Aspen guidelines for acute pancreatitis

Questions for Medical Nutrition Therapy: A Case Study Approach 5th ed.

Case D – Acute Pancreatitis

Case 15 in Text

Instructions: Answer the questions below. You may print your answers or e-mail them to your instructor.

1. Describe the normal exocrine and endocrine functions of the pancreas.

2. Determine the potential etiology of both acute and chronic pancreatitis. What information provided in the physical assessment supports the diagnosis of acute pancreatitis?

3. What laboratory values or other tests support this diagnosis? List all abnormal values and explain the likely cause for each abnormal value.

4. The physician lists an APACHE score in his note. What factors are used to determine this score? What does this mean? Ranson's Criteria and the Atlanta Criteria are also used to determine the severity of pancreatitis. Define each of these sets of criteria.

5. What are the potential complications of acute pancreatitis?

6. Historically, the patient with acute pancreatitis was made NPO. Why? This patient has an NG tube placed. Why?

7. The physician has written an order for a nutrition consult. Using the most current literature and ASPEN guidelines, explain the role of enteral feeding in acute pancreatitis. Do you agree with the initiation of enteral feeding? Why or why not?

8. Assess Mr. Mahon’s height and weight. Calculate his BMI and % usual body weight.

9. Evaluate Mr. Mahon’s initial nursing assessment. What important factors noted in his nutrition assessment will affect your nutrition recommendations?

10. Determine Mr. Mahon’s energy and protein requirements. Explain the rationale for the method you used to calculate these requirements.

11. Determine Mr. Mahon’s fluid requirements. Compare this with the information on the intake/output record.

12. From the nutrition history, assess Mr. Mahon’s alcohol intake. What is his average caloric intake from alcohol each day using the information that he provided to you?

13. List all medications that Mr. Mahon is receiving. Determine the action of each medication and identify any drug-nutrient interactions that you should monitor.

Medication

Action

Drug-nutrient interaction or nutrition-related side effects

Imipenem

Pepcid

Meperidine

Ondansetron

Colace (docusate)

Milk of Magnesia (MOM)

Ativan

14. What recommendations can you make to the patient’s critical care team to help improve tolerance to the enteral feeding?

15. List factors that you would monitor to assess tolerance and adequacy of nutrition support.

16. If this patient’s acute pancreatitis resolves, what will be the recommendations for him regarding nutrition and his alcohol intake when he is discharged?

17. What is a Bible verse you could share with and individual making dietary changes that would be an encouragement to his/her? Explain how this verse is appropriate for the situation.

© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.

© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.