Two weeks after his emergency cardiac bypass surgery, R.B. was admitted to the hospital with acute..

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Two weeks after his emergency cardiac bypass surgery, R.B. was admitted to the hospital with acute..

by | Nov 24, 2022

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Two weeks after his emergency cardiac bypass surgery, R.B.
was admitted to the hospital with acute pancreatitis, probably triggered by the
trauma of the heart surgery. As a nurse, R.B. knew that the mild form of the
disease was self-limiting, whereas severe pancreatitis has a mortality rate
near 50%. He was terrified, having survived heart surgery, to now have to worry
about multisystem organ failure. He had once cared for a patient who died of
necrotizing hemorrhagic pancreatitis. On admission, R.B. had severe stabbing
midepigastric pain that radiated to his back, nausea, vomiting,
»

Two weeks after his emergency cardiac bypass surgery, R.B.
was admitted to the hospital with acute pancreatitis, probably triggered by the
trauma of the heart surgery. As a nurse, R.B. knew that the mild form of the
disease was self-limiting, whereas severe pancreatitis has a mortality rate
near 50%. He was terrified, having survived heart surgery, to now have to worry
about multisystem organ failure. He had once cared for a patient who died of
necrotizing hemorrhagic pancreatitis. On admission, R.B. had severe stabbing
midepigastric pain that radiated to his back, nausea, vomiting, abdominal
distention and rigidity, and jaundice. He also manifested a low-grade fever,
hypotension, tachycardia, and decreased breath sounds over all lung fields. His
cardiac enzymes were normal, but he showed an increase in serum leukocytes,
amylase, and lipase. CT scan of the abdomen showed pancreatic inflammation with
edema. His chest radiograph showed bilateral pleural effusion and atelectasis.
R.B.’s treatments included NPO, an NG tube, medications to decrease his pain
and gastric secretions, and supplemental oxygen. He was monitored for all
physiologic parameters, with close attention paid to his fluid and electrolyte
balance and intravascular volume, and recovered and was discharged after 6
days.

»

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