Case Presentation: The Contribution Of Nursing Care To The Treatment And Recovery Process Of A Patient Diagnosed With Pancreatitis Exocrine Insufficiency
Öz
It is a disease state characterized by the inability to digest even normal foods due to the loss of the digestive gland function, one of the two functions of the pancreas, due to insufficient production of exocrine secretion produced from the pancreas. In this case report, it was aimed to provide nursing care to the individual according to the nursing diagnoses in the North American Nurses Association (NANDA) classification system. The patient was 77 years old, male, married and had four children. The case had Diabetes Mellitus in 2012, Gout, Hypertension and Chronic Arterial Disease in 2019. The patient had 5 angioplasties and had a total of 2 stents. The patient does not know the operation dates. In 2021, the patient presented to an external center with the complaint of diarrhea (7/day) and Whole Abdomen MRI+MRCP imaging was performed. As a result of imaging, it was found that there was a 1cm diameter simple parenchymal cyst in the liver. He had been taking continuous medications, a blood thinner, a stomach protector and a long-acting insulin. The patient was allergic to Teramicine cream. The patient was admitted to the Emergency Department of a university hospital in April 2022 with complaints of abdominal pain, weakness, weight loss and diarrhea (8-10/day). Detailed laboratory results of the patient were analyzed in detail. The vital signs of the patient were heart rate: 120/min, blood pressure: 130/80mm/Hg, body temperature: 36.2C (tympanic region). The patient was hospitalized in the Gastrohepatology Service for further investigation. The patient's oral intake was stopped by the physician due to hematochezia. Hemogram follow-up was performed 6*1 in order to monitor the patient closely for signs and symptoms of bleeding. Signs and symptoms of bleeding were explained to the patient. The patient was encouraged to ask questions about the process. The main role of the nurse was to support the patient and family to live a long and trouble-free life and to comply with the treatment. It was observed that the nurse's holistic approach to the individual by analyzing the case solved the patient's problems in a short time and the nursing care given to the patient was systematic.
Anahtar Kelimeler
Kaynakça
- Aoufi Rabih S, Garcia Agudo R, Legaz Huidobro ML, et al.(2014). Exocrine pancreatic insufficiency and chronic pancreatitis in chronic alcoholic liver disease: coincidence or shared toxicity? Pancreas,43:730‐4
- Bilgin M, Bilgin S, Balci NC, Momtahen AJ, Bilgin Y, Klör HU, Rau WS.(2008). Magnetic resonance imaging and magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis. Pancreas, 36: e33-e39
- Bükülmez A.(2020). Akut Pankreatit. Selcuk Med J,36(4): 367- 373
- Deprez PH, Sempoux C, De Saeger C, et al.(2022). Expression of cholecystokinin in the duodenum of patients with coeliac disease: respective role of atrophy and lymphocytic infiltration. Clin Sci (Lond),103:171-7
- Domínguez‐Muñoz, J. E. (2011). Pancreatic exocrine insufficiency: diagnosis and treatment. Journal of gastroenterology and hepatology, 26, 12-16
- Domínguez-Muñoz JE, Alvarez-Castro A, Lariño-Noia J, Nieto L, Iglesias-García J.(2012). Endoscopic ultrasonography of the pancreas as an indirect method to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis. Pancreas, 41: 724-728
- Goobie, S., Popovic, M., Morrison, J., Ellis, L., Ginzberg, H., Boocock, G. R., ... & Rommens, J. M. (2001). Shwachman-Diamond syndrome with exocrine pancreatic dysfunction and bone marrow failure maps to the centromeric region of chromosome 7. The American Journal of Human Genetics, 68(4), 1048-1054
- Hart PA, Conwell DL.(2015). Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol,13:347‐53,
- Lindkvist, B. (2013). Diagnosis and treatment of pancreatic exocrine insufficiency. World Journal of Gastroenterology: WJG, 19(42), 7258
