Pathophysiology and Diagnostics
Why would the patient with pancreatitis be on strict NPO?
To avoid secretion of digestive enzymes
The patient's hemoglobin is 6.5, what other lab test should you make sure has been completed?
type and screen
Which universal self care requisites are compromised by NPO status?
ability to maintain sufficient intake of food and water
The priority NANDA is acute pain; why are there no NSAIDS in the patient orders?
AKI
(Cr 1.36)
Which quadrant is the pancreas in?
left upper quadrant
The patient is prescribed Zofran IV push for nausea and vomiting, what is the ideal push rate?
2-4 minutes
Why is it important to perform the ordered q8h neuro checks?
assess alcohol withdrawal
Which vitals (4) can you monitor for risk for imbalanced fluid volume?
blood pressure, pulse, temperature, oxygen saturation
What might be the presenting symptoms of pancreatitis?
abdominal pain, nausea, vomiting
The patient has been prescribed 1g Ceftriazone QD for UTI, what are common side effects to monitor for?
diarrhea, nausea, vomiting
What can you assess during the HTT to get an idea of fluid status?
skin turgor
To replace fluid volume, what IV solution would you expect the patient with EtOH withdrawal to be on?
Banana Bag
What changes in vitals might you expect with pancreatitis?
tachycardia, fever
(Pt vitals: HR 102, T 39)
The toal bilirubin comes back as 2.8 mg/dL, what potential diagnosis are you concerned about?
Cirrhosis
The patient is able to get up to go to the bathroom, but occasionally needs help due to severe pain - what nursing system do they require?
partially compensatory - severe pain limits full ADLs
When the patient is able to tolerate oral intake again to improve imbalanced nutrition, what diet orders do you think the provider will place?
clear liquids
How can alcoholism cause pancreatitis?
alcohol can cause intracellular accumulation of digestive enzumes, and their premature activation and release
Which lab value would you expect to be elevated with pancreatitis?
Amylase, Lipase
(Pt lipase: 6,374)
What bedside imaging test can be done to visualize the pancreas for abnormalities?
Ultrasound
Which lab will you monitor to assess nutritional status as the patient remains to have imbalanced nutrition: less than body requirements?
Albumin
(last value 3.3)