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Whipples operation or pancreatoduodenectomy (excision ofthe head of the pancreas along with the encircling loop of theduodenum) Antineoplastic combinations: fluorouracil, streptozocin(Zanosar), ifosfamide (Ifex), and doxorubicin; gemcitabine anderlitinib (Tarceva) Insulin after pancreatic resection to provide adequate exogenous insulin supply Opioid analgesics: morphine, meperidine (Demerol), andcodeine, which can lead to biliary tract spasm and increasecommon bile duct pressure (used only when other methodsfail) Pancreatic enzyme: pancrelipase (Pancrease)Key interventions Monitor fluid balance, abdominal girth, metabolic state, andweight daily.

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PULMONARY EMBOLISMKey signs and symptoms Sudden onset of dyspnea, tachypnea, cracklesKey test results ABG levels show respiratory alkalosis and hypoxemia.

Some morningsthey awake confused and combative.

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Increasing fluid intake, especially duringhot weather, illness, and exercise Increasing fluids at night and voidingfrequently Voiding whenever urge is felt Testing urine pHSyphilisA chronic, infectious STD, syphilis begins inthe mucous membranes and quickly becomessystemic, spreading to nearby lymph nodesand the bloodstream.

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GASTROESOPHAGEAL REFLUXKey signs and symptoms Dysphagia Heartburn (burning sensation in the upper abdomen)Key test results Barium swallow fluoroscopy indicates reflux.

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Premedicate the client 1 hour beforethe procedure to ensure the clientscomfort during the procedure.

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AMPolish up on client careTeaching topicsNURSING DIAGNOSES Explanation of the disorder and treatmentplan Medication and possible adverse effects Recognizing signs of relapse Strategies to reduce stress Contacting the National Depressive andManic Depressive association for support405 Anxiety Ineffective coping Deficient knowledge (disorder andtreatment plan)Generalized anxiety disorderA client with generalized anxiety disorderworries excessively and experiences tremendous anxiety almost daily.

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