Acute Pancreatitis
This intervention is the nurse’s first priority when a patient with acute pancreatitis presents with pale skin, weak pulses, abdominal distention, and a CVP of 2 mmHg.
What is administering intravenous fluids?
Critically ill patients who are NPO >24 hours require this intervention to maintain immune function and prevent gut atrophy.
What is timely assessment and administration of nutritional support?
Large-volume IV crystalloid infusion is used to treat dehydration from this process caused by hyperglycemia.
What is osmotic diuresis?
Tachycardia, hypotension, syncope, cyanosis, and decreased bowel sounds indicate this emergent condition requiring immediate IV fluids.
What is hypovolemic shock from an upper GI bleed?
Patients with cirrhosis may develop respiratory distress because this condition causes abdominal pressure that impairs breathing.
What is ascites?
Low oxygen levels unresponsive to O₂, fever, abnormal lung sounds, and patchy infiltrates on chest X-ray may indicate this life-threatening complication of pancreatitis.
What is acute respiratory distress syndrome (ARDS)?
Continuous enteral nutrition should begin within this time frame in critically ill, intubated patients, even without bowel sounds.
What is within 24 hours?
A pH of 7.30, HCO₃⁻ of 18, and PaCO₂ of 28 reflect this type of acid-base disorder.
What is metabolic acidosis (partially compensated)?
Binge drinking followed by forceful vomiting is a classic cause of this upper GI tear.
What is a Mallory-Weiss tear?
Lactulose improves mental status in hepatic encephalopathy by removing this neurotoxin.
What is ammonia?
Fever, tachycardia, and worsening abdominal distention in a patient with pancreatitis indicate this serious systemic complication.
What is sepsis?
Generalized edema, sloughing skin, hair loss, and low albumin levels are hallmark assessment findings of this condition.
What is malnutrition?
Insulin administration in DKA is delayed when potassium is 3.0 mEq/L because insulin causes this shift.
What is shifting potassium into cells (leading to hypokalemia)?
Tachycardia, fever, and a rigid “board-like” abdomen in a patient with SBO are signs of this complication.
What is bowel ischemia or perforation?
TPN is administered through a dedicated IV line primarily to reduce this risk.
What is catheter or formula contamination?
This hallmark pain of acute pancreatitis is described as severe, deep, and boring, often radiating to the back and worsening after eating.
What is mid-epigastric pain that radiates to the back and worsens post-prandially?
Serum albumin, prealbumin, total protein, and electrolytes are labs used to assess this patient condition associated with poor wound healing and infection risk.
What is severe malnutrition?
Patients recovering from DKA are taught to prevent recurrence by continuing this even when not eating.
What is taking insulin as prescribed?
In a lower GI bleed, this serial lab monitoring is the nurse’s top priority.
What are hemoglobin and hematocrit (H&H)?
In patients with variceal bleeding, supplemental oxygen, NPO status, Foley insertion, and ICU admission are all part of this phase of care.
What is initial management of upper GI hemorrhage?
These two labs are most commonly elevated and help confirm a diagnosis of acute pancreatitis.
What are serum amylase and lipase?
Prolonged lack of enteral nutrition may lead to GI atrophy and this life-threatening complication.
What is sepsis?
The anion gap is elevated in DKA because of the accumulation of these acids.
What are ketoacids?
Octreotide is administered in variceal bleeding because it reduces this major underlying cause.
What is portal hypertension?
Patients with pancreatitis are at risk for ARDS because inflammation travels from this organ system to the lungs.
What is the pancreas (systemic inflammatory response)?