HEALTHCARE PROCESS OF THE PATIENT WITH ACUTE PANCREATITIS

Akutni pankreatitis je nagla upala gušterače koja se može javiti u blagom ili teškom obliku. Ova nagla upala se u gotovo 80% prijema u bolnicu pripisuje postojanju žučnih kamenaca ili konzumaciji alkohola. Žučni kamenci kao uzrok budu 1,5 puta češći kod žena, dok se alkohol kao uzrok u muškaraca pojavljuje šest puta više nego kod žena. Žučni kamenci najčešće začepe otvor pankreatičnog voda ili se na neko vrijeme zaustave u Oddijevu sfinkteru uzrokujući time upalu dok svakodnevna konzumacija alkohola također može dovesti do začepljenja malih vodova. Jaki bolovi se javljaju najčešće naglo nakon konzumacije prekomjerne količine obroka ili alkohola u gornjem srednjem dijelu abdomena. Osim što je bol nagla, pacijenti je opisuju kao probadajuću bol koja se širi u leđa. Može se javiti mučnina kao i nagon na povraćanje, u većini slučajeva popratnu uz temperaturu. Bolesnik se javlja u hitni trakt radi jakih bolova koji se ne smanjuju te se podvrgava daljnjoj dijagnostici. Laboratorijskim pretragama ne može se potvrditi dijagnoza akutnog pankreatitisa ali povišenom razinom enzima gušterače tu dijagnozu možemo potkrijepiti. Daljnjim radiološkim pretragama (rendgen abdomena, kompjutorizirana tomografija) dokazuje se mogućnost postojanja žučnih kamenaca kao i promjene u veličini i strukturi gušterače. Sa utvrđenom dijagnozom akutnog pankreatitisa, osoba se zaprima na odjel gdje se prekida daljnji unos hrane i pića kako bi se smanjila daljnja proizvodnja enzima u gušterači. Svu potrebnu tekućinu i ostale hranjive tvari nadoknađuju se intravenskim putem. U cijelom procesu liječenja ključna je i medicinska sestra koja najprije može uočiti eventualne promjene koje se mogu javiti kod pacijenta, kao što su primjerice smanjeno mokrenje, otežano disanje te stagniranje ili pogoršavanje intenziteta boli unatoč primijenjenoj analgetskoj terapiji.Acute pancreatitis is a sudden pancreatic inflammation occurring in mild or severe form. This sudden inflammation in almost 80% of admission to the hospital is attributed to the existence of gallstones or drinking alcohol. The gallstones as a cause of Acute pancreatitis are 1.5 times more common in women, while alcohol as a cause is present men appears six times more than in women. Gallstones usually close the pancreatic opening or stop for a while in Oddies sphincter causing it to inflate ,while daily alcohol consumption also leads to clogging of small lines. Strong pain usually are occurring suddnely after eating excessive meals or presence of alcohol in the upper mid-section of the abdomen. Apart pain is acute, patients are describeing as a stabbing kind of pain that is spreading in their back. There can be nausea and vomiting, in most cases accompanied by temperature. The patient is coming to an emergency with severe pain that does not diminish and undergoes further diagnosis. Laboratory examinations can not confirm the diagnosis of acute pancreatitis but elevated pancreatic enzyme levels can be supported by this diagnosis. Further radiological examinations (X-ray abdomena, computerized tomography) are proveing the possibility of gallstones as well as changes in the size and structure of the pancreas. With established diagnosis of acute pancreatitis, a person is hospitalized in intensice care where further food and drink intake is discontinued in order to reduce further enzyme production in the pancreas. All the necessary fluid and other nutrients are compensated by the intravenous. Throughout the process of treatment, role of nurse is also crucial to notice possible changes that may occur in the patient, such as decreased urination, difficulty breathing and stagnation or aggravation of pain intensity despite analgesic therapy

Geospatial variability of soil CO2–C exchange in the main terrestrial ecosystems of Keller Peninsula, Maritime Antarctica

Soils and vegetation play an important role in the carbon exchange in Maritime Antarctica but little is known on the spatial variability of carbon processes in Antarctic terrestrial environments. The objective of the current study was to investigate (i) the soil development and (ii) spatial variability of ecosystem respiration (ER), net ecosystem CO2 exchange (NEE), gross primary production (GPP), soil temperature (ST) and soil moisture (SM) under four distinct vegetation types and a bare soil in Keller Peninsula, King George Island, Maritime Antarctica, as follows: site 1: moss-turf community; site 2: moss-carpet community; site 3: phanerogamic antarctic community; site 4: moss-carpet community (predominantly colonized by Sanionia uncinata); site 5: bare soil. Soils were sampled at different layers. A regular 40-point (5 × 8 m) grid, with a minimum separation distance of 1 m, was installed at each site to quantify the spatial variability of carbon exchange, soil moisture and temperature. Vegetation characteristics showed closer relation with soil development across the studied sites. ER reached 2.26 μmol CO2 m− 2 s− 1 in site 3, where ST was higher (7.53 °C). A greater sink effect was revealed in site 4 (net uptake of 1.54 μmol CO2 m− 2 s− 1) associated with higher SM (0.32 m3 m− 3). Spherical models were fitted to describe all experimental semivariograms. Results indicate that ST and SM are directly related to the spatial variability of CO2 exchange. Heterogeneous vegetation patches showed smaller range values. Overall, poorly drained terrestrial ecosystems act as CO2 sink. Conversely, where ER is more pronounced, they are associated with intense soil carbon mineralization. The formations of new ice-free areas, depending on the local soil drainage condition, have an important effect on CO2 exchange. With increasing ice/snow melting, and resulting widespread waterlogging, increasing CO2 sink in terrestrial ecosystems is expected for Maritime Antarctica

Geospatial variability of soil CO2–C exchange in the main terrestrial ecosystems of Keller Peninsula, Maritime Antarctica

Soils and vegetation play an important role in the carbon exchange in Maritime Antarctica but little is known on the spatial variability of carbon processes in Antarctic terrestrial environments. The objective of the current study was to investigate (i) the soil development and (ii) spatial variability of ecosystem respiration (ER), net ecosystem CO2 exchange (NEE), gross primary production (GPP), soil temperature (ST) and soil moisture (SM) under four distinct vegetation types and a bare soil in Keller Peninsula, King George Island, Maritime Antarctica, as follows: site 1: moss-turf community; site 2: moss-carpet community; site 3: phanerogamic antarctic community; site 4: moss-carpet community (predominantly colonized by Sanionia uncinata); site 5: bare soil. Soils were sampled at different layers. A regular 40-point (5 × 8 m) grid, with a minimum separation distance of 1 m, was installed at each site to quantify the spatial variability of carbon exchange, soil moisture and temperature. Vegetation characteristics showed closer relation with soil development across the studied sites. ER reached 2.26 μmol CO2 m− 2 s− 1 in site 3, where ST was higher (7.53 °C). A greater sink effect was revealed in site 4 (net uptake of 1.54 μmol CO2 m− 2 s− 1) associated with higher SM (0.32 m3 m− 3). Spherical models were fitted to describe all experimental semivariograms. Results indicate that ST and SM are directly related to the spatial variability of CO2 exchange. Heterogeneous vegetation patches showed smaller range values. Overall, poorly drained terrestrial ecosystems act as CO2 sink. Conversely, where ER is more pronounced, they are associated with intense soil carbon mineralization. The formations of new ice-free areas, depending on the local soil drainage condition, have an important effect on CO2 exchange. With increasing ice/snow melting, and resulting widespread waterlogging, increasing CO2 sink in terrestrial ecosystems is expected for Maritime Antarctica