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Acute Pancreatitis
Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes in order of frequency include: 1) a gallstone impacted in the common bile duct beyond the point where the pancreatic duct joins it; 2) heavy alcohol use; 3) systemic disease; 4) trauma; 5) and, in minors, mumps. Acute pancreatitis may be a single event; it may be recurrent; or it may progress to chronic pancreatitis. Mild cases are usually successfully treated with conservative measures: hospitalization, pain control, nothing by mouth, intravenous nutritional support, and intravenous fluid rehydration. Severe cases often require admission to an intensive care unit to monitor and manage complications of the disease. Complications are associated with a high mortality, even with optimal management. Signs and symptoms Common *severe epigastric pain (upper abdominal pain) radiating to the back in 50% of cases * nausea * vomiting *loss of appetite * fever *chills (shivering) *hemodynamic instability, i ...
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American Journal Of Nursing
The ''American Journal of Nursing'' (AJN) is a monthly peer-reviewed nursing journal established in 1900. the editor-in-chief was Maureen Shawn Kennedy and it is published by Lippincott Williams & Wilkins. In 2009 the journal was selected as one of the "100 Most Influential Journals in Biology and Medicine in the Last 100 Years" by the Biomedical and Life Sciences Division of the Special Libraries Association. History The ''American Journal of Nursing'' was established in 1900 as its official journal by the Associated Alumnae of Trained Nurses of the United States which later became the American Nurses Association (ANA). Isabel Hampton Robb, Lavinia Dock, Mary E. P. Davis and Sophia Palmer are credited with founding the journal, the latter serving as the first editor. Other editors have included Mary May Roberts (1921–1949), Nell V. Beeby (1949–1956), Jeanette V. White (1956–1957), Edith P. Lewis (1957–1959), Barbara G. Schutt (1959–1971), Thelma M. Schorr (1971–198 ...
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Epigastric Pain
Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. About 15% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy. In a third of cases the exact cause is unclear. Given that a variety of diseases can cause some form of abdominal pain, a systematic approach to the examination of a person and the formulation of a differential diagnosis remains important. Differential diagnosis The most frequent reasons for abdominal pain are gastroenteritis (13%), irritable bowel syndrome (8%), urinary tract problems (5%), inflammation of the stomach (5%) and constipation (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or p ...
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Cullen's Sign
Cullen's sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. It is named for gynecologist Thomas Stephen Cullen (1869–1953), who first described the sign in ruptured ectopic pregnancy in 1916.T.S. Cullen. Embryology, anatomy, and diseases of the umbilicus together with diseases of the urachus. Philadelphia, Saunders, and London, 1916. This sign takes 24–48 hours to appear and can predict acute pancreatitis, with mortality rising from 8–10% to 40%. It may be accompanied by Grey Turner's sign (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding. Causes Causes include: * acute pancreatitis, where methemalbumin formed from digested blood tracks around the abdomen from the inflamed pancreas * bleeding from blunt abdominal trauma * bleeding from aortic rupture * bleeding from ruptured ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which th ...
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Grey-Turner's Sign
Grey Turner's sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration, and is a sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity. Grey Turner's sign takes 24–48 hours to develop, and can predict a severe attack of acute pancreatitis. Grey Turner's sign may be accompanied by Cullen's sign. Both signs may be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding. Grey Turner's sign is named after British surgeon George Grey Turner. Causes Causes include * Acute pancreatitis, whereby methemalbumin formed from digested blood tracks subcutaneously around the abdomen from the inflamed pancreas. * Pancreatic hemorrhage * Retroperitoneal hemorrhage * Blunt abdominal trauma * Ruptured / hemorrhagic ectopic pregnancy. * Spontaneous bleeding secondary to coagulopathy (congenital or acquired) * Aortic ...
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Hiccup
A hiccup (scientific name ''singultus'', from a Latin word meaning "to catch one's breath while sobbing"; also spelled hiccough) is an involuntary contraction ( myoclonic jerk) of the diaphragm that may repeat several times per minute. The hiccup is an involuntary action involving a reflex arc. Once triggered, the reflex causes a strong contraction of the diaphragm followed about a quarter of a second later by closure of the vocal cords, which results in the "hic" sound. Hiccups may occur individually, or they may occur in bouts. The rhythm of the hiccup, or the time between hiccups, tends to be relatively constant. A bout of hiccups generally resolves itself without intervention, although many home remedies are often used to attempt to shorten the duration. Medical treatment is occasionally necessary in cases of chronic hiccups. Incidence Hiccups affect people of all ages, even being observed '' in utero''. They become less frequent with advancing age. Intractable hiccups ...
