Critical Pathway: Pancreatitis, Acute Essay

3720 words - 15 pages

I. Introduction
Mr. B is a 33 year old Caucasian, non-Hispanic male who presented to the emergency department with severe abdominal pain that began after returning home from a party where he consumed hot wings and ten beers. The pain is constant, located in the epigastric and right upper quadrant area, and radiates to his back. Approximately 2-3 hours after the pain began, the patient stated he vomited a large amount but it did not alleviate his pain.
Mr. B is married with no children with his wife at bedside. He is complaining of intermittent pain over the last several months that has been relieved with vomiting. He states tonight vomiting has not help. He admits to consuming approximately two to four alcoholic beverages daily after coming home from work. His diet consists of fast food or skipping meals during the day but his wife prepares meals in the evening. He does state that on weekends he may overeat and he enjoys spicy meals. He also states he has tried to quit but continues to smoke one pack of cigarettes a day.
Mr. B ambulated to the exam room bent over holding abdomen. He is unable to lie down due to increased pain and appears to be more comfortable sitting up in bed with knees pulled up to his chest. Upon arrival to the emergency department, Mr. B’s vital signs were initially:
Height – 6 ft 1 in
Weight – 250 lbs
BMI – 33
Pain – 10/10
Blood Pressure – 110/70
Pulse – 110
Respirations – 28
Oxygen Saturation – 98% (room air)
Temperature – 101.8 F
Initial examination of Mr. B revealed epigastric distention, severe abdominal tenderness and guarding with hypoactive bowel sounds, shallow respirations and complaints of severe nausea. An EKG was obtained and showed normal sinus rhythm. Mr. B was instructed he would not be given anything by mouth until the cause of pain and vomiting was identified. IV access was established and 0.9% Normal Saline was initiated at 250ml/hr. Laboratory test were obtained including a urine sample. Zofran 4mg and Hydromorphone 1mg was given IV for nausea and pain. Oxygen at 2L/min nasal cannula was placed to assist with increased oxygen demands with tachycardia, tachypnea and fever. Plain films of the chest and abdomen were ordered to exclude the presence of free air and identify small-bowel obstruction.
After twenty minutes, Mr. B stated his pain was 8/10 and nausea was relieved. Hydromorphone 1mg IV was repeated which decreased his pain level to 5/10. Chest radiography showed a small pleural effusion and abdominal films were negative. Abdominal ultrasonography revealed an inflamed pancreas but no signs of gallstones. CT scan of the abdomen revealed an inflamed, swollen pancreas without signs of necrosis. Lab results were:
Complete Blood Count
WBC - 17 3.8-11.0 K/mm3
RBC -5.0 4.2-5.6 M/L
Hematocrit -45 39-54%
Hemoglobin -17 14-18 g/dL
Platelets -200 150-450 U/L
MCH -28 27-35 pg
MCHC -33 31-37%
MCV -80 78-98 fL
PT -12 10-14 seconds

Find Another Essay On Critical Pathway: Pancreatitis, Acute

Effect Of Tamoxifen Essay

1938 words - 8 pages IntroductionProgressive degeneration of nigrostriatal dopaminergic pathway leads to the depletion of striatal dopamine which causes Parkinson’s disease (PD). This disease is a disorder that affects the nerve cells or neurons in the part of brain that controls the movement. The neurons named dopamine which makes some chemicals in the body die or do not work properly. No one knows about the damages made by these cells. (Parkinson's disease

Lung transplantation Essay

885 words - 4 pages inhibition during acute rejection episodes in lung transplant recipients may limit the development of BOS. INTRODUCTION Cessation of microvascular flow may be a key cause for chronic rejection in all solid organ transplants recipients. Preserving microvasculature health in lung allografts may be critical for preventing terminal airway fibrosis, also known as the bronchiolitis obliterans syndrome (BOS) (Babu et al., 2007), a fibrotic process

review mechanism by which endothelial cells contribute inflammation in key diseases

988 words - 4 pages atherosclerosis. Similarly for the coronary heart disease, toxins and lipids entered the damaged endothelial layer. The oxidation and inflammatory factor develops the plaque and the plaque ruptures forming a blood clot in the arteries. Experimental evidence suggests numerous mechanisms through which leukocytes may affect the stability of plaques in acute coronary syndromes. (Tousoulis D., Charakida M. & Stefandis C.) Inflammatory markers

Transmission of Pain Signals by the Brain at the Spinal Level

2041 words - 8 pages Transmission of Pain Signals by the Brain at the Spinal Level Pain has been defined by Coates & Hindle as an unpleasant emotional and sensory experience which signals a potential or actual damage to tissues (2011, p. 213). Pain is a common human experience and can emanate from injury and illness. There are two main types of pain; acute pain is short-lived, lasting for minutes or several days and its onset often takes place rapidly. It results

Does the Film Awakenings Accurately Portray the Motor Disorder Encephalitis Lethargica?

