Nokea
An adult patient has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this patients plan of care?
- A. Measure the patients abdominal girth daily.
- B. Limit the use of opioid analgesics.
- C. Monitor the patient for signs of dysphagia.
- D. Encourage activity as tolerated.
Correct Answer: A
Rationale: Due to the risk of ascites, the nurse should monitor the patients abdominal girth. There is no specific need to avoid the use of opioids or to monitor for dysphagia, and activity is usually limited.
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A patient has been treated in the hospital for an episode of acute pancreatitis. The patient has acknowledged the role that his alcohol use played in the development of his health problem, but has not expressed specific plans for lifestyle changes after discharge. What is the nurses most appropriate response?
- A. Educate the patient about the link between alcohol use and pancreatitis.
- B. Ensure that the patient knows the importance of attending follow-up appointments.
- C. Refer the patient to social work or spiritual care.
- D. Encourage the patient to connect with a community-based support group.
Correct Answer: D
Rationale: After the acute attack has subsided, some patients may be inclined to return to their previous drinking habits. The nurse provides specific information about resources and support groups that may be of assistance in avoiding alcohol in the future. Referral to Alcoholics Anonymous as appropriate or other support groups is essential. The patient already has an understanding of the effects of alcohol, and follow-up appointments will not necessarily result in lifestyle changes. Social work and spiritual care may or may not be beneficial.
A patients assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply.
- A. How many alcoholic drinks do you typically consume in a week?
- B. Have you ever been tested for diabetes?
- C. Have you ever been diagnosed with gallstones?
- D. Would you say that you eat a particularly high-fat diet?
- E. Does anyone in your family have cystic fibrosis?
Correct Answer: A,C
Rationale: Eighty percent of patients with acute pancreatitis have biliary tract disease such as gallstones or a history of long-term alcohol abuse. Diabetes, high-fat consumption, and cystic fibrosis are not noted etiologic factors.
A patient is admitted to the ICU with acute pancreatitis. The patients family asks what causes acute pancreatitis. The critical care nurse knows that a majority of patients with acute pancreatitis have what?
- A. Type 1 diabetes
- B. An impaired immune system
- C. Undiagnosed chronic pancreatitis
- D. An amylase deficiency
Correct Answer: C
Rationale: Eighty percent of patients with acute pancreatitis have biliary tract disease or a history of long-term alcohol abuse. These patients usually have had undiagnosed chronic pancreatitis before their first episode of acute pancreatitis. Diabetes, an impaired immune function, and amylase deficiency are not specific precursors to acute pancreatitis.
A patient with ongoing back pain, nausea, and abdominal bloating has been diagnosed with cholecystitis secondary to gallstones. The nurse should anticipate that the patient will undergo what intervention?
- A. Laparoscopic cholecystectomy
- B. Methyl tertiary butyl ether (MTBE) infusion
- C. Intracorporeal lithotripsy
- D. Extracorporeal shock wave therapy (ESWL)
Correct Answer: A
Rationale: Most of the nonsurgical approaches, including lithotripsy and dissolution of gallstones, provide only temporary solutions to gallstone problems and are infrequently used in the United States. Cholecystectomy is the preferred treatment.
A patient has been diagnosed with pancreatic cancer and has been admitted for care. Following initial treatment, the nurse should be aware that the patient is most likely to require which of the following?
- A. Inpatient rehabilitation
- B. Rehabilitation in the home setting
- C. Intensive physical therapy
- D. Hospice care
Correct Answer: D
Rationale: Pancreatic carcinoma has only a 5% survival rate at 5 years regardless of the stage of disease at diagnosis or treatment. As a result, there is a higher likelihood that the patient will require hospice care than physical therapy and rehabilitation.