Arellano University

Jose Abad Santos Campus

College of Nursing

DEXEL LORREN R. VALDEZ

BSN-3
CASE STUDY

Acute Pancreatitis

Patient Profile
Philip, is a 55-year-old man admitted to the hospital with acute pancreatitis

Subjective Data
• Has severe abdominal pain in the LUQ radiating to the back
• States that he is nauseated and has been vomiting

Objective Data
Physical Examination
• Vital signs: Temp 101°F (38.3°C), HR 114 bpm, RR 26, BP 92/58
• Jaundice noted in sclera

Laboratory Tests
• Serum amylase: 400 U/L
• Serum lipase: 600 U/L
• Urinary amylase: 3800 U/day
• WBC count: 20,000/μL
• Blood glucose: 180 mg/dL (10 mmol/L)
• Serum calcium: 7 mg/dL (1.7 mmol/L)

Collaborative Care
• NPO status
• NG tube to low, intermittent suction
• IV therapy with lactated Ringer’s solution
• Morphine
• Pantoprazole (Protonix) IV

Discussion Questions:

1. Explain the pathophysiology of acute pancreatitis.

 Acute pancreatitis is a sudden pancreatic inflammation that can be mild or fatal but
typically goes away.
The main causes of acute pancreatitis include gallstones and alcoholism. The main
symptom is intense
abdominal pain.
2. What are the most common causes of acute pancreatitis?
-Gallstones
-Too much Consumption of Alcohol

3. How do the results of Philip’s laboratory values relate to the

pathophysiology of acute pancreatitis?
- During acute pancreatitis, blood amylase or lipase levels are frequently
three times higher than normal.

4. What causes hypocalcemia in acute pancreatitis? How does the nurse assess
for hypocalcemia?
Inborn metabolic faults, specific drugs, severe hepatic and renal disorders,
specific toxins, alcoholic ketoacidosis, and by monitoring blood glucose
levels are some of the reasons of hypoglycemia.

5. Describe the characteristics of the pain that occurs in acute pancreatitis.

Abdominal discomfort from acute pancreatitis is typically dull, monotonous,
and constant.
6. What complications can occur with acute pancreatitis?
Systemic issues are typically present in cases of acute, severe pancreatitis.
These include pulmonary
problems such adult respiratory distress syndrome and pulmonary edema.
Ascites, pancreatic pseudocyst,
pancreatic necrosis, and infectious pancreatic necrosis are examples of local
problems.

7. Why is Philip NPO? What is the purpose of the NG tube?

Due to the risk that eating may trigger an already irritated or wounded
pancreas to release pancreatic enzymes. The use of NPO and the gradual
reintroduction of meals after extended periods without food are linked to
pain relapses and longer hospital admissions.

8. Identify the purpose of each medication prescribed for this patient.

 IV therapy with lactated Ringer’s solution: the acidosis enhances
inflammation and necrosis in acute pancreatitis.
  Morphine PCA: severe pain
 Pantoprazole (Protonix) IV: pancreatic anti-secretory effect and a
pronounced inhibitory reactivity towards hydroxyl radicals.

9. Priority Decision: Based on the assessment data presented, what are the
priority nursing diagnoses? Make 2 NCP.

Assessment Diagnosis Planning Intervention Rationale Evaluation

Subjective: Severe abdominal 8 hours later 1. Give morphine. 1. to relieve and Goal met
The patient pain in the LUQ the 2. Encourage the control pain In 8 hours. after
verbally recounts radiating to the client will patient to adopt a 2. eases stress in receiving nursing
feeling sick to his back, together report comfortable position the abdomen and care, the patient will
stomach, with the patient's feeling pain- (knees flexed). increases control report feeling less
experiencing back complaints of free 3. Offer relaxation 3. encourages pain
discomfort that nausea and after techniques calm, refocuses
radiates from the vomiting, are receiving (backrubs, concentration,
LUQ, and having symptoms of nurse care. repositioning) and and may improve
been vomiting. peritoneal entertaining coping skills
irritation-related activities.
Objective: discomfort.
Vital signs:
Temp 101°F
(38.3°C)
HR 116 bpm
RR 26
BP 91/58
 Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective: abdomen pain in 4 hours The 1. Determine the 1. To evaluate whether Goal met
and vomiting patient stops characteristics gastroenteritis is present, After receiving
In addition to suggest that an vomiting and and quality of the nurse looks at the nursing care
experiencing stomach infection from experiences less the patient's characteristics of the for four
ache, the patient has bacteria in food discomfort after feces. stool. hours, the
also is causing the receiving nurse 2. Identify pain 2. To successfully treat patient
vomiting. acute abdominal care. 3. Make sure then assess whether it feels better
pain. you're properly has modified, we require and stops
Objective: hydrated; you a thorough foundation. vomiting.
Vital signs: might need IV
Temp 103°F fluids. 3. It's possible for
(39.4°C) 4. Record the patients with stomach
HR 116 bpm patient's weight discomfort to be NPO,
RR 28 and keep an eye have a low appetite, or
BP 94/58 on his intake not want to drink any
fluids. In order to
monitor and support
ideal fluid balance, the
provider might need to
be made aware of a
decreased oral intake
and the need for IV fluids
to maintain fluid balance.

4. It is possible to gauge
the patient's level of
dehydration via
the patient's weight
being measured.