Acute Pancreatitis 

       Acute pancreatitis is a condition where the pancreas inflames suddenly which can be mild or life threatening. This is an illness that usually requires the patient to be hospitalized. Some causes of this condition include gallstones, alcohol abuse, and even a virus. This condition could be hereditary and having cystic fibrosis may also contribute to this disease. A main symptoms of acute pancreatitis is severe abdominal pain.  If gallstones cause acute pancreatitis the pain comes on suddenly while alcohol results in a more gradual onset of pain. Other common symptoms include pain that increases with coughing, vigorous movement, and breathing deeply. The degree to which someone has symptoms also varies. Some patients may only have moderate to severe pain while others may have changes to their breathing, sweating, become tachycardic, and could have pleural effusion (Bansal, 2019).  

Diagnostic testing for Acute Pancreatitis 

       In order to diagnosis acute pancreatitis, blood tests and imaging may be used. There is not a conclusive blood test for this illness but testing can indicate a likelihood of having this condition. Some findings that indicate this illness is an increase in pancreatic enzymes amylase and lipase. The patient may also have an increase in white blood cells and blood urea nitrogen. Some imaging used to diagnosis acute pancreatitis include ultrasounds, Computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography. Most of these imaging tests show inflammation or changes to the pancreas (Bansal, 2019).   

Treatment 

       Some treatment for acute pancreatitis include IV fluids, pain medication, nutritional education, and in some cases endoscopy or surgery. Most of the treatment will occur in a hospital setting. (Bansal, 2019). The IV fluids are to help prevent dehydration, pain medication is necessary for those with abdominal pain. Unfortunately, not all patients are fortunate enough to get pain relief through pain medication with this illness. If a patient is hospitalized it is not uncommon for that patient to fast. This is necessary to help the pancreas recover and help get inflammation under control. In severe cases, a feeding tube could be warranted. Other ways to help with treatment could include enzymes to help improve digestion and moving toward low-fat meals that are also high in nutrients (Mayo Clinic, 2018).  As a provider, if I had a patient come in that I suspected could have acute pancreatitis I would refer this patient to the ER to be properly evaluated. I would not want to waste time on this patient in the event there condition was already severe or worsened.  

Reference 

Bansal, R. (2019). Acute Pancreatitis. Retrieved from https://www.merckmanuals.com/home/digestive-disorders/pancreatitis/acute-pancreatitis

 (Links to an external site.)

Links to an external site.

Mayo Clinic. (2018). Pancreatitis. Retrieved from https://www.mayoclinic.org/diseases-conditions/pancreatitis/diagnosis-treatment/drc-20360233

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QUESTION DESCRIPTION

Topic 8 DQ1

Based on how you will evaluate your EBP project, which independent and dependent variables do you need to collect? Why?

Topic 8 DQ2

Not all EBP projects result in statistically significant results. Define clinical significance, and explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project?

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QUESTION DESCRIPTION

Question 1

One of the five elements of emotional intelligence is self-awareness. What behaviors would someone with strong self-awareness demonstrate within the context of leading and managing groups? Provide an example. ( TWO PARAGRAPH ANSWER WITH TWO SOURCES APA Format)

Question 2

Today’s workforce is diverse and has multiple conflicting priorities. As a nurse leader, you would like to see your hospital implement an outreach program that will benefit needy members of the community. What are some methodologies of communication you would use to develop a shared vision with your stakeholders? How would you apply strategic management to make your visions for the outreach program become reality? ( TWO PARAGRAPH ANSWER WITH TWO SOURCES APA Format)

Question 3

You have an idea to improve patient care that you would like upper management to support and fund. What type of communication tool would you use to present your idea and why? ( TWO PARAGRAPH ANSWER WITH TWO SOURCES APA Format)

Question 4

What differentiates someone that is intrinsically motivated from someone that is extrinsically motivated? Give an example of how you would go about motivating an individual who is intrinsically motivated and one who is extrinsically motivated. What are the characteristics of a performance-driven team? ( TWO PARAGRAPH ANSWER WITH TWO SOURCES APA Format)

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A Nursing theory is a set of concepts, definitions, relationships, and propositions derived from nursing models (Smith & Liehr, 2008). A conceptual model is a visual method of representing a set of causal relationships between factors that were believed to impact one or more biodiversity targets (Morgan, 2005). One of the main differences between the two is that a theory is based off research questions and study variables, while a conceptual model is used to guide research and can be tested and changed. Nursing theories are made up of conceptual models. Nurses like Virginia Henderson, Martha Rogers, Dorothea E. Orem, Betty Neuman, Hildegard Peplau, Madeleine Leininger, Patricia Benner, have created theories to help better understand the nursing profession. From different point of views, we can build our own concepts of what this career is about. Understanding this and extracting the best of each theory, we, as nurses, can take the level of healthcare to its maximum.

