A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

Pancrelipase 500 units/kg PO three times daily with meals

Pantoprazole 80 mg IV bolus twice daily

Initiate a low-residue diet

D Ambulate twice day

Answer and Explanation

The Correct Answer is B

A. Pancrelipase 500 units/kg PO three times daily with meals: Pancrelipase is an enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates in clients with pancreatic insufficiency. However, in acute pancreatitis, the pancreas is inflamed and typically unable to produce sufficient enzymes. Therefore, enzyme replacement therapy is not typically initiated during the acute phase of pancreatitis.
B. Pantoprazole 80 mg IV bolus twice daily: This is the correct answer. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion. It is commonly prescribed in acute pancreatitis to decrease gastric acid production and reduce pancreatic enzyme activity, thereby promoting pancreatic rest and reducing further pancreatic inflammation and injury.
C. Initiate a low-residue diet: In acute pancreatitis, clients are typically kept NPO (nothing by mouth) initially to allow the pancreas to rest and inflammation to decrease. Once oral intake is resumed, a low-fat, easily digestible diet is usually recommended. However, the initiation of a low-residue diet is not typically indicated during the acute phase of pancreatitis.
D. Ambulate twice daily: While early ambulation is generally encouraged in hospitalized clients to prevent complications such as deep vein thrombosis and pneumonia, ambulation may be limited initially in clients with acute pancreatitis due to pain and discomfort. Ambulation is not typically a priority during the acute phase of pancreatitis; instead, pain management and supportive care are emphasized.

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Correct Answer is B

Explanation

A. "I will tell your family of your concern so that they can be here." This option involves the family in the client's care, which is important during end-of-life situations. However, it assumes that the client's primary concern is about the family's presence rather than exploring the underlying emotions or fears the client may be experiencing. While involving the family is beneficial, it may not directly address the client's emotional needs.
B. "I wonder if you are fearful of dying alone." This response demonstrates therapeutic communication by acknowledging the client's statement and exploring the underlying feelings or concerns behind it. It shows empathy and provides an opportunity for the client to express their emotions. Fear of dying alone is a common concern for many individuals facing the end of life, and addressing this fear can help alleviate distress.
C. "We will call your family in time for them to get here." While involving the family is important, this response primarily focuses on the logistics of family arrival rather than addressing the client's emotional needs. It may not fully explore or validate the client's feelings about dying alone.
D. "I will make sure a staff member is in your room at all times." While providing support and ensuring the client's comfort is essential, this response does not directly address the client's emotional needs or explore their concerns about dying alone. It also may not be feasible to have a staff member constantly present in the room. This option may not fully address the client's underlying fears or emotions related to dying alone.

A. "Have you talked to your parents about this yet?" B. "Why do you think you are so anxious?" C. "It sounds like you are having a difficult time." D. "How long has this been going on?"

Correct Answer is C

Explanation

A. Asking the client if they have talked to their parents about their anxiety may not be appropriate, as it assumes the client is comfortable discussing their concerns with their parents. It's important to establish rapport and trust with the client before delving into personal matters such as family dynamics.
B. Asking "Why do you think you are so anxious?" may come across as confrontational and put the client on the defensive. It's important to approach the client's concerns with empathy and understanding rather than seeking an explanation for their anxiety.
C. This response acknowledges the client's feelings and validates their experience, showing empathy and understanding. It opens the door for further exploration of the client's concerns and allows the nurse to provide support and assistance.
D. While assessing the duration of symptoms is important, asking "How long has this been going on?" as an initial response may feel dismissive to the client's current distress. Starting with an empathetic acknowledgment of the client's experience can help build rapport and trust before delving into more specific questions about the duration and severity of symptoms.

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A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

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