Question

Case Study #1: Caring for Clients With Disorders of the Liver, Gallbladder, or Pancreas

Lewis Day, a 38-year-old male client, is admitted to the hospital with acute pancreatitis. He has a long history of drinking a 6-pack of beer daily and smokes 2 packs of cigarettes per day. He complains of severe midepigastric pain radiating straight to his back, which is worse after eating. He has nausea, vomiting, flatulence, and assumes a fetal position to get relief from the pain he rates as 8/10. The nurse notes absent bowel sounds, abdominal distention, and the abdomen is tender to palpation. The vital signs are T, 100°F; BP, 100/70 mm Hg; HR, 100 beats/minute; RR, 24 breaths/minute and shallow. The labs reveal elevated serum and urine amylase, lipase, and liver enzymes. The potassium level is low, and the glucose level is elevated. The abdominal ultrasound shows pancreatic inflammation. The nurse performs a head-to-toe assessment and notes the lungs are clear anterior and posterior. The client has no known allergies. The LPN/LVN needs to provide nursing management for the client.

a. What treatment should the nurse anticipate?

b. What nursing management will the client need?

Answer 1

Question no 1

Patient is suffering from acute pancreatic and can be managed by using

1. Pain management with the help of opioid or non opioid analgesics can be anticipated as management
2. Prophylactic antibiotics can be administered to the patient to avoidinfection in the individual
3. SPHINCTEROTOMY can be done using a very small wire  on the endoscope, a surgen will specifically  find the muscle that surrounds the pancreatic duct of the individual or the bile duct of the individual  and will make a tiny cut to enlarge the duct opening and will drain the duct
4. STENT PLACEMENT -Using the endoscope, a surgen will places a tiny piece of metal or plastic  that will look like a straw into a narrowed bile duct or pancreatic duct
5. BALLOON DILATATION endoscopes have a very small balloon that the surgen uses to stretch or dialate , a narrowed pancreatic or bile duct of an individual . A temporary stent can be placed for a few months to keep the duct open in the individual  
6. Antipyretic mediaction can be given for temperature regulation

These are the main treatment can be anticipated.  

Question no 2

Nursing management of the patient

1. Adherence to the treatment protocol is the most important nursing intervention
2. comfortable devices can be given to the patient to maintain comforf
3. Cold application can help to relive pain
4. Pain management by administering the analgesics
5. Low pottasium level can be managed by administration of potassium to the client and pottasium rich diet has to be given to the patient .
6. Antihyperglycemic medication as well as insulin can be given to reduce the elevated glucose level in body
7. Tachycardia has to be managed by providing rest as well as providing beta blockers
8. Antiemetiemetics can be given to manage vomiting in the individual's
9. Flatulence can be removed by using a flatulance tube if condition persists
10. Medications has to be given at correct time to the individual