancreatitis as evidenced by abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. Laboratory results showed increased amylase, lipase, glucose, and white blood cells along with decreased calcium, consistent with pancreatic inflammation and infection. The patient was placed on NPO status and given an NG tube and IV fluids to rest the pancreas. Morphine and pantoprazole were administered for pain and to reduce gastric acid secretion. The priority nursing diagnosis was acute pain and collaborative issues included potential for sepsis and fluid/electrolyte imbalance.

    Original Title

    WEEK 4. COURSE TASK 1

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    V.A., a 55-year-old man, was admitted to the hospital with acute pancreatitis as evidenced by abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. Laboratory results showed increased amylase, lipase, glucose, and white blood cells along with decreased calcium, consistent with pancreatic inflammation and infection. The patient was placed on NPO status and given an NG tube and IV fluids to rest the pancreas. Morphine and pantoprazole were administered for pain and to reduce gastric acid secretion. The priority nursing diagnosis was acute pain and collaborative issues included potential for sepsis and fluid/electrolyte imbalance.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    34 views3 pages

    Week 4. Course Task 1

    Uploaded by

    DE LEON, CRONICA FAY G.
    V.A., a 55-year-old man, was admitted to the hospital with acute pancreatitis as evidenced by abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. Laboratory results showed increased amylase, lipase, glucose, and white blood cells along with decreased calcium, consistent with pancreatic inflammation and infection. The patient was placed on NPO status and given an NG tube and IV fluids to rest the pancreas. Morphine and pantoprazole were administered for pain and to reduce gastric acid secretion. The priority nursing diagnosis was acute pain and collaborative issues included potential for sepsis and fluid/electrolyte imbalance.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    Cronica Fay G.

    De Leon
    BSN 3-Y2-20

    CASE STUDY
    Acute Pancreatitis

    Patient Profile
    ● V.A. is a 55-year-old man admitted to the hospital with acute pancreatitis.

    Subjective Data
    ● Has severe abdominal pain in the LUQ radiating to the back
    ● States that he is nauseated and has been vomiting

    Objective Data
    Physical Examination
    ● Vital signs: Temp 101°F (38.3°C), HR 114 bpm, RR 26, BP 92/58
    ● Jaundice noted in sclera
    Laboratory Tests
    ● Serum amylase: 400 U/L (6.67 mkat/L)
    ● Serum lipase: 600 U/L
    ● Urinary amylase: 3800 U/day
    ● WBC count: 20,000/μL
    ● Blood glucose: 180 mg/dL (10 mmol/L)
    ● Serum calcium: 7 mg/dL (1.7 mmol/L)

    Collaborative Care
    ● NPO status
    ● NG tube to low, intermittent suction
    ● IV therapy with lactated Ringer's solution
    ● Morphine PCA
    ● Pantoprazole (Protonix) IV

    1. Explain the pathophysiology of acute pancreatitis.


    Acute pancreatitis is characterized by inflammation of the pancreas, which can
    lead to autodigestion of pancreatic tissue. The key events include:
    a. Enzyme Activation: Digestive enzymes (such as amylase and lipase) become
    activated within the pancreas instead of the small intestine.
    b. Autodigestion: Activated enzymes cause damage to pancreatic cells, leading to
    inflammation and edema.
    c. Inflammatory Response: The inflammation triggers an inflammatory response,
    leading to systemic manifestations.
    d. Vascular Changes: Blood vessel damage can result in hemorrhage, necrosis, and,
    in severe cases, organ failure.

    2. What are the most common causes of acute pancreatitis?


    ● Gallstones: Blocking the pancreatic duct.
    ● Alcohol Consumption: Chronic alcohol abuse.
    ● Trauma: Injury to the pancreas.
    ● Infections: Viral or bacterial infections.

    3. How are the results of V.A.'s laboratory values relate to the pathophysiology of acute
    pancreatitis?
    ● Elevated Amylase and Lipase: Released from damaged pancreatic cells.
    ● High Urinary Amylase: Release of digestive enzymes like amylase into the
    bloodstream.
    ● Increased WBC Count: Indicative of inflammation or infection.
    ● Elevated Blood Glucose: Insulin release impaired due to pancreatic
    inflammation.
    ● Hypocalcemia: Calcium binds to necrotic fatty acids, forming insoluble salts,
    leading to decreased serum calcium levels.

    4. What causes hypocalcemia in acute pancreatitis? How does the nurse assess
    hypocalcemia?
    Calcium binds to necrotic fatty acids in the form of insoluble salts. Assessment
    includes observing for signs of tetany, Chvostek's sign (facial muscle spasm), and
    Trousseau's sign (carpal spasm).

    5. Describe the characteristics of the pain that occurs in acute pancreatitis.


    ● Location: Severe abdominal pain in the LUQ, radiating to the back.
    ● Quality: Continuous, severe, and unrelenting.
    ● Aggravating Factors: Eating or drinking.

    6. What complications can occur with acute pancreatitis?


    ● Pancreatic Necrosis: Tissue death in the pancreas.
    ● Systemic Inflammatory Response Syndrome (SIRS): Widespread inflammation
    affecting distant organs.
    ● Abscess Formation: Collection of pus in the pancreas.

    7. Why is V.A. NPO? What is the purpose of the NG tube?


    ● NPO (Nothing by Mouth): To rest the pancreas, decrease enzyme secretion, and
    prevent stimulation of pancreatic activity.
    ● NG Tube: Reduces gastric secretion and decompresses the stomach, minimizing
    pancreatic stimulation.

    8. Identify the purpose of each medication prescribed for this patient.


    ● Morphine PCA: Manages severe pain.
    ● Pantoprazole (Protonix) IV: Reduces gastric acid secretion, preventing further
    pancreatic stimulation.

    9. Priority Decision: Based on the assessment data presented, what is the priority nursing
    diagnosis? Are there any collaborative problems?
    ● Priority Nursing Diagnosis: Acute Pain related to pancreatic inflammation and
    abdominal distension.
    ● Collaborative Problems: Potential for sepsis due to pancreatic necrosis, potential
    for fluid and electrolyte imbalance.

    You might also like