Patient with a tumor near the pancreas blocking the common bile duct
Your patient is a 52-year-old male with a history of smoking and alcohol abuse. He presents to the ED with complaints of "my skin looks yellow, my stomach hurts, and I feel nauseous". He is taken to CT and a tumor near the pancreas is observed. It appears to be blocking the common bile duct. Develop a plan of care for the patient. Use the attached concept map.
General plan of care for a patient with a tumor near the pancreas blocking the common bile duct based on the information provided.
Plan of Care:
Assessment and Monitoring:
Monitor vital signs regularly, paying close attention to temperature, heart rate, blood pressure, and respiratory rate.
Assess pain level using a pain scale and document pain characteristics.
Monitor intake and output, including urine output and daily weights.
Monitor laboratory values such as liver function tests, bilirubin levels, and complete blood count (CBC).
Pain Management:
Administer analgesics as ordered for pain relief based on the patient’s pain level.
Assess the effectiveness of pain medication and make necessary adjustments.
Provide non-pharmacological pain relief measures such as relaxation techniques or positioning.
Symptom Management:
Administer antiemetic medications as ordered to alleviate nausea and vomiting.
Offer small, frequent meals to manage nausea and improve nutritional intake.
Encourage the patient to maintain hydration by drinking fluids in small amounts frequently.
Nutritional Support:
Collaborate with a registered dietitian to develop a modified diet plan based on the patient’s individual needs and restrictions.
Monitor the patient’s nutritional status and provide nutritional supplements if necessary.
Educate the patient on the importance of maintaining adequate nutrition and managing nutritional deficiencies.
Collaborative Care:
Consult with a gastroenterologist or surgeon to determine the best course of action for managing the tumor and relieving the obstruction.
Arrange for endoscopic retrograde cholangiopancreatography (ERCP) or surgical intervention to remove or bypass the tumor if necessary.
Coordinate with interprofessional team members for ongoing monitoring, management, and support.
Psychosocial Support:
Assess the patient’s emotional well-being and provide psychological support.
Offer counseling services or referral to a support group for the patient and their family members.
Collaborate with a social worker or case manager to address any financial or social concerns.
It is important to note that this is a general plan of care, and specific interventions may vary depending on the patient’s condition, treatment options, and individual needs. Consulting with the healthcare team and tailoring the plan of care accordingly is crucial for optimal patient outcomes.