Watch More! Unlock the full videos with a FREE trial
Add to Study plan
Master
Included In This Lesson
Study Tools
Acute Pancreatitis Interventions (Picmonic)
Acute Pancreatitis Assessment (Picmonic)
Pancreas (Picmonic)
Pancreatitis Pathochart (Cheat Sheet)
Access More! View the full outline and transcript with a FREE trial
Transcript
Hey guys, in this care plan, we will discuss pancreatitis. In this care plan on pancreatitis, we will cover the desired outcome, the subjective and objective data along with the nursing interventions and rationales.
Our medical diagnosis is pancreatitis. Pancreatitis is when the pancreas is literally digested by its own proteolytic enzymes, which is going to cause inflammation of the pancreas. The enzymes may be prematurely activated by the obstruction of gallstones in the bile duct. Acute pancreatitis is usually caused by gallstones, alcohol intake, hypercalcemia medications, cancer, hypertriglyceridemia, or an autoimmune disease. Chronic pancreatitis may occur after recurrences of acute pancreatitis. Maybe the patient continues to drink alcohol over and over. They're going to keep getting pancreatitis until it becomes chronic. Our desired outcome is the absence of obstruction, inflammation, or infection of the pancreas in the bowel duct. The patient will be free from pain and vomiting.
Let's take a look at our pancreatitis care plan. The subjective data of our patient may include abdominal pain. It may be midepigastric and it could radiate to the back. I sometimes have patients that have so much abdominal pain, and then I've even had some that have pancreatitis and they don't experience any, so it just kind of depends. The patient might be experiencing anorexia from not wanting to eat because it causes more pain when the pancreas makes those insights. The patient might have nausea, especially after eating because of those digestive enzymes secreted by the already inflamed pancreas.
Now let's look at our objective data. The patient might experience some vomiting, especially after eating because of those digestive enzymes secreted by the pancreas. They might have a fever from inflammation or infection brewing. You may see that they have some dry mucous membranes, especially if they're dehydrated, and their abdomen may become rigid from that peritoneal irritation by the excessive enzyme secretion into the abdominal cavity. Look out for hypotension. The patient might have that because of the hydration, their lipase and amylase levels are probably going to be elevated because that's something that's secreted by the pancreas normally. So, when it's inflamed, it's going to excrete more than usual.
Now, let's look at our nursing interventions and the rationales for each. So as the nurse, you're going to assess your patient and monitor their vital signs. Look for signs of hypovolemia and infection in your patient. Look for elevated temperature because fever is a sign of infection and distress response. Look for hypotension and tachycardia because those are signs of hypovolemia or not getting enough fluid, and that can lead to shock. You want to assess and manage your patient's pain. Remember, this can be very painful. Administer pain medications as ordered by the doctor and try to work with positioning them to help relieve the abdominal pain. You may want to put them in a semi-Fowler's position to decrease the pressure of the abdomen. Monitor your patient's lab values. You want to look at the lipase amylase and even glucose levels, remember, that insulin secreted by the pancreas. The lipase level could be elevated for up to 12 days after, but the amylase actually returns to normal within a few days.
Our next nursing intervention is to administer medications as ordered by the doctor. You might want to give medications that will help to address that stomach acid and the hyperglycemia if they have it, then of course, pain medicine. Our next nursing intervention for pancreatitis is nutritional monitoring and education. You know, a lot of times patients want to keep eating, but you have to explain to them, listen, you have to rest your pancreas, allow it to rest. Just don't eat or drink anything. We'll advance the diet as tolerated and ordered by the doctor when you're not experiencing pain anymore. Parenteral nutrition might have to be given, and in really severe cases, to inhibit the stimulation of pancreatic enzymes and decrease the metabolic stress.
