Nursing Diagnosis Questionnaire: Pancreatitis Case Study Analysis

This nursing assignment presents a detailed analysis of a pancreatitis case study, focusing on the diagnostic process. The student identifies pancreatitis based on presented symptoms, lab results, and physical examinations. The assignment explores elevated blood glucose, cholesterol, and lipase levels as indicators. Risk factors such as epigastric abdominal pain, diabetes diagnosis, and abdominal tenderness are discussed. The two common causes of pancreatitis, alcoholism and gallstones, are considered, with alcoholism being the likely cause in this case. The pathophysiology of pancreatitis, including acinar cell injury, zymogen granule secretion, and inflammatory responses, is explained. The assignment also highlights the importance of diagnosing potential complications like pancreatic cancer and cystic fibrosis. References to supporting literature are included.

Running head: NURSING DIAGNOSIS QUESTIONNAIRE
NURSING DIAGNOSIS BASED ON THE CASE STUDY
Name of the Student
Name of the University
Author note

1NURSING DIAGNOSIS QUESTIONNAIRE
Table of Contents
Answer 1..............................................................................................................................3
Answer 2..............................................................................................................................3
Answer 3..............................................................................................................................3
Answer 4..............................................................................................................................4
4.1....................................................................................................................................4
4.2....................................................................................................................................4
4.3....................................................................................................................................4
4.4....................................................................................................................................5
Answer 5..............................................................................................................................5

2NURSING DIAGNOSIS QUESTIONNAIRE
Answer 1
 The scenario of diagnosis present in the case study related to differential
diagnosis.
 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).
Answer 2
 The blood glucose level, as during pancreatitis, the insulin producing cells are
damaged, hence the glucose level gets elevated.
 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.
Answer 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.

3NURSING DIAGNOSIS QUESTIONNAIRE
 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).
Answer 4
4.1
The two most common cause of pancreatitis are:
 Alcoholism
 Gallstones
4.2
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).
4.3
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

4NURSING DIAGNOSIS QUESTIONNAIRE
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 (İnce & Baysel, 2014).
4.4
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).
Answer 5
 The patient need to be diagnosed about pancreatic cancer as the high lipase and
triglycerides level indicates to the chronic level of pancreatitis.
 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.

5NURSING DIAGNOSIS QUESTIONNAIRE
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+pancr
eatitis&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.
İnce, 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.