Mrs Kart is a 63 years old woman presented to the emergency department with nausea and vomiting, epigastric pain and very severe pain at left upper quadrant abdominal pain in sharp and boring and radiates through to her mid back. She had the pain started 24 hours ago. Her respiratory rate and temperature is high. An abdominal CT scan is shows moderately severe pancreatitis. Pancreas is a gland behind the stomach and next to small intestine which does two main jobs 1: it is releases digestive enzymes into the small intestine for digestion the food 2: it releases the hormones insulin and glucagon into the bloodstream (Roberts, 2015). A pancreatitis occurs when digestive enzymes produced in your pancreas become activated while inside the pancreas causing damage to the organ. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. (Upchurch, 2014) this essay will examine the pathology of pancreatitis and demonstrate the assessment, diagnosis, and intervention based on evidences of care. And it will set perioperative care plan that helps in gets better outcome.
In the upper posterior abdomen is a gland which is pancreas (Swearingen, 2012). “It is responsible for insulin creation (endocrine pancreas) and the make and discharge of digestive enzymes (exocrine pancreas) leading to carbohydrate, fat, and protein metabolism” (Gardner, 2014). Pancreatitis is happening when the pancreas gets inflammation, pancreatitis can be acute or chronic. The pancreatitis is usually caused by too much intake of alcohol, medications, infections, trauma, and obstruction of pancreatic ducts by gallstones (Braganza, Lee, McCloy & McMahon, 2011). Inflammation is caused when pancreatic enzymes scaping into the tissues of the pancreas (autodigestion). However inflammation gets into the bloodstream and it cause abnormal coagulation and damaging the vessels and other organs such as lungs and kidneys (Swearingen, 2012). These digestive liquids cause irritation, collection of fluid and blocking of the blood vessels. Sometime there is bleeding, infection, and necrosis of pancreatic tissue (Braganza, Lee, McCloy & McMahon, 2011).
Assessment and diagnosis
When we are Inspecting patient, she has sign of abdominal cramps and bloating and acute abdominal pain; the pain can be mild to severe (Farrell & Dempsey, 2010). In Mrs. Kart case the severe epigastric pain which radiates through to her back, nausea, vomiting, and also the ct scans result are hallmarking acute pancreatitis. Assessing the patients if the bowel sound are reduced or absent or symptomatic of ileus being there (Swearingen, 2012). Assessing the patient’s lungs if she is in normal dept and pattern and breathing sound is clear and also if the oxygen saturation is greater than 92%. Make sure patient is on the normal range of temperature and hearth rate to prevent of any risk of infection. In Mrs. Kart case because of vomiting she has we have to check for her fluid volume balance by measuring the input and output fluid, peripheral pulse area greater than girth measurements. Normal limits of electrolytes (K+ and Ca2+)(Swearingen, 2012).
Usually first step to assist diagnosis acute pancreatitis it will be patient’s blood test. during acute pancreatitis, patients blood have as a minimum tree times the usual amount of lipase and amylase in that case the digestive enzymes appearance in pancreatitis. In other body chemicals some changes occur such as calcium, glucose, sodium, magnesium, bicarbonate and potassium. After the person's condition improves, the levels usually return to normal. It will go back to normal stage when the patient’s condition improves (MedicineNet, 2014).
A plain chest and abdominal X-rays is necessary to diagnosis acute pancreatitis. A chest X-ray can show a pleural effusion, adult respiratory distress syndrome (ARDS). This X-ray also can tell us how severe the disease is and if other abdominal problem which