[Bala Shark]

My patient has pancreatitis...The abnormal lab values are

ALT: 80 High
Normal values: 7-56
Significance: Used to diagnose and monitor treatment of liver disease

AST: 47 High
Normal values:15-46
Significance: Pancreatitis

Lipase: 345 High
Normal values: 23-300
Significance: Pancreatitis

I want to know the significance of abnormal lab values in relation to patient care. As an example, what to look for in a patient? What are the symptoms? What to do? Please help..I have a lab test, nursing implications text book but the information is very brief and does not go into detail about pancreatitis..Can any experienced nurse help me? Thank you.

[zenman]

Originally Posted by Bala Shark

I want to know the significance of abnormal lab values in relation to patient care. As an example, what to look for in a patient? What are the symptoms? What to do? Please help..I have a lab test, nursing implications text book but the information is very brief and does not go into detail about pancreatitis..Can any experienced nurse help me? Thank you.

Remember that as a nursing student, google.com is your best friend. Here's the first listing I found under "pancreatitis."
http://digestive.niddk.nih.gov/ddise.../pancreatitis/

[southern rn]

Originally Posted by Bala Shark

My patient has pancreatitis...The abnormal lab values are

ALT: 80 High
Normal values: 7-56
Significance: Used to diagnose and monitor treatment of liver disease

AST: 47 High
Normal values:15-46
Significance: Pancreatitis

Lipase: 345 High
Normal values: 23-300
Significance: Pancreatitis

I want to know the significance of abnormal lab values in relation to patient care. As an example, what to look for in a patient? What are the symptoms? What to do? Please help..I have a lab test, nursing implications text book but the information is very brief and does not go into detail about pancreatitis..Can any experienced nurse help me? Thank you.

Hi, quick answer for you,almost times to get the kids ready for school.Pts with pancreatitis will typically present with nausea/vomiting, abd pain. Some general malaise. The lab values you quoted while elevated are relatively mild elevations. Need to watch for dehydration,treat abd pain, etc. Typically are given ivf's and prn pain/nausea meds,npo or liquid diet while watching labs. Can be caused by etoh intake, gallstones/duct stones, and some meds.
Hopefully someone can elaborate more for you. Good luck!

[mtnmom]

In pancreatitis the primary labs to watch for elevation are amylase and lipase. The liver enzymes you showed were only mildly elevated.
I would be curious what the pt's amylase level was.
Also, sometimes acute pancreatitis can be associated with high...I mean sky high....triglycerides. Another reason to keep the triglycerides down.

[P_RN]

Merck manual is/was my dearest friend for lab values.

http://www.merck.com/mrkshared/mmanu...es/296tb2a.jsp

[labman]

Bala

Thank of the organs they are affecting. ALT and AST both pertain to the liver. When I think of care of the patient and elevated liver enzymes I immediatly think of medication. If there liver can't really process the medication that well a lower dose of the medication should be given (pretty sure). These elevations both say that there are liver problems but not major ones. I know hepatitis has really high values so I think this would be before pain. Also a pancreatitis. I know that people with pancreatitis usually have abdominal pain. So plan to do frequent pain assessments q 1 hour or something. But also how the pancreas helps in the GI system. It secrets bicarb and enzymes to help with digestion. So maybe a change in dietary habits. I wished I knew the exact change but I just have no idea.

I hope this helps a little
KENT

[sirI]

Originally Posted by Bala Shark

My patient has pancreatitis...The abnormal lab values are

ALT: 80 High
Normal values: 7-56
Significance: Used to diagnose and monitor treatment of liver disease

AST: 47 High
Normal values:15-46
Significance: Pancreatitis

Lipase: 345 High
Normal values: 23-300
Significance: Pancreatitis

I want to know the significance of abnormal lab values in relation to patient care. As an example, what to look for in a patient? What are the symptoms? What to do? Please help..I have a lab test, nursing implications text book but the information is very brief and does not go into detail about pancreatitis..Can anyone help me? Thank you.

Hello, Bala Shark,

Check out this article from eMedicine. Very good w/u regarding pancreatitis.

http://www.emedicine.com/emerg/topic354.htm

[Spatialized]

As for pancreatitis, just did a teaching presentation for class on this so it's still fresh. The labs aren't too bad, they're in the normal high range. Here's what I can recall at the moment.

ALT & AST
LFTs, usually elevated in ETOH abuse, hepatitis, somewhat inpancreatitis (due to inflammation of the pancreas). However these can be elevated for many different reasons. Things I would be looking for on a pt. w/elevated LFTs would be anorexia, jaundice, abd. distention r/t ascites, to name a few.

Lipase
Not the major pancreatitis marker. Again, normal high range, seen folks with much higher. Some meds can cause elevation too.

The big one with pancreatitis is amylase.

But I realize you're trying to correlate lab values with pt. assessment. Once you understand the labs, you an start knowing what to look for. For example, on the tele floor where I work, we watch K all the time. If you have an elevated or decreased K, you know to watch for arrhythmias due to increased irritability of the heart. A great resource I found that made the labs click is: http://www.icufaqs.org/. Check out his section on labs as he ties in lab values and assessments findings.

Good luck!
Tom

[Bala Shark]

Originally Posted by southern rn

Hi, quick answer for you,almost times to get the kids ready for school.Pts with pancreatitis will typically present with nausea/vomiting, abd pain. Some general malaise. The lab values you quoted while elevated are relatively mild elevations. Need to watch for dehydration,treat abd pain, etc. Typically are given ivf's and prn pain/nausea meds,npo or liquid diet while watching labs. Can be caused by etoh intake, gallstones/duct stones, and some meds.
Hopefully someone can elaborate more for you. Good luck!

Yes, I know what lipase, AST, ALT does..And you gave the signs and symptoms of pancreatitis..On paper, should I write the signs and symptoms and can I say, that the patient has high lipase values that show pancreatits then I will discuss the signs and symtoms of pancreatitis to the patient...Is that a good way of approaching it?

[earle58]

if you're going strictly by your pt's labs, i would guess the pt is asymptomatic. as already stated, the labs are rather unremarkable.

leslie