880 words - 4 pages In the early twentieth century, during the end of the First World War, the puzzling illness of Encephalitis Lethargica (EL) swept the world. Millions of people were left to die and others less fortunate continued to live, trapped within their frozen and emotionless bodies. EL causes an inflammation of the brain, targeting the brain stem, which is home to critical motor components like the Basal Ganglia and Substantia Nigra. As it progresses

Alcohol Liver Disease

1274 words - 6 pages In addition to the disruption of fatty acid synthesis and oxidation, ethanol alters lipid droplet (LD, the storage form of TG) metabolism in hepatocytes and very low-density lipoprotein secretion from the liver. This effect, together with the inhibition of mitochondrial fatty acid β-oxidation, contributes to the pathogenesis of fatty liver (hepatosteatosis), the initial stage of ALD. Another major pathway of ethanol metabolism that involves

Clinical Chemistry Tests in Medicine

2850 words - 11 pages carbon atoms are more reduced than those of sugars, oxidation of triglycerides yields more than twice as much energy, gram for gram, as that of carbohydrates (Lehninger, 1993).Hyperlipidemia refers to an abnormally high concentration of triglyceride and/or cholesterol in the blood. Primary hyperlipidemia is an inherited disorder of lipid metabolism. Secondary hyperlipidemias are usually associated with pancreatitis, diabetes mellitus, hypothyroidism

A literature review on patient transport in Intensive Care units

4856 words - 19 pages examinations of critically ill surgical patients for reasons such as suspected abdominal focus (74%), acute necrotizing pancreatitis (12%) or suspected delayed intra-abdominal organ lesion after trauma (14%) [19], the results of the examination resulted in a change of therapy (operation or other invasive therapeutic intervention) in 43% of the patients. Similar studies of thoracic computed tomography in critically ill patients (predominantly trauma

The Interaction

1214 words - 5 pages adaptive immunity of nervous system. Microgliosis (increase in density of MG due to migration and local proliferation associated with rapid change in morphology, gene expression profile and functional behavior) is usual finding in nerve injury, neuropathy and painful conditions. Constant and anatomically precise conversation between MG and neurons play critical role in nociception. Involved primary afferent nerves release Neuregulin-1which binds to

The Use and Types of Electrocardiograms

995 words - 4 pages - The level of humiliation for the patient-low, medium, high - Specific information the test will provide - Unique features, special about the test - Time takes to do the test - Anxiety level which patients experience in related to the test. ( okner & c. corence 2009) The electrocardiogram is a critical tool of paramedic. Paramedic rapidly used this tool to identify patients who requires time sensitive therapies, which also identify acute or

The Effects of Otitis Media with Effusion on Hearing

2304 words - 9 pages fluid to drain into the nose and throat, but when agents such as bacteria and germs spread up the tube from the mouth and nose into the middle ear, the Eustachian tube may swell and close off the drainage pathway. This trapping of fluid is known as effusion and can remain even after the acute episode is resolved. In some children, the exchange between acute otitis media and otitis media with effusion is almost constant (Medley et al., 1995

Similar Essays

Patient Structured Reflection Essay

2423 words - 10 pages 6. Presenting symptoms 7. Care, treatment and medications already instigated 8. Patients consultant 9. Dietary status 10. Allergies 11. Any outstanding treatment that the patient required. For example, X-rays or Ultra Sound. Once I was happy that I had the relevant information I would accept handover and accept Rob onto the ward and into my care. It was explained to me that Rob had suspected acute pancreatitis. This condition

Alcohol And Its Effects Essay

755 words - 3 pages thiamine deficiencies. Though there are a variety of drinking patterns and the range of injuries among alcohol abusers, some are mild and can recover on their own with the right tools and techniques. Others are critical and need hospitalization and prolong rehabilitation with custodian supervision.      Ten percent of the adult drinkers in the United States are considered alcoholics or at least they experience drinking problems

Organic Nitrates As A Theraputic Agent

2514 words - 11 pages mechanism-based pathway, which produces glyceryl 1, 2-dinitrate (1, 2-GDN) as the major metabolite of NTG denitration, is associated with bioactivation of ORNs and NO generation. In contrast, clearance-based pathway yields glyceryl 1, 3-dinitrate (1, 3-GDN) and less potent vasodilator nitrite ion (NO_2^-) preferentially. In addition, while their long history and efficiency in the treatment of ischemia, chronic application of ORNs has been associated

Health Care System Comparison Essay

1123 words - 4 pages . Several practices like psychology, chiropractic, physiotherapy and medication (services not deemed critical) are not covered by the government but can be insured by private companies issued through employers or purchased individually. If the patient lacks private insurance, they have to pay out of their own pocket. The United States health care system is privatized and is profit based. Americans do not automatically have health coverage. They pay out