Nursing Interventions: Acute Pancreatitis and Borderline Personality Disorder - Essay Example

Acute pancreatitis and borderline personality disorder Introduction The primary trait of borderline personality disorder (BPD) is a persistent pattern of instability in self-image, interpersonal relationships, and emotions. Persons with borderline personality disorder are additionally very impulsive and often at times demonstrate self-injurious behaviours. Therefore based on Susan’s condition it is clear that the patient had this disorder based on her history of self-harm. Additionally the patient had acute pancreatitis, which is characterised by the inflammation of the pancreas (G, King, p 31, 2015). The ineffective breathing experienced by the patient is because of the severe pain resulting from the acute pancreatitis. The acute pain is because of edema and irritation of the inflamed pancreas. Additionally it may be due to tissue damage. The patient experiences breathing problems, which results due to the acute pain that the patient is experiencing. The paper will discuss approaches, which as a nurse will be necessary to ensure that breathing problems are addressed. Ineffective coping exhibited by the patient may be a likelihood that prohibits proper treatment for being effective therefore nursing interventions will ensure that appropriate strategies are undertaken to ensure the patient becomes responsive to the medication given. Nursing intervention: acute pain In the case of Susan, the patient investigating verbal reports of the acute pain she is experiencing is very vital. Pain is often severe, diffuse, and unrelenting in acute pancreatitis. Therefore, various interventions need to be undertaken by a nurse in trying to resolve the acute pain experienced by a patient. The patient needs to maintain bed rest during the acute attack, and that means there should be a quiet and restful environment. The patient has a borderline personality disorder. Therefore, proper measures need to be undertaken to ensure that the patient is relaxed at the time of acute pains. The restful environment provides that the metabolic rate and secretions are little to reduce the pancreatic activity, which ultimately reduces the pains of the patient (G, King, p 31, 2015). Promote the patient’s position of comfort on one side with the knees flexed, leaning forward and in a sitting up position. The measures undertaken will ensure that the patient experiences reduced abdominal pressure and tension, therefore providing some measure of pain relief and comfort. It is vital to note that the Supine position often increases the pain experienced by a patient. As a nurse, I would try to maintain a meticulous skin care program, especially in the presence of draining abdominal wall fistulas. The Pancreatic enzymes secreted can digest the tissues and skin of the abdominal wall hence creating a chemical burn, which ultimately cause pain to the patient. Acute pain may also be addressed by ensuring that the patient is in an odor free environment as the sensory stimulations caused by such orders can cause the activation of pancreatic enzymes, which ultimately leads to pain. Finally, I would undertake Administering of analgesics in timely manner. Prolonged pain can aggravate shock, which is harder to relieve hence requiring larger medication doses. The underlying problems and complications if not well handled May lead to respiratory depression. Ineffective breathing patterns. The patient is experiencing breathing problems therefore as a nurse there are various steps that need to be undertaken. Assessing the symptoms and signs of the ineffective breathing pattern is vital, for instance, use of accessory muscles, dyspnea, tachypnea and monitoring the chest excursion. Improving breathing pattern may involve the performance of action on ways of improving and reducing anxiety and fear. In this case ensuring individuals I work with provide a restful environment that will aid the patient not to experience breathing problems, which result from fear and anxiety. Instruct the patient to remain flat on the bed and assist the patient to change position after every 2 to 3 hours will aid in the breathing process. The change in position would require the patient to use the incentive spirometer, which will assist in measuring the positive airway pressure within the patient’s respiratory system. In addition, it would be necessary to perform actions that would prevent and treat pleural effusion in cases where severe pain has subsided (G, King, p 31, 2015). The process would involve placing the patient in a semi- to high Fowlers position with pillows, which will be vital in preventing slumping. Further, I would be necessary to administer central nervous system depressants to the patient, and if the respiratory rate is less than 12/minute it is vital to consult the physician. Ineffective coping Since the patient has a borderline disorder, it would be vital to note the causes of ineffective coping that encompass identification of situational factors, such factors would assist in gaining an understanding of the patient’s current situation. The nurse’s knowledge would assist the patient in coping more effectively (Carpenito, p27, 2013). The borderline disorder causes the victims to feel more dependent on others for decision-making therefore as a nurse proper explanation to the patient need to be given to assist the patient in making her decisions. Monitoring the risk of harming exhibited by the patient can be useful in ensuring the patient does not have thoughts of committing suicide. A patient exhibiting hopelessness and inability to problem solve often have a high risk of committing suicide. It is often vital to note the source of stressors that causes the patient to cause effects exhibited by the patients. Understanding the stressors can be important in ensuring the patient has active coping (McIntosh, p 22, 2014) Usage of empathetic communication with the patient is essential in ensuring the client feels empowered and satisfied that assists the patient in building a conducive environment with the nurses. Communication with the patient ensures that the patient has less anxiety and depression situations that ensure proper breathing ultimately reducing acute pain (Carpenito, p18, 2013). Patient Outcomes Criteria for likely outcomes should be SMART with S, which stands for specific, and focus on the client. In this, the medication needs to be precise to ensure that the likely outcome is achieved. M stands for measurable that entails quantifying the desired response impartially. A stands for Attainable or perceivable – setting goals that are attainable is vital in treating the borderline personality disorder and acute pancreatitis to ensure the patients can recover from the condition steadily. R stands for Realistic, therefore, as a nurse, it will be vital and realistic to have all things in place to help in addressing the patients situation.T stands for Time-bound or time-limited. As a nurse time is of the essence, therefore, timing concerning the medication is essential that the condition is treated within the desired period. Conclusion Therefore based on the presented nursing interventions performed will ensure that the symptoms exhibited by the patient will ease and lead to better health for the patient. Containing the patients borderline disorder is vital in ensuring there is stability in the patient’s behaviour, which will, provides proper reception given by the nurses to the patient. Reference Carpenito, L. J. (2013). Handbook of nursing diagnosis. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. King, Gemma. "Staff Attitudes Towards People With Borderline Personality Disorder." Mental Health Practice 17.5 (2014): 30-34. Academic Search Complete. Web. 20 Apr. 2015. Mcintosh, J. (2014) what is borderline personality disorder (BPD)?’ medical news today Read More