Our next nursing intervention is to assess the fluid and electrolyte balance. This is important because they might not be eating and drinking as much, right? Ensure hydration per IV fluids when they're NPO, check their mucous membranes, make sure they're nice and moist. Keep an eye on their eyes and nose. You might have to give aggressive IV hydration as ordered by the doctor. Our last nursing intervention is to encourage lifestyle changes. You want to try to help them avoid the recurrence of this pancreatitis. The doctor will talk to them about what they think caused this. Maybe it was excessive alcohol intake, maybe it was a certain drug that they're taking, so, just encourage them to stop. Whatever was causing that, encourage them to eat a healthy diet. That's always an important hydration exercise to maintain an appropriate weight. Also discuss a low-fat diet because this is going to help them to improve any hypertriglyceridemia that's.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
Our medical diagnosis is pancreatitis. Pancreatitis is when the pancreas is literally digested by its own proteolytic enzymes, which is going to cause inflammation of the pancreas. The enzymes may be prematurely activated by the obstruction of gallstones in the bile duct. Acute pancreatitis is usually caused by gallstones, alcohol intake, hypercalcemia medications, cancer, hypertriglyceridemia, or an autoimmune disease. Chronic pancreatitis may occur after recurrences of acute pancreatitis. Maybe the patient continues to drink alcohol over and over. They're going to keep getting pancreatitis until it becomes chronic. Our desired outcome is the absence of obstruction, inflammation, or infection of the pancreas in the bowel duct. The patient will be free from pain and vomiting.
Let's take a look at our pancreatitis care plan. The subjective data of our patient may include abdominal pain. It may be midepigastric and it could radiate to the back. I sometimes have patients that have so much abdominal pain, and then I've even had some that have pancreatitis and they don't experience any, so it just kind of depends. The patient might be experiencing anorexia from not wanting to eat because it causes more pain when the pancreas makes those insights. The patient might have nausea, especially after eating because of those digestive enzymes secreted by the already inflamed pancreas.
Now let's look at our objective data. The patient might experience some vomiting, especially after eating because of those digestive enzymes secreted by the pancreas. They might have a fever from inflammation or infection brewing. You may see that they have some dry mucous membranes, especially if they're dehydrated, and their abdomen may become rigid from that peritoneal irritation by the excessive enzyme secretion into the abdominal cavity. Look out for hypotension. The patient might have that because of the hydration, their lipase and amylase levels are probably going to be elevated because that's something that's secreted by the pancreas normally. So, when it's inflamed, it's going to excrete more than usual.
Now, let's look at our nursing interventions and the rationales for each. So as the nurse, you're going to assess your patient and monitor their vital signs. Look for signs of hypovolemia and infection in your patient. Look for elevated temperature because fever is a sign of infection and distress response. Look for hypotension and tachycardia because those are signs of hypovolemia or not getting enough fluid, and that can lead to shock. You want to assess and manage your patient's pain. Remember, this can be very painful. Administer pain medications as ordered by the doctor and try to work with positioning them to help relieve the abdominal pain. You may want to put them in a semi-Fowler's position to decrease the pressure of the abdomen. Monitor your patient's lab values. You want to look at the lipase amylase and even glucose levels, remember, that insulin secreted by the pancreas. The lipase level could be elevated for up to 12 days after, but the amylase actually returns to normal within a few days.
Our next nursing intervention is to administer medications as ordered by the doctor. You might want to give medications that will help to address that stomach acid and the hyperglycemia if they have it, then of course, pain medicine. Our next nursing intervention for pancreatitis is nutritional monitoring and education. You know, a lot of times patients want to keep eating, but you have to explain to them, listen, you have to rest your pancreas, allow it to rest. Just don't eat or drink anything. We'll advance the diet as tolerated and ordered by the doctor when you're not experiencing pain anymore. Parenteral nutrition might have to be given, and in really severe cases, to inhibit the stimulation of pancreatic enzymes and decrease the metabolic stress.
Our next nursing intervention is to assess the fluid and electrolyte balance. This is important because they might not be eating and drinking as much, right? Ensure hydration per IV fluids when they're NPO, check their mucous membranes, make sure they're nice and moist. Keep an eye on their eyes and nose. You might have to give aggressive IV hydration as ordered by the doctor. Our last nursing intervention is to encourage lifestyle changes. You want to try to help them avoid the recurrence of this pancreatitis. The doctor will talk to them about what they think caused this. Maybe it was excessive alcohol intake, maybe it was a certain drug that they're taking, so, just encourage them to stop. Whatever was causing that, encourage them to eat a healthy diet. That's always an important hydration exercise to maintain an appropriate weight. Also discuss a low-fat diet because this is going to help them to improve any hypertriglyceridemia that's.
We love you guys. Now, go out and be your best self today and as always, happy nursing!
View the FULL Transcript
When you start a FREE trial you gain access to the full outline as well as:
- SIMCLEX (NCLEX Simulator)
- 6,500+ Practice NCLEX Questions
- 2,000+ HD Videos
- 300+ Nursing Cheatsheets
“Would suggest to all nursing students . . . Guaranteed to ease the stress!”
