Professional Documents
Culture Documents
College of Nursing
Case
Study
On
Acute
Pancreatitis
Prepared by:
De Castro, Richelle Sandriel C.
BSN III-D
Submitted to:
Mrs. Cedie Loo RN, MSN
I. INTRODUCTION
Acute pancreatitis is an acute inflammatory process with variable involvement of
adjacent and remote organs. Although pancreatic function and structure eventually
return to normal, the risk of recurrent attacks is nearly 50% unless the precipitating
cause is removed. Initial manifestations and exacerbations of chronic pancreatitis
may be indistinguishable from attacks of acute pancreatitis. And they should be
treated as such. The inflammation begins in the perilobular and peripancreatic fatty
tissue, manifested by edema and spotty fat necrosis. The disease may progress to
the peripheral acinar cells, pancreatic ducts, blood vessels, and bordering organs. In
severe cases; patchy areas of the pancreatic parenchyma become necrotic.
II. OBJECTIVES
General:
After this case study, I will be able to know what Acute Pancreatitis is, causes of
Acute Pancreatitis, how it is acquired and prevented, its treatments and prevention
its occurrence.
Specific:
Name: E.S
Address: San Juan City
Age: 65 years old
Sex: Female
Nationality: Filipino
Religion: Roman Catholic
Date & Time of Admission: April 16, 2010 (09:34 pm)
Mode of Arrival: wheelchair
Chief Complaint: Severe Abdominal Pain
Source of Information: Patient, Chart, SO
Final Diagnosis: Acute Pancreatitis, Acalculous Cholecystitis, Multiple Hepatic Cysts
According to the patient’s SO, both his maternal and paternal have a history
Hypertension and Kidney Problem: Polycystic Kidney.
The patient is the 4th among 6 siblings. She is living with 7 other family
members. His spouse is unemployed and so was she. They are only financially
supported with their children who are working.
V. Laboratory Works
NURSING NORMAL ABNORMAL
TEST PURPOSE
CONSIDERATIONS VALUES RESULTS
1. Serum Levels of The patient need 26 to 102 A marked increase
amylase amylase in a not fast before units/L (more than three
blood sample test but must (SI, o.4 to 1.74) times the upper
Most abstain alcohol. limit of normal) in
commonly If severe the level strongly
used test to abdominal pain suggests acute
diagnosis of occur, obtain pancreatitis.
acute sample before After the onset of
pancreatitis. therapeutic acute pancreatitis,
To evaluate intervention. levels of amylase in
possible Handle sample the blood rise
pancreatic gently to prevent within six to 12
injury caused hemolysis. hours, peak within
by abdominal 12 to 48 hours and
trauma. remain elevated for
three to five days in
uncomplicated
attacks.
2. Serum Determines Instruct less than 160 Increased levels
lipase levels of lipase patient to fast units/L suggest acute
in a blood overnight (SI,<2.72 pancreatitis or
sample before test. µkat/L) pancreatic duct
Elevated Handle obstruction. After an
serum lipase sample gently acute attack, levels
levels help to to prevent remain elevated for
confirm the hemolysis. up to 14 days.
pancreatic Increased levels
origin of may occur in other
elevated pancreatic injuries
serum amylase such as perforated
levels. peptic ulcer with
chemical
pancreatitis caused
by gastric juices.
Pancreas
• Pancreas is an organ located behind the stomach and next to the liver and the gall
bladder. Pancreatic juices contain Enzymes, which help digest or break down food
proteins. Normally the juices leave the pancreas via a duct like channel and join the
common bile duct, which carries the secretions from the gallbladder, and pour the
mixture into the duodenal portion of the stomach.
•
VIII. DISCHARGE PLANNING
MEDICATIONS:
- Metoclopromide (Plasil)
- Omeprazole ( Omepron) 40mg
- Metronidazole 500mg
- Amikacin ( Konmalin) 500mg
- Calcibloc 5mg
ECONOMIC STATUS:
E.S. a housewife, supported financially by her children who are working, can
afford for to pay for her medications, and other necessities by using the money sent
to her.
TREATMENT:
The client should be encouraged to learn and use of relaxation techniques
including guided imagery and music therapy are used to shift the focus of the brain
away from the pain, decrease muscle tension, and reduce stress. Tension and stress
can also be reduced through biofeedback. Being massaged or applying backrub is
very relaxing and helps reduce stress.
HEALTH TEACHINGS:
- Encourage to take a well - balanced diet.
- Encourage a healthy lifestyle.
- Educate patient in pain management.
OPD VISITS:
Teach patient that if acute abdominal pain or biliary tract disease (as evidenced
by jaundice, clay- colored stools, and darkened urine) occurs, she should notify it to
the physician. She may report to the physician after 7 to 10 days to know the
indictor of disease or response progression.
DIET:
The client should be instructed to avoid alcohol, spicy foods, any caffeine-
containing foods, heavy meals, high fatty foods. Small, frequent feeding of bland
diet.
SPIRITUAL CARE:
Encourage client to pray in accordance with their beliefs. Ask for help to God for
complete recovery.
DAILY DIARY
REFLECTION
This is the second time that I am handled by Mrs. Loo. And yet again, she
never failed us to give insights and new learnings about the things in the
ward. This is our first time to have a duty in St. Anthony Unit in Our Lady of
Lourdes Hospital. Yet, the things to do are the same with the ones in the St.
Vincent Unit. This time, the patients are less and our ratio is 1:1. I have a
patient with NGT, T-Tube and JP. I’m tasked to drain those at the end of our
shift. I felt really excited because it is my first time to handle a patient with
those tubings. I’m glad that our c.i, Mrs. Loo was very patient to teach me
the things I need to do with my patient. I felt great that day because we’re
not that kind of busy and at the same time we had a lot of time to talk about
things under the sun.
Researchers at North Carolina State University and East Carolina University have
gained insight into scorpion venom’s effects on the ability of certain cells to release
critical components - a finding that may prove useful in understanding diseases like
pancreatitis or in targeted drug delivery.
Fletcher pinpointed a protein production system found in the pancreas that seemed
to be targeted by the venom of the Brazilian scorpion Tityus serrulatus and then
contacted NC State physicist Dr. Keith Weninger, who had studied that particular
protein system.
"This particular protein system has special emphasis at two places in the body - the
pancreas and the nervous system," Weninger says. "In the pancreas, it is involved
in the release of proteins through the membrane of a cell."
The pancreas specializes in releasing two kinds of proteins using separate cells:
digestive enzymes that go into the small intestine and insulin and its relatives that
go into the bloodstream, yet this same release mechanism is important in all of our
cells for many processes.
Cells move components in and out through a process called vesicle fusion. The
vesicle is a tiny, bubble-like chamber inside the cell that contains the substance to
be moved, stored and released - in this case, proteins like enzymes or hormones.
The vesicle is moved through the cell and attaches to the exterior membrane,
where the vesicle acts like an airlock in a spaceship, allowing the cell membrane to
open and release the proteins without disturbing the rest of the cell’s contents. The
proteins that aid in this process are known as Vesicle Associated Membrane
Proteins, or VAMPs.
Weninger provided Fletcher with two different VAMP proteins found in the pancreas,
VAMP2 and VAMP8. They were engineered to remove the membrane attachments
so they could be more easily used for experiments outside cells and tissues.
Fletcher’s team demonstrated that the scorpion venom attacked the VAMP proteins,
cutting them in one place and eliminating the vesicle’s ability to transport its
protein cargo out of the cell.i
i
http://timesofindia.indiatimes.com/life/health-fitness/health/Scorpion-venom-may-help-treat-
pancreatitis/articleshow/5742047.cms