Evelyn Bean, 52 years of age, is admitted to the same-day surgery unit for an elective laparoscopic cholecystectomy. The patient presents with jaundice of the skin and sclera.Joe Harrison, a 62-year-old bank executive, presents to the emergency room with severe abdominal pain.

  1. If the common bile duct is obstructed by a gallstone, an additional procedure called an endoscopic retrograde cholangiopancreatography (ERCP) may be performed. An endoscope can be used during an ERCP to inspect the ducts in the liver, gallbladder and pancreas. An endoscope is equipped with a camera on one end and a light at the other. This allows the doctor to view inside the body and find the obstruction. A doctor will then be able to use special tools to get rid of the gallstones and remove obstructions.

Before you are allowed to leave, the nurse must give these written and verbal instructions:

  • How to manage pain: What to do when prescribed pain medication isn’t working, how to report any side effects and what to do.
  • Care of the incisions: This section explains how to maintain the surgery site clean, dry and dressings changed as necessary. Also, look out for signs and symptoms that might indicate infection.
  • Activity restrictions: Please explain any limitations on your activity, like driving heavy or lifting objects. Also, please tell us how long the restrictions will be in effect.
  • Talk about diet. Explain to the patient any restrictions or modifications that may be made, like avoiding fattening or greasy food, or eating low-fat foods. When can they resume their normal diet?
  • Follow-up Care: Provide information about when, where, and how the patient should be seen by their doctor. Also, explain what they can expect from their visit.
  1. Acute pancreatitis is characterized by markedly increased levels of serum lipase and amylase. The pancreas produces digestive enzymes called lipase and amylase. When the pancreas becomes inflamed, or is damaged, the enzymes can leak into the bloodstream. These enzymes are elevated in cases of pancreatic inflammation, or even damage.

Pancreatic enzymes are not present in this condition, and they cause a lack of fluids that can be absorbed into the stomach. Dark tea-colored urine can be caused by bilirubin. This is a product of the liver that is usually excreted through bile. An obstruction of the commonbile duct may cause bilirubin accumulation in the bloodstream. This can lead to darkened urine.

Based on the Criteria for Predicting the Severity of Pancreatitis, Mr. Harrison’s mortality risk is intermediate. The criteria take into account several factors, including age, comorbidities, and laboratory values, to predict the severity of pancreatitis and the patient’s risk of mortality.

Hypocalcemia should be addressed by the nurse.

  • Calcium supplements should be taken as directed.
  • Monitoring for hypocalcemia symptoms, including tetany (numbness, tingling and extremity tingling) and cramps.
  • Pay attention to signs and symptoms for hypomagnesemia. Hypocalcemia is often accompanied by hypomagnesemia.
  • Inform the patient’s family and caregivers about the benefits and possible side effects of supplementing calcium or magnesium.
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