NUR 300 Nursing Transition : Patient Acquires Diabetes

3. What risk factor(s) led to this person's diagnosis? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence.

4. Describe the key pathophysiologic concepts of the diagnosis in question 1. To answer this question completely, you must answer all of the sub-questions below using complete sentences. Each sub-question may be answered in 1-6 sentences.

a. What are the two most common causes of the disorder identified in question 1?

b. What is the most likely cause of this patient's diagnosis?

c. Describe the pathological process which explains why this person is experiencing pain?

d. What does the lipase value indicate?

5. For what actual or potential complications related to the diagnosis in question 1 does he need to be monitored? You may simply list your answer(s) below using a bullet point format. This does not have to be in a complete sentence.

• The case study resented the list of diagnosis with physical exam and lab reports.
• The symptoms are presented in a manner that focuses on the presence of disease entity.
• The symptoms clearly differentiates the identified disease from all the probable diseases with the help of the lab reports and physical tests.
• Therefore, the diagnosis led to the identification of pancreatitis in that patient (Gong, Hu & Zhu, 2012).

• High cholesterol level indicated to the presence of pancreatitis.
• Lipase level more than thrice the normal clearly indicated to the presence of pancreatitis
• High triglyceride level in the blood also indicated to the pancreatic disorder in the patient.

3.As per the signs of the patient, the risk factors that led to this diagnosis are:

• Epigastric abdominal pain was the first risk factor that led to the identification of pancreatitis, as the pain was radiating to the back.
• The pain was increasing after eating of during eating, which is another indicator of pancreatitis.
• As pancreatitis destroys the insulin producing cells in pancreas, the patient acquires diabetes. The patient was also diagnosed as diabetic a month ago.
• Patient was suffering from abdominal pain and tenderness.
• Associated symptoms were high cholesterol level, nausea and vomiting that clearly indicated to the presence of pancreatitis (Whitcomb, 2013).

4.a.The two most common cause of pancreatitis are:

• Alcoholism
• Gallstones

b.The right upper abdomen sonogram of the patient clearly defines the absence of gallstones. Therefore, in this case alcoholism can be the cause of pancreatitis. Moreover, the pale and dry skin of the patient indicates to the patient’s habit of drinking. Hence, excess usage of alcohol can be the reason behind of his pancreatitis (Gukovskaya & Gukovsky, 2012).

c.Pancreatitis happens after the imbalance occurs in the presence of factors, which maintains cellular homeostasis. The initial stage includes the injury in the acinar cell and impaired secretion of zymogen granules. Alcohol, presence of gallstones or certain drugs generally cause this (Brock et al., 2013). As the injury starts happening all over the pancreas, the lysosomal and zymogen granules fuse together activated trypsinogen to trypsin. This trypsin triggers the intracellular cascade of zymogen granules. After those neutrophils is activated and release superoxide and macrophages release cytokines. These are inflammatory substances leads to gastrointestinal hemorrhage, renal failure leading to severe pain (?nce & Baysel, 2014).  

d.High lipase level in the blood stream in pancreatitis indicates the existence of a condition affecting the pancreas. The lipase level generally increases during pancreatitis and the level sometimes rises five to 10 times of the normal level (Balakrishnan & Rajesh, 2016).

• As kidney damage is one of the major consequences of pancreatitis, diagnosis abut that need to be done.
• The patient should also be diagnosed about cystic fibrosis as this disease also causes the symptoms of pancreatitis.

References

Balakrishnan, V., & Rajesh, G. (2016). Chronic pancreatitis. Practical Gastroenterology, 175. https://books.google.co.in/books?hl=en&lr=&id=5keJDAAAQBAJ&oi=fnd&pg=PA175&dq=high+lipase+level+in+pancreatitis&ots=V0BUA3qsZv&sig=9Gqn7KpG7r17nIKMEeimtpTK3d0#v=onepage&q&f=false

Brock, C., Nielsen, L. M., Lelic, D., & Drewes, A. M. (2013). Pathophysiology of chronic pancreatitis. World Journal of Gastroenterology: WJG, 19(42), 7231.

Gong, T. T., Hu, D. M., & Zhu, Q. (2012). Contrast-enhanced EUS for differential diagnosis of pancreatic mass lesions: a meta-analysis. Gastrointestinal endoscopy, 76(2), 301-309.

Gukovskaya, A. S., & Gukovsky, I. (2012). Autophagy and pancreatitis. American Journal of Physiology-Gastrointestinal and Liver Physiology, 303(9), G993-G1003.

?nce, A. T., & Baysal, B. (2014). Pathophysiology, classification and available guidelines of acute pancreatitis. Turk J Gastroenterol, 25(4), 351-7.

Whitcomb, D. C. (2013). Genetic risk factors for pancreatic disorders. Gastroenterology, 144(6), 1292-1302.