Olgu Sunumu: Pankreatit Ekzokrin Yetmezliği Tanılı Bireyin Hemşirelik Bakımının Hastanın Tedavi ve İyileşme Sürecine Katkısı
Öz
Pankreastan üretilen ekzokrin salgısının yeterince üretilememesi nedeniyle pankreasın iki işlevinden biri olan sindirim bezi işlevini yitirmesiyle normal besinlerin dahi sindirilememesi ile karakterize bir hastalık durumudur. Bu olgu sunumunda bireye Kuzey Amerika Hemşireler Birliği (NANDA) sınıflama sistemindeki hemşirelik tanılarına yönelik hemşirelik bakımı verilmesi amaçlandı. 77 yaşında, erkek, evli ve dört çocuk babasıdır. Olguya 2012 yılında Diabetes Mellitus, 2019 yılında Gut, Hipertansiyon ve Kronik Arter Hastalığı tanısı konulmuştur. Olgu 5 tane anjiyo geçirmiş olup toplamda 2 tane stenti mevcuttur. Operasyon tarihlerini olgu bilmemektedir. 2021 yılında dış merkeze olgu diyare (7/gün) şikayeti ile başvurmuş ve Tüm Batın MRI+MRCP görüntülemesi yapılmıştır. Görüntüleme sonucunda karaciğerde 1cm çaplı basit parankimal kist olduğu saptanmıştır. Sürekli kullandığı ilaçlar, bir kan sulandırıcı, bir adet mide koruyu ve bir adet uzun etkili insülin kullanmaktadır. Olgunun Teramicine kreme allerjisi mevcuttur olgu Nisan 2022 tarihinde karın ağrısı, halsizlik, kilo kaybı ve diyare (8-10/gün) şikayeti ile bir üniversite hastanesi Acil Servisi’ne başvurmuştur. Olgunun detaylı laboratuvar sonuçları detaylı incelendi. Olgunun yaşam bulguları kalp atımı:120/dk, kan basıncı: 130/80mm/Hg, vücut sıcaklığı:36.2oC (timpanik bölge) olarak kaydedildi. Olgunun ileri tetkik edilmesi amacıyla Gastrohepatoloji Servisi’ne yatışı gerçekleştirildi. Olgunun hematokezya olması üzerine hekim tarafından hastanın oral alımı kapatıldı. Kanama belirti ve bulguları yönünden hastanın yakında takip edilmesi amacıyla 6*1 olarak hemogram takibi yapıldı. Olguya kanama belirti ve bulguları anlatıldı. Süreç hakkında soru sorması konusunda hasta desteklendi. Hemşirenin esas rolü, hastanın uzun ve sıkıntısı olmadan yaşam sürmesini ve tedaviye uyum sağlamasını desteklemektir. Hemşire vaka analizi yaparak bireyi bütüncül yaklaşması hastanın sorunlarını kısa sürede çözüme kavuşturduğu ve hastaya verilen hemşirelik bakımının sistematik bir şekilde olduğu gözlemlenmiştir.
Anahtar Kelimeler
Kaynakça
- Aoufi Rabih S, Garcia Agudo R, Legaz Huidobro ML, et al.(2014). Exocrine pancreatic insufficiency and chronic pancreatitis in chronic alcoholic liver disease: coincidence or shared toxicity? Pancreas,43:730‐4
- Bilgin M, Bilgin S, Balci NC, Momtahen AJ, Bilgin Y, Klör HU, Rau WS.(2008). Magnetic resonance imaging and magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis. Pancreas, 36: e33-e39
- Bükülmez A.(2020). Akut Pankreatit. Selcuk Med J,36(4): 367- 373
- Deprez PH, Sempoux C, De Saeger C, et al.(2022). Expression of cholecystokinin in the duodenum of patients with coeliac disease: respective role of atrophy and lymphocytic infiltration. Clin Sci (Lond),103:171-7
- Domínguez‐Muñoz, J. E. (2011). Pancreatic exocrine insufficiency: diagnosis and treatment. Journal of gastroenterology and hepatology, 26, 12-16
- Domínguez-Muñoz JE, Alvarez-Castro A, Lariño-Noia J, Nieto L, Iglesias-García J.(2012). Endoscopic ultrasonography of the pancreas as an indirect method to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis. Pancreas, 41: 724-728
- Goobie, S., Popovic, M., Morrison, J., Ellis, L., Ginzberg, H., Boocock, G. R., ... & Rommens, J. M. (2001). Shwachman-Diamond syndrome with exocrine pancreatic dysfunction and bone marrow failure maps to the centromeric region of chromosome 7. The American Journal of Human Genetics, 68(4), 1048-1054
- Hart PA, Conwell DL.(2015). Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol,13:347‐53,
- Lindkvist, B. (2013). Diagnosis and treatment of pancreatic exocrine insufficiency. World Journal of Gastroenterology: WJG, 19(42), 7258
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Haziran 2023 |
| Gönderilme Tarihi | 2 Ekim 2022 |
| Kabul Tarihi | 14 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 9 Sayı: 2 |
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