Acute pancreatitis and hypertriglyceridemia.

Pancreatitis is a condition characterized by painful inflammation of the pancreas and can be either chronic or acute. The most common causes of acute pancreatitis (AP) in the United States are gallstones and excessive alcohol consumption. In addition, significantly elevated serum triglyceride levels can precipitate episodes of AP. Genetic defects are associated with severe elevations in serum triglyceride levels, whereas poorly controlled diabetes, obesity, and high-fat diets can contribute to elevated triglyceride levels substantial enough to provoke pancreatitis (secondary hypertriglyceridemia). Treatment of hypertriglyceridemia-induced AP consists of immediate reduction in serum triglyceride levels and long-term medications and lifestyle modifications. Nurses are instrumental in patient education about lifelong treatment strategies.

Preventing Long-term Poor Outcomes in the Bariatric Patient Postoperatively.

The obesity epidemic in America continues to rise. People are desperately trying to find ways to lose weight successfully and keep the weight off, and many people are turning to bariatric surgery as the only remaining option for morbid obesity. Bariatric surgery is considered to be a viable treatment option for morbid obesity. However, long-term data are revealing that many postsurgical bariatric patients are regaining the weight after 5 years. The purpose of lifelong follow-up appointments in the bariatric patient is to prevent weight regain and poor outcomes. A case study is used as an example for a poor outcome in a postsurgical bariatric patient. The author of this article provides definitions related to postsurgical bariatric patients, explains the value of early detection and prevention, provides an example of a poor outcome, and concludes with a discussion of evidence-based practice changes that prevent poor outcomes.

Complications of acute pancreatitis.

In 1925, Sir Berkeley Moynihan stated that "acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera." The case of M.H. clearly reflects the accuracy of that statement. It should be pointed out that through the exceptional, dedicated care provided by all members of the health care team, a young woman whose predicted mortality approached 100 percent was restored to her previous state of good health, and has since delivered a healthy baby girl by cesarean section. This illustrates that the nurse who possesses a sound understanding of the complications of acute pancreatitis and the pathophysiologic processes responsible, can integrate this knowledge into the management of the patient and improve the quality of care.

Acute pancreatitis.

The patient with acute pancreatitis requires constant assessments and interventions to minimize pancreatic inflammation and promote early detection and treatment of systemic complications. The onset of acute pancreatitis is most commonly initiated by biliary or alcohol disease, although many other causes have identified. The course of the disease may range from mild to fulminant based on the degree of pancreatic necrosis. Significant clinical symptoms include abdominal pain, nausea, and vomiting. The patient may present with signs of hypovolemic shock, with associated sequestration of fluid in the peritoneum as a result of inflammatory and mediated responses. Laboratory evidence of the disease includes increased levels of amylase and lipase, although a definitive diagnosis cannot be made without radiographic tests. Multisystem failure can occur in necrotizing acute pancreatitis as a result of mediators that are activated by the proteolytic enzymes, normally produced by the pancreas, and released into the peritoneum by injured cells. Collaborative management of the patient includes therapies directed at correcting initiating events, hemodynamic stabilization, and supportive measures to rest the pancreas and resolve presenting clinical symptoms. The management of multisystem organ failure that can result from necrotizing pancreatitis is a multidisciplinary challenge.

Nutritional support for the patient with pancreatobiliary disease.

Critically ill patients with severe pancreatobiliary disease exhibit multiple nutritional alterations compounded by the stress response. Acute pancreatitis may present as a life-threatening illness; patients are likely to be hypermetabolic and may have hyperglycemia and hypocalcemia. Nutritional support from parenteral or enteral feeding will probably be required in patients presenting with three or more positive risk factors as determined by Ranson criteria. Nutritional therapies for liver disease vary according to the specific disorder manifested. Patients with fulminant hepatic failure need to be monitored for profound hypoglycemia. Encephalopathy may develop in patients with acute-on-chronic liver disease, necessitating a protein restriction. Patients undergoing liver transplant are a perioperative challenge due to the combination of preoperative malnutrition, an extensive surgical procedure, and postoperative stress. Such patients require individualized assessment and management.

The pancreas--hermit of the abdomen.

The pancreas is almost impossible to palpate because it is located in the retroperitoneal space. Life-threatening lesions, therefore, often are not diagnosed until they are very advanced and encroaching on adjacent structures. The pancreas has a large endocrine and exocrine reserve, which also contributes to difficulty in diagnosing pancreatic disease. This article provides an in-depth analysis of the anatomy and physiology of the pancreas and endocrinopathies, allowing nurses to provide optimal care for patients with pancreatic abnormalities.

Treating pancreatitis in the acute care setting.

Acute pancreatitis is associated with significant complications and mortality. This article describes the pathophysiology and complications of, and treatments for acute pancreatitis, and the nurse's role in caring for a patient in the acute care setting.

Preventing complications in acute pancreatitis.

Acute pancreatitis is an auto-digestive process with severe complications that can lead to multisystem failure. The nurse is critical in monitoring and preventing complications in these patients.

Update on acute pancreatitis.

Acute pancreatitis is a complex, life-threatening disease that requires diligent and comprehensive medical and nursing care. Recent research and expert panels consensus statements provide new direction with regard to the causes, diagnosis, prognostic indicators, treatment, and nursing care of patients with acute pancreatitis.

The biological and nursing implications of pancreatitis.

Joseph McArdle examines the physiology of pancreatitis, discussing the nurse's contribution to the patient's recovery. He addresses the need for blood glucose monitoring during an acute episode, contrasts the risks associated with venepuncture and capillary sampling and identifies good practice in capillary blood glucose sampling.

Making sense of the care of patients with pancreatitis.

Pancreatitis is a painful condition with potentially long-term after-effects. This paper describes the condition, its causes and the factors that need to be taken into account both in its immediate management and in terms of its impact on a person's lifestyle.

The treatment of pancreatitis.

Pancreatitis is a complex and life-threatening condition. A multidisciplinary approach to patient care is required to ensure early diagnosis and treatment to improve patient outcome. Treatment is designed to support vital functions and prevent complications and admission to hospital is, therefore, necessary. This article provides an overview of pancreatitis from causes, presentation of signs and symptoms, and subsequent treatment. The importance of the nurse's role in providing care and continuing support throughout the patient's journey is also described.

[Integrating the nursing role in our daily practice]. / Integrar el rol de enfermería en nuestra práctica diaria.

This articles concerns a study which combines quantitative and qualitative methods. Based on a nursing team method, a process to unify knowledge with nursing terms was initiated. A transversal study identifying the care needs of patients checked into the hospital from January 2000 to May 2000 diagnosed with pancreatitis has been carried out. Using M. Gordon's functional patterns, an evaluation of nurses has taken place. It is necessary to use a nurse's attention process having a scientific focus directed at solving problems which offers a conceptual frame for nurses' organization, planning and follow through.