CASE STUDY

Acute Pancreatitis

Patient Profile

V.A. is a 55-year-old man admitted to the hospital with acute pancreatitis.

Subjective Data

• Has severe abdominal pain in the LUQ radiating to the back

• States that he is nauseated and has been vomiting

Objective Data

Physical Examination

• Vital signs: Temp 101°F (38.3°C), HR 114 bpm, RR 26, BP 92/58

• Jaundice noted in sclera

Laboratory Tests

• 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)

Collaborative Care

• NPO status

• NG tube to low, intermittent suction

IV therapy with lactated Ringer's solution

Morphine PCA

Pantoprazole (Protonix) IV .

Questions:

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?

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