543 CASE SCENARIO. ELEVATED LFT,PANCREATITIS.

Follow doctor orders,your hospital policy and procedures.

An inflammation of the pancreas. It can be Acute pancreatitis or Chronic pancreatitis. Acute pancreatitis is generally due to Alcoholism, certain drugs, trauma or infection.Characterize by severe pain that radiates to the back,nausea and vomiting,fever and possible anorexia.

If the Common bile duct is obstructed Jaundice will develop. Complications such as Pseudocyst or Abcess in the pancreas may develop.

DIAGNOSTIC TESTS:

Physical Assessment.

Endoscopy.

Laboratory analysis to find out the level of Pancreatic enzymes in the blood.

TREATMENT.

Pain management.

NPO

Hydration intravenously.

Ngt placement.

Chronic Pancreatitis treatment is the same as acute pancreatitis.

Check for calcification and scarring of the smaller Pancreatic ducts,Abdominal pain, nausea, vomiting,

Steatorrhea,and creatorhea due to decreased output of Pancreatic enzymes.

Some patients will develop diabetes Mellitus due diminished insulin production by the pancreas.

TREATMENT.

Pain control.

Subtotal Pancreatectomy if pain is intractable. Pancreatic extract given.

KINGDOM OF GOD HOSPITAL LOS ANGELES CALIFORNIA 900000.INTERDISCIPLINARY KARDEX. Age/ Sex 65years old female.

Account number : Q005234372.

MR# Q00069593424.

Admitted date : 05/22/2021 @04 am.

Status : Inpatient admission.

Location: MedTelemetry.

Room: 42114.

Attending doctor: Green,Gode.

Resuscitation Status: Full Code.

Weight 152.

Height 5feet 6inches.

Allergy NKDA.

Primary diagnosis:

Elevated LFT,Pancreatitis. Abdominal pain.

Secondary diagnosis: Diabetes,Hypertension, high cholesterol. Bile duct dilation.

Isolation Status :Contact Isolation( MRSA of nare).

Risk for fall:Yes.

Do patient have advance Directive: No.

Copy of advance Directive on the chart.

Diet NPO after midnight .

ERCP.Consent signed and in the chart.

Alert and oriented x4.

Room air.

Voiding well.

Skin intact.

0.9NS @ 50ml/hour IV right forearm 18guage clean/ dry/Patent.

Flagyl 500mg IV Q8hours.

Zosyn 3.375mg IV Q8hours.

Carvedilo 6.25mg po Bid scheduled.

Accucheck Qac and Qhs.Sliding scales:

Bs sugar 50 to 200 = zero insulin.

201 to 250= 2units of insulin.

251 to 300= 4units of insulin.

301 to 350= 6units.

351 to 400 =8 units and notify the doctor.

Norco 5/325mg 2tablets po Q4hours prn severe pain.

Morphine sulfate 4mg IV Q4hours prn severe pain.

Colace 100mg po Bid.

Dilaudid 0.5mg IV Q3hours prn severe pain.

Metroprolol 10mg po Qday.

Tylenol 650mg po Q4hours prn temperature.

Zofran 4mg IV Q4hours prn nausea/ vomiting.

Laboratory results:

WBC: 8.5.0.

H/H 12.0,37.2.

K= 3.4 replaced with 40.0mEqkcl×1.

magnesium: 1.8.

Ca+8.9.

Nacl 135.

ALT,AST are high.( Elevated liver function test)

Discharge plans:

Discharge home when medically stable.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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