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C. Interpretation of Client's Laboratory/ Diagnostic Results
C. Interpretation of Client's Laboratory/ Diagnostic Results
Test e)
indicates two
chronic fibrotic
conditions and
Decrease in
RBC count
10^9/L impairment in
the RBC
pancreas
indicates
inadequate
production of
coagulating
factors which
causes increase
in bleeding
tendencies
causing
anemia.
Abnormally
high levels of
neutrophils
indicate an
infection has
occurred in the
body. Decrease
levels of
lymphocytes in
pancreatitis
indicatespleeno
megaly due to
portal
hypertension.
Blood Novembe SGPT: 137 mg/dL 0-42 Increasing
mg/dL impaired
pancreatiticfun
ction and
hemolytic
disorders.
Increase levels
of creatinine
and urea
indicates
pancreaslimpai
rment.
hepatorenal
syndrome. Low
levels of
ionized calcium
highly suggest
an increasing
levels of
metabolic
waste is
accumulated in
the blood
stream.
Cast: renaland
3-5/hpf defects.
dysfunction.
Presene of
hyaline and
waxy cast is
severe
glomerular
damage.
Susceptibility: spontaneous
Cefoxitin, bacterial
Ceftaroline, peritonitis in
pneumonia.
Most common
is E. coli due to
their presence
in the GI tract.
---
Abdomen) AT
ZAMBOAN
GA
loss of exocrine and endocrine function results from parenchymal fibrosis. Abdominal
Cystic Fibrosis
ductal dilatation
Acinar atrophyfrom
hemorrhage (destruction
damagedof
pancreatic tissue)
blood vessels
( head part)
Stool with blood
JAUNDICE
Medical-Surgical Management
Nursing responsibilities:
condition.
Nursing responsibilities:
enlargement.
imaging test that uses dye as a medium CT-scan @ Zamboanga Del Norte
of the condition.
will check the histological status of the Liver Core Needle Biopsy @
going inflammation.
analyze the cellular component of the Needle Aspiration Biopsy not done
Nursing Responsibilities:
BEFORE Procedure:
· Before an ultrasound, the woman needs
a good explanation of what will happen.
Also tell her that it is safe for the father of
the baby to remain in the room during the
test. Other Test Done:
· To ensure that the mother has a full
bladder at the time of the procedure, she Abdominal X-ray @ Zamboanga del
should drink a full glass of water every 15
minutes beginning an hour and a half Norte Medical Center
before the procedure.
· Instruct the mother not to void before
the procedure.
DURING Procedure:
· Explain to patient the procedure and its
purpose.
· The ultrasound technician may apply a
clear gel to the skin in order to help the
transducer more freely over the body.
· Ask the patient to relax while the
procedure is going on.
AFTER Procedure:
· Allow mother to void.
· Allow the mother to take home a
photograph of the sonogram image which
can enhance bonding because it is a proof
that the pregnancy exists and that the
fetus appears well.
infections.
anti hemophilic.
Nursing responsibilities:
administer medications
monitoring.
administration.
Nursing responsibilities:
a. Low fat, high residue diet- this form a. Low fat diet
management
Outline of Nursing Management
1. TO RELIEVE PAIN
( 0-10 )scale
Assess and identify factors( medications, bed rest, diet) that may
orthostatic hypotension
Assess pt. heart rate, blood pressure and capillary refill time. Note for
Protect pt. from physical injury such as falls and abrasions. Monitor
Monitor urine output every hour. Note for sudden changes in the
volume.
components.
5. TO MAINTAIN ADEQUATE HYDRATION
The pancreas is a glandular organ in the upper abdomen, but really it serves as two
glands in one: a digestive exocrine gland and a hormone-producing endocrine gland.
Functioning as an exocrine gland, the pancreas excretes enzymes to break down the
proteins, lipids, carbohydrates, and nucleic acids in food. Functioning as an endocrine
gland, the pancreas secretes the hormones insulin and glucagon to control blood sugar
levels throughout the day. Both of these diverse functions are vital to the body’s
survival
Anatomy of the pancreas:
The pancreas is an elongated, tapered organ located across the back of the abdomen,
behind the stomach. The right side of the organ (called the head) is the widest part of
the organ and lies in the curve of the duodenum (the first section of the small
intestine). The tapered left side extends slightly upward (called the body of the
pancreas) and ends near the spleen (called the tail).
The pancreas is made up of two types of glands:
exocrine
The exocrine gland secretes digestive enzymes. These enzymes are secreted
into a network of ducts that join the main pancreatic duct, which runs the
length of the pancreas.
endocrine
The endocrine gland, which consists of the islets of Langerhans, secretes
hormones into the bloodstream.
Gross Anatomy
The pancreas is a narrow, 6-inch long gland that lies posterior and inferior to the
stomach on the left side of the abdominal cavity. The pancreas extends laterally and
superiorly across the abdomen from the curve of the duodenum to the spleen. The
head of the pancreas, which connects to the duodenum, is the widest and most medial
region of the organ. Extending laterally toward the left, the pancreas narrows slightly
to form the body of the pancreas. The tail of the pancreas extends from the body as a
narrow, tapered region on the left side of the abdominal cavity near the spleen.
