Question

please help me with the questions. Thanks.

Case Study PIE Pancreatitis Mrs. Miller • CART Mrs. Miller is an 88 year old woman who presented with complaints of nausea, vomiting, and abdominal pain. Her vital signs on admission are temperature 99.6 F (37.6C), blood pressure 115782, pulse 84, and respiratory rate 20. Her laboratory test reveal white blood cell count (WBC) 13,000/mm3, potassium (K) aspartate aminotransferase (AST) 142 U.L, and alanine aminotransferase (ALT) 390 U/L. Physical examination reveals a distended abdomen that is very tender on palpation. Bowel sounds are present in all four quadrants, but hypoactive. Mrs. Miller is admitted with a diagnosis of acute pancreatitis. She will be kept NPO. Intravenous fluid of DS / NS with 40 mEq of potassium chloride (KCL.) per liter at 100 cc per hour is prescribed. The health care provider prescribes continued administration of her preadmission medications, that is pantoprazole sodium and levothyroxine sodium (in IV form since the client is NPO) and spironolactone (available in oral form), and adds the prescription of IV metoclopramide and morphine sulfate. A nasogastric (NG) tube is inserted and attached to low wall suction. She is scheduled to have a kidneys, ureters and bladder (KUB) abdominal X-ray in the morning. CASE STUDY Mrs. Miller's NG tube is draining yellow-brown drainage. Her pain is being managed effectively with IV morphine 4 mg every four hours She is NPO and awaiting transport to radiology for a KUB. Mrs. Miller is anxious and has many questions for the nurse: "What is the test I am having done today? What is pancreatitis? Will I need to have surgery? Why did they put this tube in my nose? When will I be able to eat real food?" Questions: 1. Briefly explain acute pancreatitis and discuss its incidence. 2. Mrs. Miller's admitting diagnosis is acute pancreatitis. Can a person have chronic pancreatitis? If so, what is the incidence, and how would you define chromic pancreatitis? 3. Discuss the common clinical manifestations of acute pancreatitis. 4. Briefly discuss the diagnostic tests that help confirm the diagnosis of pancreatitis 5. Identify the assessment findings in Mrs. Miller's case that are consistent with acute pancreatitis. 6. Mrs. Miller asks, "What is the test I am having done today?" How would the nurse describe a KUB to Mrs. Miller? 7. Identify the possible causes of acute pancreatitis. Discuss the physiology of the two major causes of acute pancreatitis in the United States, and note which individuals are at greatest risk. 8. The severity of an acute pancreatitis episode can be assessed using tow tools: (1) Ranson/Imrie criteria and (2) modified Glasgow criteria. Describe each of these tools.

Answer 1

Answer: Acute pancreatitis is a condition where there is inflammation of pancreas. It is a painful condition which becomes serious if left untreated. The incidence rate in the United States has been reported as 5 -80 per 100,000 population.

Chronic pancreatitis occurs when the pancreatitis is being left untreated. The incidence of pancreatitis is 5-12 per100,000 population. The chronic pancreatitis is a condition where there is excessive inflammation of the pancreas causes damage to it and hence it is irreversible process.

The acute pancreatitis involves the symptoms such as extreme stomach pain which is sharp and sudden. This may become more severe with time.

One of the major diagnostic test is the blood test of the patient as the blood amylase level increases 3 times than the normal conditions during the pancreatitis.