V.A. is a 55-year-old man admitted to the hospital with acute pancreatitis.
• Has severe abdominal pain in the LUQ radiating to the back
• States that he is nauseated and has been vomiting
• Vital signs: Temp 101°F (38.3°C), HR 114 bpm, RR 26, BP 92/58
• Jaundice noted in sclera
• Serum amylase: 400 U/L (6.67 mkat/L)
Serum lipase: 600 U/L
Urinary amylase: 3800 U/day
• WBC count: 20,000/L
Blood glucose: 180 mg/dL (10 mmol/L)
• Serum calcium: 7 mg/dL (1.7 mmol/L)
• NPO status
• NG tube to low, intermittent suction
IV therapy with lactated Ringer's solution
Pantoprazole (Protonix) IV .
1. Explain the pathophysiology of acute pancreatitis.
2. What are the most common causes of acute pancreatitis?
3. How do the results of V.A.'s laboratory values relate to the pathophysiology of acute pancreatitis?
4. What causes hypocalcemia in acute pancreatitis? How does the nurse assess for hypocalcemia?
5. Describe the characteristics of the pain that occurs in acute pancreatitis.
6. What complications can occur with acute pancreatitis?
7. Why is V.A. NPO? What is the purpose of the NG tube?
8. Identify the purpose of each medication prescribed for this patient.
9. Priority Decision: Based on the assessment data presented, what are the priority nursing diagnoses? Are there any collaborative problems?