pleural effusion atelectasis pneumonia ARDS Could eventually have multi organ

Pleural effusion atelectasis pneumonia ards could

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pleural effusion, atelectasis, pneumonia, ARDS, Could eventually have: multi-organ and system failure respiratory distress and oliguria o Cardiovascular Hypotension Tetany d/t low calcium ( sign of severe disease)
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o Trypsin can activate prothrombin and plasminogen increase risk for emboli o Patients with severe disease are at risk for Abdominal compartment syndrome- r/t intraabdominal hypertension and edema Lab results for pancreatitis: o Serum amylase - usually elevated early and remains elevated 24-72 hours . o Serum lipase - Results will confirm diagnosis because amylase can be affected by other diseases o Urinary amylase o Blood glucose o Serum calcium o Serum triglycerides o ESR elevated Collaborative Care Acute pancreatitis o Goals Relief of pain Prevention/alleviation of shock Reduction of pancreatic secretions Correction of fluid and electrolyte imbalances Prevention/treatment of infection Removal of precipitating factors o Care focuses on: Aggressive hydration (IV Fluids) Pain management – morphine maybe used , antispasmodics Management of metabolic complications – supplemental oxygen, placed on PPIs, H2 blocker and receive pancreatic enzymes to help with digestion Minimize pancreatic stimulation NPO,NGT, medications to decrease gastric secretions, may need parenteral nutrition ( risk for infection) . Once feeding is resumed- assess for intolerance to foods, increasing abdominal girth – all signs of pancreas being irritated. Diet usually high carbohydrates Monitor blood sugar closely Abstain from alcohol
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Nursing management: o Goals: Relief of pain Normal fluid and electrolyte balance Minimal to no complications No recurrent attacks o Acute Interventions Monitor vitals response to IV fluids Monitor electrolytes, I&O ( remember what's lost with GI secretions), blood glucose , CBC, Assess mental status Assess respiratory function! Assess pain levels Oral care for the patient who is NPO or has NGT (assess for patency and blockage) Abdominal assessment – risk for paralytic ileus Assess renal status Discharge Instructions o Physical therapy maybe needed o Abstain from alcohol – may need counseling o Dietary teaching – restrict fats, carbohydrate high diet ( less stressful to pancreas) – avoid crash diets- o Patient should be aware of symptoms of infection, diabetes, steatorrhea, Chronic pancreatitis : Continuous prolonged inflammatory and fibrosing process of the pancreas. o Causes : Alcohol abuse ,obstruction by gallstones, tumor, pseudocysts, trauma and systemic diseases ( SLE, cystic fibrosis) It may follow acute pancreatitis. o Symptoms Abdominal pain Pancreatic insufficiency Collaborative care o If there is an acute episode – care is the same o Want to prevent further attacks o Relief of pain o Diet , pancreatic enzymes, & control of blood sugar – ways to control pancreatic insufficiency.
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o No consumption of alcohol and caffeine beverages. o May need endoscopic procedures Choledochojejunostomy
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  • Fall '16
  • Denise Cauble
  • Nursing

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