Running head: DISCHARGE PLANNING PROJECT 1

Discharge Planning Project

Brittaney Bures
University of South Florida














DISCHARGE PLANNING PROJECT 2
The patient is a 34 year-old male who presented to the emergency department and was
admitted with left upper and left lower quadrant pain, along with radiating pain to his lower
back. The patients lipase levels were elevated, indicating the presence of pancreatitis. During his
hospitalization, the patient was treated with 2mg of morphine for pain every four hours/PRN, and
received IV fluids to prevent dehydration. He was also on a clear, liquid diet in order to limit the
workload on the pancreas, and was expected to have a nasogastric tube placed in order to remove
contents in the stomach. A CT of the abdomen/pelvis without contrast confirmed the lab findings
as pancreatitis, showing edema in the pancreatic tail region consistent with pancreatitis and
peripancreatic stranding.
The patient is expected to remain on a clear, liquid diet until symptoms of pancreatitis get
better. The patient should then continue eating a healthy diet that is low in fat, no more than 30
grams of fat per day, and eating smaller meals more frequently. The patient was also instructed
not to drink any alcohol and to quit smoking.
The patient verbalizes that he understands his pancreatitis is related to his alcoholism,
which is the reason for his admission. The patient was further educated on the pancreas and how
its affected in the disease process. It was explained to the patient that the pancreas is the organ
in the body that produces enzymes needed to digest food. When the pancreas becomes inflamed,
it is called pancreatitis. When inflammation occurs over periods of time, scaring can occur and
cause damage to the organ. If the right amount of damage is done to the organ, it impairs the
function of the pancreas and it can no longer make the right amount of enzymes to allow the
body to digest fat and other foods properly.
If the patient can no longer absorb fats, he can take pancreatic enzymes, which will help
the body absorb fats better. These are in tablet form and are to be taken with every meal. Along
DISCHARGE PLANNING PROJECT 3
with the pancreatic enzymes, the patient will take need to take a medicine to decrease the acid in
the stomach, famotidine (PEPCID), which is to be taken twice daily. It is taken for the
management of gastroesophageal reflux disease, resulting in inhibition of gastric acid secretion.
The side effects of this medication include constipation, dizziness, nausea, and diarrhea. He also
takes a multivitamin (THERA vitamin) and a thiamine tablet, 100 mg daily. Thiamine is a
supplement for patients with a history of alcoholism for treatment of thiamine deficiencies. The
use acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) should be tried first to control pain if
symptoms reoccur. If stronger pain persists, the patient may need an opiate pain reliever, such as
morphine. Side effects of morphine include sedation, constipation, hypotension, bradycardia,
and respiratory depression. The patient was educated of these medications and understands their
use and side effects.
The patient currently lives alone but travels often for work. While he does live alone, he
mentions that his parents live close by and that he maintains a good relationship with them. He
does not have any financial concerns, but does admit that follow-up and commitment to
appointments would be a struggle, due to his busy lifestyle and travel for work. The patient lives
in a safe living environment; however, due to his fast-paced lifestyle, it is not conducive to a
healthy diet regimen. The importance of adherence to medication and maintaining a healthy diet
was reinforced to the patient, even while traveling. It was encouraged that the patients parents
are involved in his discharge planning and help to encourage healthier eating choices. Also, the
patient mentions that he smokes and drinks because of the stresses he faces at work. Patient
education on coping mechanisms and alternatives to dealing with stress were discussed with the
patient, as well as information for AA meetings.
DISCHARGE PLANNING PROJECT 4
For this patient, home health services and the home medical equipment are not needed.
Upon discharge, however, I would recommend that the patient discuss options and dietary goals
with a dietary team member. The goal for this patient is to help him plan a diet that is low in fat
and high in nutrients, with frequent meals and adequate liquids throughout the day. I would also
get pain management involved if symptoms reoccur or do not improve with lifestyle changes and
medications.
The most important consideration for the patient is patient education. It is imperative that
the patient understands the disease process and the risk factors associated with it. The patient
needs may include complicated home regimens, psychosocial interventions, or both. Resources
need to be identified, implemented, and evaluated to ensure positive outcomes, adequate patient
satisfaction, and lower readmission rates.