Glandular tissue that makes up the pancreas gives it a loose, lumpy structure. The
glandular tissue surrounds many small ducts that drain into the central pancreatic
duct. The pancreatic duct carries the digestive enzymes produced by endocrine cells
to the duodenum.
Microscopic Anatomy
The pancreas is classified as a heterocrine gland because it contains both endocrine
and exocrine glandular tissue. The exocrine tissue makes up about 99% of the
pancreas by weight while endocrine tissue makes up the other 1%. The endocrine
tissue is arranged into many small masses known as acini. Acini are small raspberry-
like clusters of exocrine cells that surround tiny ducts. The exocrine cells in the acini
produce digestive enzymes that are secreted from the cells and enter the ducts. The
ducts of many acini connect to form larger and larger ducts until the products of many
acini run into the large pancreatic duct.
The endocrine portion of the pancreas is made of small bundles of cells called islets of
Langerhans. Many capillaries run through each islet to carry hormones to the rest of
the body. There are 2 main types of endocrine cells that make up the islets: alpha cells
and beta cells. Alpha cells produce the hormone glucagon, which raises blood glucose
levels. Beta cells produce the hormone insulin, which lowers blood glucose levels.
Physiology of the Pancreas
Digestion
The exocrine portion of the pancreas plays a major role in the digestion of food. The
stomach slowly releases partially digested food into the duodenum as a thick, acidic
liquid called chyme. The acini of the pancreas secrete pancreatic juice to complete the
digestion of chyme in the duodenum. Pancreatic juice is a mixture of water, salts,
bicarbonate, and many different digestive enzymes. The bicarbonate ions present in
pancreatic juice neutralize the acid in chyme to protect the intestinal wall and to create
the proper environment for the functioning of pancreatic enzymes. The pancreatic
enzymes each specialize in digesting specific compounds found in chyme.
The alpha cells of the pancreas produce glucagon. Glucagon raises blood
glucose levels by stimulating the liver to metabolize glycogen into glucose
molecules and to release glucose into the blood. Glucagon also stimulates
adipose tissue to metabolize triglycerides into glucose and to release glucose
into the blood.
Insulin is produced by the beta cells of the pancreas. This hormone lowers
blood glucose levels after a meal by stimulating the absorption of glucose by
liver, muscle, and adipose tissues. Insulin triggers the formation of glycogen
in the muscles and liver and triglycerides in adipose to store the absorbed
glucose.
The endocrine system uses 2 hormones to regulate the digestive function of the
pancreas: secretin and cholecystokinin (CCK).
The pancreas’ soft, spongy, tissue is very blood-rich, but its texture makes it
extremely difficult to suture.
Tumors are often advanced by the time they are detected.
Due to the complexities, candidates for surgery are often strongly advised to seek
their treatment in a facility that conducts a higher volume of such procedures.
Functions of the pancreas:
The pancreas has digestive and hormonal functions:
The enzymes secreted by the exocrine gland in the pancreas help break down
carbohydrates, fats, proteins, and acids in the duodenum. These enzymes
travel down the pancreatic duct into the bile duct in an inactive form. When
they enter the duodenum, they are activated. The exocrine tissue also secretes
a bicarbonate to neutralize stomach acid in the duodenum.
The hormones secreted by the endocrine gland in the pancreas are insulin and
glucagon (which regulate the level of glucose in the blood), and somatostatin
(which prevents the release of the other two hormones).
PT. RT HEIGHT: 5’6 WT: 55KLS.
Conjunctiva is pale
ALTERED BOWEL
ELIMINATION R/T
CONSTIPATION
Name of DoseFrequen
Date Mechanismof Specifi
Drug Classification cyRoute&Ti SideEffects Nursing
Ordere Action cIndicati
Generic and me Responsibilities
d on
Brand Name
Metronidazole November Antibiotic Dose:500mg Inhibits growth of - To treat CNS: headache, Before:
30, 2017 amoebae by infectio dizziness, lethargy,
(flagyl) Antibacterial 1. Assess pt.
Frequency: q 8 bindng to DNA, n with paresthesias
infection.
Amebecide resulting in loss of suscepti 2. Observe the 10
helical structure, GI: nausea,
hours be R’s befor giving
antiprotozoal stand breakage, vomiting, diarrhea,
anaerob the drug.
inhibition of anorexia, 3. Instruct to take
ic
Route: IVTT abdominal pain, the drug with
nucleic acid bacteria
flatulence, food or milk to
(ANST (-) ) synthesis and cell - -to treat
pseudomembranou decrease GI
death. intestina
s colitis, diarrhea upset
l During:
Time: 8am-4pm-
- amoebia
sis 1. Monitor pt. for
12mn
unusualities.
2. Inform that drug
may turn urine
brown
3. Watch carefully
for edema
because it may
cause sodium
retention
After:
1. Report
immediately to
doctor if any
unusualities
occur.
