I've been working all day on my care plan for my patient with obstructive jaundice and I had no idea it would be this difficult!! My patient is a 65 y/o F who presents to her PMD with complaints of a yellow tinge to her eyes. He admits her to the hospital for further eval. She has an ERCP, EGD, and sphincterotomy preformed. No gall stones noted but there was a mention of biliary stricture. They wanted to preform an MRCP but the patient refused d/t claustrophobia. There was no CT preformed. I have come up with my key problems of:
My constipation and Pain are not difficult to work up interventions for, however her jaundice is most problematic. Her supporting data for all that is the ERCP findings, and all of her LFT including Bili T, C, U, alk phos, AST and ALT. However I have no idea what kind of interventions to preform on her besides assessing for improvements of her bili and ast and alt. Lastly, her NANDA for jaundice! I was leaning towards Impaired Liver function which I found as a new NANDA on this list http://wps.prenhall.com/wps/media/ob...74686_AppC.pdf
However I'm unsure if this is even correct. Perhaps a nanda of Risk for imbalanced nutrition less than body requirements due to impaired absorption.. but does impaired absorption occur with obstructive jaundice??
PLEASE HELP!!! All comments are welcome