Pancreatitis : Interprofessional Care

Interprofessional Care Objectives include Relief of pain Prevention or alleviation of shock Decreased pancreatic secretions Correction of fluid/electrolyte imbalance Prevention/treatment of infections Removal of precipitating cause Conservative Therapy Supportive care Aggressive hydration Pain management IV morphine, antispasmodic agent Management of metabolic complications Oxygen, glucose levels Minimizing pancreatic stimulation NPO status, NG suction, decreased acid secretion, […]

Pancreatitis : Complications

Complications Pseudocyst Fluid, enzyme, debris, and exudates surrounded by wall Abdominal pain, palpable mass, nausea/vomiting, anorexia Detected with imaging Resolves spontaneously or may perforate and cause peritonitis Surgical or endoscopic drainage Pancreatic abscess Infected pseudocyst Results from extensive necrosis May rupture or perforate Upper abdominal pain, mass, high fever, leukocytosis Requires prompt surgical drainage Systemic […]

Pancreatitis

Pancreatitis Acute Pancreatitis Acute inflammatory process of pancreas Spillage of pancreatic enzymes into surrounding pancreatic tissue causing autodigestion and severe pain Varies from mild edema to severe necrosis Etiology and Pathophysiology Gallbladder disease (women) Chronic alcohol intake (men) Smoking Hypertriglyceridemia Less common causes Trauma Viral infections Penetrating duodenal ulcers Cysts Abscesses Cystic fibrosis Kaposi sarcoma […]

Upper Gastrointestinal Bleeding : Nursing Implementation

Nursing Implementation Health Promotion Patient with a history of chronic gastritis, cirrhosis, or peptic ulcer disease is at high risk Patient who has had previous upper GI bleeding episode is more likely to have another bleed Patient on daily low-dose aspirin to reduce cardiovascular disease risk are at risk Patient teaching Avoidance of gastric irritants […]

Upper Gastrointestinal Bleeding : Nursing Management

Nursing Management Nursing Assessment Subjective Data Important Health Information Past health history: Precipitating events before bleeding episode Previous bleeding episodes and treatment Peptic ulcer disease Esophageal varices Esophagitis Acute and chronic gastritis Stress-related mucosal disease Medications: Aspirin Nonsteroidal anti-inflammatory drugs Corticosteroids Anticoagulants Functional Health Patterns Health perception–health management: Family history of bleeding Smoking Alcohol use […]

Upper Gastrointestinal Bleeding : Interprofessional Care

Interprofessional Care Endoscopic hemostasis therapy First-line therapy of upper GI bleed Goal: to coagulate or thrombose the bleeding vessel Useful for gastritis, Mallory-Weiss tear, esophageal and gastric varices, bleeding peptic ulcers, and polyps Several techniques are used including Thermal (heat) probe Multipolar and bipolar electrocoagulation probe Argon plasma coagulation (APC) Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser Mechanical therapy […]

Upper Gastrointestinal Bleeding : Diagnostic Studies

Diagnostic Studies Endoscopy Primary tool for diagnosing source of upper GI bleeding Before performing Lavage may be needed for clearer view NG or orogastric tube placed, and room-temperature water or saline used Do not advance tube against resistance Stomach contents aspirated through a large-bore (Ewald) tube to remove clots Angiography Used to diagnose only when […]

Upper Gastrointestinal Bleeding

Upper Gastrointestinal Bleeding Each year, 300,000 hospital admissions for UGI bleeding Approximately 60% of patients are older than 65 years Mortality rate has been 6% to 13% for past 45 years Etiology and Pathophysiology Most serious loss of blood from UGI characterized by sudden onset Insidious occult bleeding can be a major problem Severity depends […]

Nursing planning : Obesity

Nursing planning Overall Goals Modify eating patterns Participate in a regular physical activity program Achieve and maintain weight loss to a specified level Minimize or prevent health problems Nursing implementation Obesity is one of most challenging health problems Successful weight management can be both difficult and lifelong Treatment begins with patients understanding their weight history […]

Nursing and Interprofessional management: Obesity

Nursing and Interprofessional management: Obesity Nursing Assessment Subjective Data Important Health information First rule out physical conditions that may be causing or contributing to obesity Be sensitive and nonjudgmental Clarify rationale for inquiries about weight, dietary habits, and exercise Address patient concerns Past health history Time of obesity onset Diseases related to metabolism and obesity […]