- Acute Pain related to Inflammation and Autodigestion of the pancreas causing toxins to be released as evidenced by Verbalization of abdominal pain and Agitation/restlessness
- Deficient Knowledge related to Cognitive limitation and Poor access to resources as evidenced by verbalizes a lack of understanding and worsening of pancreatitis
- Imbalanced Nutrition less than body Requirement related to Vomiting and NPO status or dietary restrictions as evidenced by reports of insufficient food intake and nutritional deficits identified through lab work
| Assessment | Nursing Diagnosis | Outcome/Planning | Nursing Intervention | Evaluation |
| Subjective Data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain related to Inflammation and Autodigestion of the pancreas causing toxins to be released as evidenced by Verbalization of abdominal pain and Agitation/restlessness | Patient will verbalize reduced pain or relief by pharmacologic pain interventions. Patient will follow the prescribed treatment plan to maintain pain relief. | 1. Administer pain medications routinely. Administering pain medications frequently, as ordered, is important in managing pain. Smaller, more frequent doses of pain medications are preferred over larger doses. Larger doses of pain medications can cause complications for a patient with pancreatitis, including respiratory depression. 2. Maintain NPO status and suctioning. Eating will likely worsen abdominal pain and any nausea or vomiting. Patients will likely be placed on NPO status and a nasogastric tube may be inserted to allow the pancreas to rest. IV fluids will be given for hydration. 3. Provide alternative pain management. The patient may experience pain relief by participating in distraction activities (TV, games, music) or activities that promote relaxation such as massage, guided imagery, and hot/cold therapy. 4. Promote a position of comfort. The supine position often increases a patient’s pain. Encourage patients to lay on their side with knees slightly flexed to decrease abdominal pressure. This aids in pain relief and comfort | Patient verbalized reduced pain or relief by pharmacologic pain interventions. Patient followed the prescribed treatment plan to maintain pain relief. |
| Subjective Data: -Verbalizes poor understanding -Seeks additional information Objective Data: -Inaccurate demonstration or teach-back of instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition -Avoiding eye contact or remaining silent during teaching | Deficient Knowledge related to Cognitive limitation and Poor access to resources as evidenced by verbalizes a lack of understanding and worsening of pancreatitis | Patient will verbalize an understanding of pancreatitis and potential complications. Patient will demonstrate adherence to prescribed medications and diet. Patient will verbalize an understanding of required testing and follow-up. | 1. Use multiple learning techniques. Offer a variety of learning techniques after assessing which way the patient learns best. Evaluate which techniques work best for the patient by asking them questions to assess how much they have retained. 2. Ensure a comfortable learning environment. Ensure the environment is calm and conducive to learning. Also, ensure the patient’s pain is controlled. Someone that is distracted by pain, loud noises, and staff interruptions will not be able to focus on learning. 3. Provide supportive treatment resources. Alcohol abuse is the most common cause of chronic pancreatitis. Collaboration with a social worker or case manager may be necessary to ensure the patient has resources available to seek treatment. Educate the patient on the effects alcohol and smoking has on their health and how pancreatitis can develop again. 4. Stress the importance of follow-up. Educate the patient on the importance of following up to ensure they are healing properly. Inform them of symptoms to look for and when to notify their doctor. Doctor’s appointments, lab work, substance abuse resources, and dietician guidelines are important for the patient to adhere to. | Patient verbalized an understanding of pancreatitis and potential complications. Patient demonstrated adherence to prescribed medications and diet. Patient verbalized an understanding of required testing and follow-up. |
| Subjective Data: Reports of insufficient food intake Objective Data: -Weight loss -Aversion to food -Poor energy -Decreased muscle tone -Nutritional deficits identified through lab work | Imbalanced Nutrition less than body Requirement related to Vomiting and NPO status or dietary restrictions as evidenced by reports of insufficient food intake and nutritional deficits identified through lab work | Patient will maintain their weight or will not lose more than 5 pounds while inpatient. Patient will verbalize dietary recommendations upon discharge. Patient will maintain lab values within normal range | 1. Provide nutritional support. The patient’s nutritional habits may not be supportive of healing. They will most likely need education on what to eat and drink, and what to avoid. Usual recommendations include high protein and nutrients found in fruits, vegetables, and whole grains. Patients should avoid alcohol and greasy or fried foods. 2. Provide optimal oral hygiene. Increasing the patient’s appetite is important. Providing good oral hygiene can stimulate their appetite by creating a more pleasant sensation after vomiting and from dry mucous membranes. 3. Administer antiemetics when needed. Vomiting not only causes an imbalance in electrolytes but creates an aversion to eating. Administering an antiemetic before mealtime can help. 4. Provide nutritional supplements. Chronic pancreatitis causes altered metabolism and absorption. Regular lab work will monitor nutritional deficits. Patients may need vitamin supplements such as multivitamins, calcium, iron, folate, and vitamins A, D, E, and B12. | Patient maintained their weight or will not lose more than 5 pounds while inpatient. Patient verbalized dietary recommendations upon discharge. Patient maintained lab values within normal range |