MRS MILLER ACUTE PANCREATITIS CASE STUDY
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Mrs. Miller
GENDER Female
SOCIOECONOMIC
AGE 88
SPIRITUAL/RELIGIOUS
SETTING Hospital
ETHNICITY White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITIONS
Heart failure (HF); hypothyroidism; gastroesophageal reflux disease (GERD); allergy to penicillin (PCN)
COEXISTING CONDITION
COMMUNICATION
DISABILITY
PHARMACOLOGIC
Potassium chloride (KCl); pantoprazole sodium (Protonix); levothyroxine sodium (Synthroid); spironolactone (Aldactone); metoclopramide (Reglan); morphine sulfate (MS Contin)
LEGAL
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION
DELEGATION
Overview: This case discusses the diagnostic characteristics and treatment of acute pancreatitis. Use of the Ranson and Glasgow criteria assessment tools to determine disease severity is explained. Potential complications of acute pancreatitis are considered. The nurse educates the client about a scheduled diagnostic procedure to help reduce the client’s anxiety. Safe administration of a medication via a nasogastric tube is ensured.
Client Profile
Mrs. Miller is an 88-year-old woman who presented with complaints of nausea, vomiting, and abdominal pain. Her vital signs on admission are temperature 99.6°F (37.6°C), blood pressure 113/82, pulse 84, and respiratory rate 20. Her laboratory tests reveal white blood cell count (WBC) 13,000/mm3, potassium (K+) 3.2 mEq/L,lipase 449 units/L, amylase 306 units/L, total bilirubin 3.4 mg/dL, direct bilirubin 2.2 mg/dL, aspartate aminotransferase (AST) 142 U/L, and alanine aminotransferase (ALT) 390 U/L. Physical examination reveals a distended abdomen thatis very tender on palpation. Bowel sounds are present in all four quadrants, but hypoactive. Mrs. Miller is admitted with a diagnosis of acute pancreatitis. She will be kept nothing by mouth (NPO). Intravenous (IV) fluid of D51/2 NS with 40 mEq of potassium chloride (KCl) per liter at 100 mL per hour is prescribed. The healthcare provider prescribes continued administration of her preadmission medications, that is, pantoprazole sodium and levothyroxine sodium (in IV form because the client is NPO) and spironolactone (available in oral form), and adds the prescription of IV metoclopramide and morphine sulfate. A nasogastric (NG) tube is inserted and attached to low wall suction.
Case Study
Mrs. Miller’s NG tube is draining yellow-brown drainage. Her pain is being man-aged effectively with IV morphine 4 mg every four hours. Mrs. Miller is anxious and has many questions for the nurse: “What is the test I am having done today? What is pancreatitis? Will I need to have surgery? Why did they put this tube in my nose? When will I be able to eat real food?”
Questions
- Briefly explain acute pancreatitis and discuss its incidence.
- Mrs. Miller’s admitting diagnosis is acute pancreatitis. Can a person have chronic pancreati-tis? If so, what is the incidence, and how would you define chronic pancreatitis?
- Discuss the common clinical manifestations of acute pancreatitis.
- Briefly discuss the diagnostic tests that help confirm the diagnosis of pancreatitis.
- Identify the assessment findings in Mrs. Miller’s case that are consistent with acute pancreatitis.
- Identify the possible causes of acute pancreatitis. Discuss the physiology of the two major causes of acute pancreatitis in the United States, and note which individuals are at greatest risk.
- The severity of an acute pancreatitis episode can be assessed using two tools: (1) Ranson/Imrie criteria and (2) modified Glasgow criteria. Describe each of these tools.
- Briefly discuss the treatment options for pancreatitis, and explain why Mrs. Miller has an NG tube to low wall suction.
- Discuss the complications that can arise if pancreatitis is not treated
- Evaluate Mrs. Miller’s potassium level. Should the nurse question the health care provider’s prescrip-tion for the diuretic spironolactone? Why or why not?
- Because Mrs. Miller is NPO, the nurse must administer the oral spironolactone via the NG tube. Is it appropriate to crush this medication? Whyor why not? What intervention should the nurse take following administration of the medication to facilitate absorption?
- Which type of diet will Mrs. Miller advance to when her NPO status is discontinued? What types of liquids are allowed on this diet?
- Identify the priority nursing diagnosis for Mrs. Miller’s plan of care and two additional nursing diagnoses that the nurse should consider.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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