Nursing
Case Study #2 Acute Pancreatitis (Chapter 60 text)

You are a charge nurse on a medical unit of a large teaching hospital. The Emergency Department (ED) is sending you a new admission, a female client, age 48, with a medical diagnosis of acute pancreatitis. Upon her arrival to your unit, you fully assess your client. Included in your assessment findings are the following data:
• VS: T, 100.2° F; P, 104; R, 22; B/P, 100/60
• Sharp pain in the mid-epigastric area radiating to the back, rated as 8 (scale 0-10)
• Vomited twice in the ED; reports that she is still nauseated
• Bowel sounds hypoactive at 2 per minute

Questions
1. Why is it important to monitor vital signs of the client with acute pancreatitis?
Acute pancreatitis can lead to the development of abscesses and pseudocyst on the pancreas. These can then perforate and cause peritonitis and sepsis. An increasing high fever, hypotension, and tachycardia are a sign of more severe complications. Acute pancreatitis can also cause respiratory distress from enzyme-induced inflammation of the diaphragm. This causes reduce diaphragm movement and eventually atelectasis. For this reason it’s important to monitor respiration rate and oxygen saturation. Vital signs are also monitored for hypovolemic shock.

2. What position may help to decrease the client’s pain?

Flex the knees up to the abdomen and truck downward in a fetal like position. Assume a side-lying position with the head elevated 45 degrees. This decreases tension on the abdomen and may help ease the pain (Lewis, Dirksen, Heitkemper, & Bucher, 2014).

3. What medication will probably be ordered for the client’s pain, and why?

Morphine will be ordered due to its ability to effectively treat the pain and slow down the