Question

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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

Discussion Questions:

1. Explain the pathophysiology of acute pancreatitis.

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

3. How do the results of V.A.’s laboratory values relate to the pathophysiology of acute pancreatitis?

4. What causes hypocalcemia in acute pancreatitis? How does the nurse assess for hypocalcemia?

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

6. What complications can occur with acute pancreatitis?

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

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

9. Priority Decision: based on the assessment data presented, what are the priority nursing diagnoses? Are there any collaborative problems?

Answer 1

1) Acute pancreatitis is an inflammation of the pancreas. It is painful, develops quickly, in some cases, it can be fatal. characterized by a loss of intracellular and extracellular compartmentation, by an obstruction of pancreatic secretory transport and also by activation of pancreatic enzymes.

2) acute pancreatitis causes are gall stones and increased intake of alcohol .

3 ) Serum amylase and lipase levels are elevated in persons with acute pancreatitis.

4) Increased circulating catecholamines in sepsis cause a shift of circulating calcium into the intracellular compartment leading to relative hypocalcemia in the body .

5) Acute pancreatitis signs and symptoms include: Upper abdominal pain. that radiates to your back which feels worse after eating. and also pain felt in the upper left side or middle of the abdomen.

6 ) The major complications are Pseudocyst which means acute pancreatitis can cause fluid and debris to collect in cystlike pockets in your pancreas diabetes , malnutrition and pancreatic cancer

7) nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose.

8) to stay hydrated IV fluids are given and pantoprozole to the pain caused by the disease .