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Mr. Gregory White
Mr. Gregory White, Professor
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Case Study - Patient with Acute and Recurrent Pancreatitis Case

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Case Study - Patient with Acute and Recurrent Pancreatitis

Case Overview

Mr. Rambo, a 45-year-old male, walked into the emergency room at Good Graces Hospital because of a three day history of abdominal pain, vomiting, and nausea. The patient was discharged after IV fluids were administered. The
patient’s medical history reveals that he has had pancreatitis several times before.

The last time the patient consumed alcohol was two months ago. The patient denies any alcohol consumption, and there is no history of coronary artery disease. The patient still complains of pain in the mid-abdominal area, and does
not seem to get any relief.

The patient does not present shortness of breath, chest pain, or diarrhea. He is awake and oriented to time, person, and place. He is a smoker. He does not use any drugs.

On hospital admission, high laboratory data include: lipase 706, amylase 285. His admission diagnosis is acute recurrent pancreatitis and gastritis. His diet remains NPO 24 hrs. after admission. His admission weight is 140 lbs. and his height is
69”. Per patient, his UBW is 160 lbs. (2 months ago). His medications on admission included IV fluids, Demerol, pepcid.
He was administered one dose of lasix. Strict I&Os were ordered.

The R.D. calculated his kcal and protein needs based on the Harris Benedict equation and hospital protocol.


1.Using the five-step nutrition care process, discuss how you would work with the registered dietitian (RD) to create a Nutrition Care Plan for this patient.

2.How you would use anthropometric data to assess his nutritional status?

3.What are the options for providing nutritional support?

4.When would you initiate feeding and how?

5.If tube feedings are warranted, how will you determine the type of formula to use?

6.Why are enteral feedings important for a patient with severe acute pancreatitis?

7.What would you do to minimize potential complications from enteral tube feeds?

8.Where would you place the tube?

9.Discuss the transition from the tube to oral feeding. At what point would you discontinue the tube feedings?

10.How would you evaluate progress toward meeting his nutritional needs?

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