Betty Neuman developed the System Model, which is a nursing theory that focuses on the way that a patient responds to environmental stressors. These stressors include the intrapersonal, interpersonal, and extrapersonal types. It also involves the use of different levels of nursing prevention intervention (primary, secondary and tertiary levels) in order to maintain the highest level of wellness in the patient.  Nursing involves being concerned with the whole person, including the patient’s state of mind, which involves stress levels.

By applying nursing theories, effective nursing care can be provided for patients. An example in nursing practice in which Neuman’s theory would be effective is in treating patients that suffer from diseases with no cure, such as Multiple sclerosis (MS). This is an autoimmune disease of the central nervous system. It can take a toll on the patient’s emotions. The goal of treatment is to control the symptoms to be able to provide a better quality of life to the patient. For the patient, being able to speak about their situation to someone that would understand, such as a nurse, can help relieve stress. Nurses can ask and teach the patients to rest more, avoid certain foods, protect themselves from the sun, and other methods to help reduce fatigue and stress (Ahmadi & Sadeghi, 2017). By putting an importance on stress levels in a patient, the patient’s standard of life will improve. Reducing and preventing stress will help improve sleep patterns and reduce anxiety and depression. Also, being stressed, the body uses energy that is needed in order to maintain the immune system, and protect the body from illness, so through preventing it, immune systems will be stronger.

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Opioid use during pregnancy comes with many risks to the mother and fetus. In utero, there is a risk of preeclampsia, premature labor and rupture of membranes, placental insufficiency, abruptio placentae, intrauterine growth retardation, and intrauterine death (Ross, Graham, Money, & Stanwood, 2014). While in utero, opioids can also cross the placenta and lead to abnormal growth and development, birth defects, and opioid uptake (Yazdy, Desai, & Brogly, 2015). Neonatal abstinence syndrome (NAS) is a condition in which opioid exposed infants experience drug withdrawal symptoms shortly after birth (Krans & Patrick, 2016).

NAS is characterized by central nervous system hyperirritability, autonomic nervous system dysfunction, and gastrointestinal disturbances (Stover & Davis, 2015). Observed symptoms may include: irritability, excessive crying, poor sleep, increased muscle tone, tremors, hyperthermia, loose stools, excessive movements, yawning, sweating, sneezing, and nasal stuffiness (Stover & Davis, 2015). Some infants may also experience seizures (Stover & Davis, 2015). Neonates with NAS typically require prolonged hospitalization and pharmacotherapy with morphine or methadone (Yazdy et al., 2015).

In this scenario, it is also going to be important for the mother to get clean. Opioid withdrawal is not recommended during pregnancy, however, medication assisted treatment can be started while pregnant (Krans & Patrick, 2016). Mental health assessments and counseling will also be important for this mother. For women that are undergoing medication assisted treatment with methadone or buprenorphine, the AAP and ACOG both encourage breastfeeding (Stover & Davis, 2015). In these cases, breastfeeding is associated with a decrease in the incidence and severity of NAS (Stover & Davis, 2015).  

The long-term consequences of opioid exposure in utero and NAS have been difficult to determine (Stover & Davis, 2015). This is due to small study sizes and issues differentiating the effects of in utero exposures versus postnatal treatments versus environmental influences (Stover & Davis, 2015). Although, studies have found that in general, children with opioid exposures are more likely to have psychiatric issues, attention deficit disorders, and disruptive behaviors (Stover & Davis, 2015). Other effects may also include smaller brains, a thinner cortex, and reduced cognitive abilities (Stover & Davis, 2015).

References

Krans, E. E., & Patrick, S. W. (2016). Opioid use disorder in pregnancy: Health policy and practice in the midst of an epidemic. Obstetrics and Gynecology, 128(1), 4-10. https://dx.doi.org/10.1097%2FAOG.0000000000001446

Ross, E. J., Graham, D. L., Money, K. M., & Stanwood, G. D. (2014). Developmental consequences of fetal exposure to drugs: What we know and what we still must learn. Official Publication of the American College of Neuropsychopharmacology, 40(1), 61-87. https://dx.doi.org/10.1038%2Fnpp.2014.147

Stover, M. W., & Davis, J. M. (2015). Opioids in pregnancy and neonatal abstinence syndrome. Seminars in Perinatology, 39(7), 561-565. https://dx.doi.org/10.1053%2Fj.semperi.2015.08.013

Yazdy, M. M., Desai, R. J., & Brogly, S. B. (2015). Prescription opioids in pregnancy and birth outcomes: A review of the literature. Journal of Pediatric Genetics, 4(2), 56-70. https://dx.doi.org/10.1055%2Fs-0035-1556740

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