NU371 HESI Case Study: Pancreatitis Verified Solutions
Client Presentation
A client is admitted to the emergency department (ED) with complaints of severe abdominal and back
pain, along with vomiting that has persisted for the last 24 hours. The client has a history of chronic
pancreatitis diagnosed two years prior and this is the fourth admission for an acute exacerbation.
Assessment
As part of the client’s ED admission assessment, what information should the nurse prioritize to support
the diagnosis of acute pancreatitis?
- a) History of current tobacco use.
- b) Frequency of alcohol consumption and date of last drink.
- c) Medications taken in the past 24 hours.
- d) Any weight loss or gain in the past 6 months.
Correct answer:
- b) Frequency of alcohol consumption and date of last drink.
Long-term alcohol consumption is often linked to chronic pancreatitis, and increased alcohol intake can
trigger acute episodes.
The client informs the nurse that they have been drinking daily for several years and had an increased
intake of alcohol last night. The client also reports smoking 2 packs of cigarettes daily for the last 20
years. To further evaluate the client's condition, the healthcare provider (HCP) orders several laboratory
tests.
Which laboratory result indicates the client is experiencing acute pancreatitis?
- a) Hemoglobin (Hgb) 12.9 g/dL (129 g/L) and hematocrit (HCT) 42% (0.42).
- b) White blood cell count of 10,000/uL (10 x 10^9/L).
- c) Amylase of 982 U/L (16.4 mckat/L) and lipase of 400 U/L (6.68 ukat/L).
- d) Blood alcohol (ethanol) level of 75 mg/dL (16.28 mmol/L).
, Correct answer:
- c) Amylase of 982 U/L (16.4 mckat/L) and lipase of 400 U/L (6.68 ukat/L).
Elevated serum amylase and lipase levels can exceed three times their normal limits during an acute
pancreatitis attack, with normal values being less than 160 U/L (2.67 ukat/L) for both enzymes.
Emergency Department Nursing Interventions
The ED nurse begins an intravenous (IV) infusion of 5% Dextrose and sodium chloride 0.45% at a rate of
125 mL/hour using a 20-gauge angiocatheter in the client's left forearm. The client rates their severe
abdominal pain as 9 on a scale from 0 to 10. The nurse assesses the abdomen, noting it is soft but
tender in the upper quadrants, with audible bowel sounds present.
Which medication should the nurse anticipate administering to alleviate the client's pain?
- a) Ondansetron 0.15 mg IV push diluted and administered over 15 minutes.
- b) Ranitidine IV piggyback administered over 30 minutes.
- c) Morphine 5 mg IV push diluted and administered over 5 minutes.
- d) Promethazine 25 mg deep intramuscular injection.
Correct answer:
- c) Morphine 5 mg IV push diluted and administered over 5 minutes.
Morphine is a first-line opioid analgesic typically utilized for managing moderate to severe pain.
Upon admission, the HCP issues standing prescriptions for the client.
Which diet should the nurse expect the HCP to order for the client?
- a) Regular diet.
- b) Low-fat diet.
- c) Clear-liquid diet.
Client Presentation
A client is admitted to the emergency department (ED) with complaints of severe abdominal and back
pain, along with vomiting that has persisted for the last 24 hours. The client has a history of chronic
pancreatitis diagnosed two years prior and this is the fourth admission for an acute exacerbation.
Assessment
As part of the client’s ED admission assessment, what information should the nurse prioritize to support
the diagnosis of acute pancreatitis?
- a) History of current tobacco use.
- b) Frequency of alcohol consumption and date of last drink.
- c) Medications taken in the past 24 hours.
- d) Any weight loss or gain in the past 6 months.
Correct answer:
- b) Frequency of alcohol consumption and date of last drink.
Long-term alcohol consumption is often linked to chronic pancreatitis, and increased alcohol intake can
trigger acute episodes.
The client informs the nurse that they have been drinking daily for several years and had an increased
intake of alcohol last night. The client also reports smoking 2 packs of cigarettes daily for the last 20
years. To further evaluate the client's condition, the healthcare provider (HCP) orders several laboratory
tests.
Which laboratory result indicates the client is experiencing acute pancreatitis?
- a) Hemoglobin (Hgb) 12.9 g/dL (129 g/L) and hematocrit (HCT) 42% (0.42).
- b) White blood cell count of 10,000/uL (10 x 10^9/L).
- c) Amylase of 982 U/L (16.4 mckat/L) and lipase of 400 U/L (6.68 ukat/L).
- d) Blood alcohol (ethanol) level of 75 mg/dL (16.28 mmol/L).
, Correct answer:
- c) Amylase of 982 U/L (16.4 mckat/L) and lipase of 400 U/L (6.68 ukat/L).
Elevated serum amylase and lipase levels can exceed three times their normal limits during an acute
pancreatitis attack, with normal values being less than 160 U/L (2.67 ukat/L) for both enzymes.
Emergency Department Nursing Interventions
The ED nurse begins an intravenous (IV) infusion of 5% Dextrose and sodium chloride 0.45% at a rate of
125 mL/hour using a 20-gauge angiocatheter in the client's left forearm. The client rates their severe
abdominal pain as 9 on a scale from 0 to 10. The nurse assesses the abdomen, noting it is soft but
tender in the upper quadrants, with audible bowel sounds present.
Which medication should the nurse anticipate administering to alleviate the client's pain?
- a) Ondansetron 0.15 mg IV push diluted and administered over 15 minutes.
- b) Ranitidine IV piggyback administered over 30 minutes.
- c) Morphine 5 mg IV push diluted and administered over 5 minutes.
- d) Promethazine 25 mg deep intramuscular injection.
Correct answer:
- c) Morphine 5 mg IV push diluted and administered over 5 minutes.
Morphine is a first-line opioid analgesic typically utilized for managing moderate to severe pain.
Upon admission, the HCP issues standing prescriptions for the client.
Which diet should the nurse expect the HCP to order for the client?
- a) Regular diet.
- b) Low-fat diet.
- c) Clear-liquid diet.
