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Pacncreatitis Case Study. This paper summarizes the publishings of Doenges, Moorhouse, and Murr (2010) and Christenson and Kockrow (2011) which describes the disease process pancreatitis. Christenson et al. (2011) discusses common signs and sympt

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Introduction

Pancreatitis PFC Bell ABSTRACT This paper summarizes the publishing's of Doenges, Moorhouse, and Murr (2010) and Christenson and Kockrow (2011) which describes the disease process pancreatitis. Christenson et al. (2011) discusses common signs and symptoms patients experience with pancreas disorders. Doenges et al. (2010) discusses the most common diagnostic techniques and the most popular medical and nursing management procedures that are practiced today. Christenson et al. (2010) defines the abbreviation AST as Aspartate aminotransferase and ALT as alanine aminotransferase. Both of these publishing's have the same definitions of pancreatitis and both suggest that lifestyle changes, medications, and surgical intervention may be necessary to decrease the chance of more acute episodes. On Wednesday September 28 CS 51-year-old man, with recent laparoscopic cholecystectomy, presented to the emergency department with complaints of severe abdominal pain. The episode started around 1100 and was initially mild. He was able to eat normally, but around 1400, the pain became much worse to the point that he had difficulty breathing. He took an oxycodone, which provided little relief. CS found that flexing his hips and staying still helped relieve the pain. He described the pain as cramping and wrapping around to his back, worse on the right side. ...read more.

Middle

In chronic pancreatitis with loss of pancreatic functions, Doenges et al. (2010) stated that replacement enzymes, such as pancreatin (Dizymes) and pancrelipase (Protilase and Cotazym) can be prescribed to correct shortages to promote digestion and absorption of nutrients. On Wednesday September 28 CS, 51-year-old man, with recent laparoscopic cholecystectomy, presented to the emergency department with complaints of severe abdominal pain. The episode started around 1100 and was initially mild. He was able to eat normally, but around 1400, the pain became much worse to the point that he had difficulty breathing. He took an oxycodone without relief. Flexing his hips and staying still helped relieve the pain. He describes the pain as cramping and wrapping around to his back, worse on the right side. He has associated nausea, but no emesis. In the ER he was given diluadid, which broke the pain and now feels like his normal self. He has had 4-5 episodes like this since June and has not seen improvement since the cholecystectomy. In CSs' case he is believed to have chronic pancreatitis. CS described his severe pain as a cramping and twisting sensation, which radiates to the right side of his back. ...read more.

Conclusion

Meals given too early may worsen symptoms. Risk for unstable blood glucose level related to pancreatic impairment. Patient will maintain glucose in normal range of 80-100 until discharge. Assess for signs of increased thirst and urination or changes in mental status and sight. This may indicate the developing of hyperglycemia. Perform and monitor results of bedside fingerstick glucose testing and dipstick testing of urine for sugar. Early detection of inadequate glucose utilization makes it easier to manage. Monitor serum glucose levels closely, as this can indicate the need for insulin because hyperglycemia is frequently present. Discharge planning begins the moment the patient arrives on the floor. Patients' pain should be relieved or controlled at a reasonable level such as a 3/10 on the pain scale. They should be stable, meaning they are within normal limits concerning vital signs. The patient should understand the disease process of pancreatitis, potential complications, and therapeutic regimen understood. The patient was not discharged home with any new medications. Patient should also understand that alcohol can increase chances of re-occurrence. A referral to a support group may be needed. The patient should let his wife know that she will need to be there to take him home when he is discharged. ...read more.

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