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.

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.

[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.

Atención de enfermería a una niña conpancreatitis y relación de ayuda a la madre / Nursing care of a girl with pancreatitis and support to the mother

Introducción. Una niña postoperada de un quiste de colédoco desarrolló una pancreatitis y múltiples complicaciones (ascitis, fístula pancreática, derrrame pleural, paniculitis del tejido graso, necrólisis epidérmica tóxica y trombosis de la vena femoral derecha) durante su estancia en la unidad de cuidados intensivos pediátricos (UCIP).Todo ello generó temor en la niña, afrontamiento familiar inefectivo y dependencia hacia el equipo asistencial. Objetivos. Elaboración de un plan de curas de enfermería individualizado hacia la niña y sus padres. Fomentar la autonomía y participación de la madre respecto a los cuidados de su hija. Conseguir la independencia/desvinculación de la madre del equipo asistencial. Metodología. Aplicación del proceso de atención de enfermería desarrollado por necesidades según el modelo de Virginia Henderson con problemas de colaboración, diagnósticos de enfermería reales y de riesgo e incluyendo la utilización de la taxonomía NANDA. Resultados. Durante la estancia de la niña en nuestra unidad se lograron los objetivos fijados en el plan de curas de enfermería, se redujo la ansiedad inicial de los padres y se incrementó parcialmente la autonomía de la madre en los cuidados de la niña, ayudando a minimizar el síndrome de estrés al traslado. Conclusión. A pesar de que en cualquier UCIP las actividades de enfermería se centran básicamente en problemas de colaboración que requieren una actuación rápida, eficiente y eficaz, consideramos imprescindible la inclusión de los padres en la planificación de los cuidados ante cualquier paciente pediátrico (AU)

Integrar el Rol de Enfermería en nuestra práctica diaria / To integrate the Role of Nurses in our daily practice

Se trata de un estudio que combina métodos cuantitativos y cualitativos. Desde el método el equipo de enfermería inicia un proceso de unificación de conocimientos y lenguaje enfermero. Se ha realizado un estudio transversal identificando necesidades de cuidados a los pacientes ingresados desde el 01-2000 al 05-2000 con diagnóstico de pancreatitis. Se ha realizado una valoración enfermera por patrones funcionales de M. Gordon. Es necesario utilizar un proceso de atención enfermero con enfoque científico dirigido a la solución de problemas que ofrezca un marco conceptual para la organización, planificación y actuación de enfermería. (AU)

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.

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.

Identification of pancreatitis in the ambulatory setting.

Acute pancreatitis can be life threatening. As a nurse practitioner, you are expected to accurately diagnose, treat, and refer as necessary. Because many different types of disease can cause abdominal pain, it is prudent to know signs, symptoms, and risk factors for pancreatitis. After reviewing this article, nurses should have a better understanding of acute pancreatitis and be able to recognize when it strikes.

Insuficiencia renal aguda / Case study: acute renal insufficency

No disponible

The psychiatric consultation/liaison nurse role in case management.

Psychiatric consultation/liaison nurses focus on the emotional, spiritual, developmental, cognitive, and behavioral responses of patients and families. They help patients, family, staff, and the entire healthcare system cope with a medical illness and its treatment. Use of psychiatric consultation/liaison nurses ensures that the patient's emotional needs are met, patients and families feel more cared for and respected, and patient satisfaction is increased. Partnerships between case managers and psychiatric consultation/liaison nurses may be especially effective with complex cases, end-of-life decisions, unanticipated hospital stays, certain pediatric populations, and patients who are hospitalized far from home. This article includes four case studies to illustrate such partnerships in a large teaching hospital.

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.

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.