Pancreatitis : Nursing Implementation

  • Nursing Implementation
    • Health Promotion
      • Assessment of patient for predisposing and etiologic factors
      • Encouragement of early treatment of these factors
      • Early diagnosis/treatment of biliary tract disease
      • Elimination of alcohol intake
    • Acute Care
      • Monitoring vital signs
      • Monitor response to IV fluids
      • Closely monitor fluid and electrolyte balance
      • Assess respiratory function
      • Monitor fluid and electrolyte balance
        • Chloride, sodium, and potassium
        • Hypocalcemia
          • Tetany
          • Calcium gluconate to treat
            • Chvostek’s sign is contraction of facial muscles in response to a light tap over the facial nerve in front of the ear.
            • Trousseau’s sign is a carpal spasm induced by
            • Inflating a blood pressure cuff above the systolic pressure for a few minutes.
        • Hypomagnesemia
      • Pain assessment and management
        • Morphine
        • Position of comfort with frequent position changes
          • Flex trunk and draw knees to abdomen
          • Side-lying with head of bed elevated 45 degrees
        • Frequent oral/nasal care
        • Proper administration of antacids
        • Observation for signs of infection
        • TCDB, semi-Fowler’s position
        • Wound care
        • Observation for paralytic ileus, renal failure, mental changes
        • Monitor serum glucose
        • Post-op wound care
    • Ambulatory Care
      • Physical therapy
      • Assessment of opioid addiction
      • Counseling regarding abstinence from alcohol and smoking
      • Dietary teaching
        • Low-fat, high-carbohydrate
        • No crash diets
      • Patient/family teaching
        • Signs of infection, diabetes mellitus, steatorrhea
        • Medications/diet
      • Expected Outcomes
        • Have adequate pain control
        • Maintain adequate fluid volume
        • Be knowledgeable about treatment regimen
        • Get help for alcohol dependence and smoking cessation (if appropriate)

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