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Peritonitis
Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome. Causes include perforation of the intestinal tract, pancreatitis, pelvic inflammatory disease, stomach ulcer, cirrhosis, or a ruptured appendix. Risk factors include ascites (the abnormal build-up of fluid in the abdomen) and peritoneal dialysis. Diagnosis is generally based on examination, blood tests, and medical imaging. Treatment often includes antibiotics, intravenous fluids, pain medication, and surgery. Other measures may include a nasogastric tube or blood transfusion. Without treatment death may occur within a few days. About 20% of people with cirrhosis who are hospitalized have peritonitis. Signs and symptoms Abdo ...
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Respiratory Distress
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of its distinct sensations, the degree of distress and discomfort involved, and its burden or impact on the patient's activities of daily living. Distinct sensations include effort/work to breathe, chest tightness or pain, and "air hunger" (the feeling of not enough oxygen). The tripod position is often assumed to be a sign. Dyspnea is a normal symptom of heavy physical exertion but becomes pathological if it occurs in unexpected situations, when resting or during light exertion. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failu ...
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Tachycardia
Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (such as with exercise) or abnormal (such as with electrical problems within the heart). Complications Tachycardia can lead to fainting. When the rate of blood flow becomes too rapid, or fast blood flow passes on damaged endothelium, it increases the friction within vessels resulting in turbulence and other disturbances. According to the Virchow's triad, this is one of the three conditions that can lead to thrombosis (i.e., blood clots within vessels). Causes Some causes of tachycardia include: * Adrenergic storm * Anaemia * Anxiety * Atrial fibrillation * Atrial flutter * Atrial tachycardia * Atrioventricular reentrant tachycardia * AV nodal reentrant tachycardia * Brugada syndrome * Circulatory shock and its various causes ( ...
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Shock (circulatory)
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. Shock is divided into four main types based on the underlying cause: low volume, cardiogenic, obstructive, and distributive shock. Low volume shock, also known as hypovolemic shock, may be from bleeding, diarrhea, or vomiting. Cardiogenic shock may be due to a heart attack or cardiac contusion. Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses. The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. A decreased pulse pressure ( systolic blood ...
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Hemodynamics
Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously monitors and adjusts to conditions in the body and its environment. Hemodynamics explains the physical laws that govern the flow of blood in the blood vessels. Blood flow ensures the transportation of nutrients, hormones, metabolic waste products, oxygen, and carbon dioxide throughout the body to maintain cell-level metabolism, the regulation of the pH, osmotic pressure and temperature of the whole body, and the protection from microbial and mechanical harm. Blood is a non-Newtonian fluid, and is most efficiently studied using rheology rather than hydrodynamics. Because blood vessels are not rigid tubes, classic hydrodynamics and fluids mechanics based on the use of classical viscometers are not capable of explaining haemodynamics. The ...
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Chills
Chills is a feeling of coldness occurring during a high fever, but sometimes is also a common symptom which occurs alone in specific people. It occurs during fever due to the release of cytokines and prostaglandins as part of the inflammatory response, which increases the set point for body temperature in the hypothalamus. The increased set point causes the body temperature to rise (pyrexia), but also makes the patient feel cold or chills until the new set point is reached. Shivering also occurs along with chills because the patient's body produces heat during muscle contraction in a physiological attempt to increase body temperature to the new set point. When it does not accompany a high fever, it is normally a light chill. Sometimes a chill of medium power and short duration may occur during a scare, especially in scares of fear, commonly interpreted like or confused by trembling. Severe chills with violent shivering are called rigors. Causes Chills are commonly caused ...
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Fever
Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral, bacterial, and parasitic infections—such as influenza, the common cold, meningitis, urinary tract infections, appendicitis, Lassa, COVID-19, and malaria. Non-infectious cau ...
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