Nursing Management: Acute Pancreatitis

Nursing Management: Acute Pancreatitis

  • Nursing Assessment
    • Subjective Data
      • Important Health Information
        • Past health history:
          • Biliary tract disease, alcohol use, abdominal trauma, duodenal ulcers, infection, metabolic disorders
        • Medications:
          • Thiazides
          • Nonsteroidal anti-inflammatory drugs
        • Surgery or other treatments:
          • Surgical procedures on the pancreas, stomach, duodenum, or biliary tract.
          • Endoscopic retrograde cholangiopancreatography (ERCP)
      • Functional Health Patterns
        • Health perception–health management:
          • Chronic alcohol use, fatigue
        • Nutritional-metabolic:
          • Nausea and vomiting, anorexia
        • Activity-exercise:
          • Dyspnea
        • Cognitive-perceptual:
          • Severe midepigastric or left upper quadrant pain that may radiate to the back, aggravated by food and alcohol intake and unrelieved by vomiting
    • Objective Data
      • General
        • Restlessness, anxiety, low-grade fever
      • Integumentary
        • Flushing, diaphoresis, discoloration of abdomen and flanks, cyanosis, jaundice. Decreased skin turgor, dry mucous membranes
      • Respiratory
        • Tachypnea, basilar crackles
      • Cardiovascular
        • Tachycardia, hypotension
      • Gastrointestinal
        • Abdominal distention, tenderness, and muscle guarding. Diminished bowel sounds
      • Possible Diagnostic Findings
        • Increased serum amylase and lipase
        • Leukocytosis
        • Hyperglycemia
        • Hypocalcemia
        • Abnormal ultrasound and CT scans of pancreas
        • Abnormal ERCP or MRCP
  • Nursing Diagnoses
    • Acute pain related to distention of pancreas, peritoneal irritation, obstruction of biliary tract, and ineffective pain and comfort measures
    • Deficient fluid volume related to nausea, vomiting, restricted oral intake, and fluid shift into the retroperitoneal space
    • Imbalanced nutrition: less than body requirements related to anorexia, dietary restrictions, nausea, loss of nutrients from vomiting, and impaired digestion
    • Ineffective health management related to lack of knowledge of preventive measures, diet restrictions, alcohol intake restriction, and follow-up care
  • Nursing Planning
    • The overall goals are that the patient with acute pancreatitis will have
      • Relief of pain
      • Normal fluid and electrolyte balance
      • Minimal to no complications
      • No recurrent attacks

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