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 (37.6?C), blood pressure 113/82, pu
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 (37.6?C), blood pressure 113/82, pulse 84, and respiratory rate 20. Her laboratory tests reveal white blood cell count (WBC) 13,000/mm3, potassium (K+) 3.2 mEq/L, lipase 449 units/L, amylase 306 units/L, total bilirubin 3.4 mg/dL, direct bilirubin 2.2 mg/dL, 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 nothing by mouth (NPO). Intravenous (IV) fluid of D51/2 NS with 40 mEq of potassium chloride (KCl) per liter at 100 mL per hour is prescribed. The health care provider prescribes continued administration of her pre-admission medications, that is, pantoprazole sodium and levothyroxine sodium (in IV form because 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.
Mrs. Miller’s NG tube is draining yellow-brown drainage. Her pain is being man- aged effectively with IV morphine 4 mg every four hours. 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?”
1. Briefly explain acute pancreatitis and discuss its incidence.
2. what are some common clinical manifestations of acute pancreatitis.
3.what are some 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.
4. what complications can arise if pancreatitis is not treated.
5. three nursing diagnoses appropriate to consider for Mrs. Miller
6. what are some dietary recommendations for a patient with acute pancreatitis
7.List three medication Mrs. Miller that he might be prescribed. Please indicate reason, action, side effect ad nursing consideration.
8 List lab that Mrs. Miller may need to be monitored.
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