Name of DoseFreque
Date Mechanismo Specific
Drug Classification ncyRoute& SideEffects Nursing
Ordere fAction Indicatio
Generic and Time Responsibilities
d n
Brand Name
CIPROFLOXACIN November Anti-infectives Dose:400mg Inhibits bacterial -to treat CNS: dizziness, Before:
30 2017 DNA synthesis by infections of the headache,
1. Assess pt. BP
Frequency: q 12 inhibiting DNA. skin, lungs, insomnia
prior to drug
airways, nones administration
Death of and joints GI:abdominal
hours 2. Assess for
susceptible caused ny pain, nausea
infection prior
bacteria, spectrum susceptible to and during
Route: IVTT broad activity GU:intestinal
bacteria. therapy
includes many cystitis
During:
gram positive -to treat urinary
pathogens. infections Obtain
Endo: specimens for
culture and
hyperglycemia,
sensitivity
hypoglycemia before initiating
therapy
Observe any
unusualities
After:
1. Report to doctor
for any signs
and symptoms
of anaphylaxis(
rash, pruritus,
laryngeal
edema,
wheezing)
2. Discontinue
drug and notify
physician
immediately if
these problems
occur.
DRUGSTUDY
Name of DoseFreque
Date Mechanismo Specific
Drug Classification ncyRoute&T SideEffects Nursing
Ordere fAction Indicatio
Generic and ime Responsibilities
d n
Brand
VIT.Name
K November Blood Dose:1 amp Promotes hepaic To treat and Dizziness, Before:
30, 2017 coagulation formation of prevent diaphoresis,
1. Assess skin
modifier Frequency: q 8 coagulation factor hemorrhage rapid/weak pulse,
hypotension, chest 2. Assess urine for
Essential for pain and dyspnea hematuria
hours 3. Assess HCT,
ormal clotting of
platelet counts,
blood. urine and stool
Route: IVTT culture.
Readily absorbed
4. Assess vital
from GI tract( signs
duodenum) after
IM, subcutaneous
administration During:
metabolized in
Obtain R’s
liver. Excreted in
Advise pt. to
urine, eliminated
report
by biliary system immediately
onset of action( any
increase unusualities.
coagulation After:
factors)
1. Report
immediately to
doctor.
1. Severe allergic
reactions such as
rash, hives,itching,
dyspnea,tightness in
the chest should be
reorted
immediately.
Nursing Care Plan
Physical
injuries
causes skin
5. Monitor the pt. breakdown.
urine output Due to
every hour. altered
Note for production of
sudden clotting
changes of factors, the
urine output pt. could face
and color. increase risk
6. Check pt. of bleeding.
laboratory Bleeding can
values such as decreases the
hemoglobin circulating
levels, blood
hematocrit, volume by
and RBC shunting it to
count. the vital
7. Instruct pt. to organs
avoid straining causing
during alteration of
defecation. perfusion to
8. Encourage pt. the other
to use soft- tissues as
bristled well.
tootbrush Urine output
when brushing reflects the
one’s teeth. perfusion
9. Provide status of the
adequate rest body.
periods for the Decrease
patient. urine output
indicated
alteration in
Dependent: tissue
1. Administer perfusion.
oxygen as
prescribed by
the doctor. Reduction of
2. Administer hemoglobin
clotting factors and RBC
as prescribed. levels causes
Collaborative: reduction of
1. Anticipate for oxygen
blood perfusion on
transfusion the tissues.
procedure to
replenish and
supply Straining
adequate blood causes blood
components. vessels in the
anal area to
erupt causing
bleeding.
Vigorous
brushing of
teeth causes
bleeding
gums to pt.
with
impaired
clotting
production.
Increase rest
periods
decreases
oxygen
consumption
and demand
of the heart,
making the
heart to
pump
effectively.
Supplemental
oxygen
increases the
oxygen
content of the
blood needed
for the
tissues.
Clotting
factors are
needed to
prevent
episodes of
bleeding.
Blood
transfusion is
need when
there is
decreases
blood
volume in the
circulation to
improve
tissue
perfusion.
Conclusion:
Pancreatitis, which is the inflammation of the pancreas, can be acute or chronic in nature.
It may be caused by edema, necrosis or hemorrhage. In men, this disease is commonly
associated to alcoholism, peptic ulcer or trauma; in women, it’s associated to biliary tract
disease. Prognosis is usually good when pancreatitis follows biliary tract disease, but
poor when the factor is alcoholism. Mortality rate may go as high as 60% when the
disease is associated from necrosis and hemorrhage. (Schilling McCann, 2009)
Pancreatitis ranges from a mild, self-limited disorder to a severe, rapidly fatal disease that
does not respond to any treatment.
A prolonged period is needed to regain the strength of a patient who has experienced
pancreatitis and to return to the previous level of activity.
b. Websites
www.emedicine.medscape.com
www.mayoclinic.org
www.rnspeak.com
www.ncbi.org