Nursing 211

N211: Health Differences Across the Lifespan I Incudes anorexia, weight loss, abdominal pain that is progressive and severe, radiates to the back, and may be relieved by sitting forward. Pain may be more severe at night. Jaundice, pruritus and ascites may be present. Some clients have a palpable abdominal mass. Diarrhea and steatorhea occur later in the disease. Development of diabetes mellitus occurs because of impaired insulin production. Diagnostics CT scans, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous fine needle aspiration biopsy and percutaneous transhepaticcholangiography (PTC). Nursing Diagnosis • Altered comfort, pain related to tissue trauma and reflex muscle spasm secondary to surgery • Altered nutrition, less than body requirements related to inadequate absorption of nutrients Medical Interventions In most cases is palliative care. ERCP may be performed to place stents within ductal system to facilitate bile drainage. Surgical management is gastrojejunostomy bypasses the duodenum; choledochojejunostomy relieves biliary obstruction; and the pancreatoduodenectomy (Whipple procedure) is the surgical removal of the head of the pancreas, entire duodenum, distal third of the stomach and a portion of the jejunum, and lower half of the common bile duct. Chemotherapy and radiation are usually in adjunct to surgery. All medications are aimed at controlling symptoms of pain, nausea and vomiting. Nursi g Interventions Include assessment of pain and administer analgesics as ordered. Administer parenteral fluids, electrolytes and nutrients. Monitor serum glucose level and observe for symptoms of hyperglycemia or hypoglycemia. Provide a diet high in proteins, carbohydrates and vitamins. Administer pancreatic enzymes (Pancrease or Viokase) with meals. 3.15 Prostate Cancer Prostate Cancer is unregulated growth of abnormal cells in the prostate gland but is the second leading cause of death from cancer in American men. Adenocarcinoma is the most common type (high level of testosterone may play a role in this). High risk groups include those with a history of multiple sexual partners, sexually transmitted disease and certain viral infections. N rsing Assessme t Includes symptoms of urinary obstruction, with metastasis low back pain, fatigue, aching legs and hip pain. Asymptomatic if confined to the gland. Client will complain of dysuria, reduced force of stream,


Page 100

of 148


Made with FlippingBook - professional solution for displaying marketing and sales documents online