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1.
Possible considerations: The elevated amylase and lipase levels are concerning and indicate potential blockage of the pancreatic duct. The patient’s history of recent birth, elevated BMI, and symptoms surrounding ingestion of fatty food including increased abdominal pain are also worrying signs.
2.
The most concerning information is the elevated liver enzymes combined with the findings from the CT scan indicating acute cholecystitis with potential pancreatitis. This suggests a significant inflammation and inability to eliminate bile that could lead to complications if not promptly managed.
3.
An expected finding is the presence of inflamed bile duct due to blockage, because the patient has a known history of gallstones. The patient is the classic example of the 4 Fs (female, fat, forty, fertile). She has pain after ingestion of a fatty meal, accompanied with steatorrhea.
4.
It is important to question if the patient has any history of allergic reactions to the previous anesthesia. Surgical removal of gallbladder is evident, and the nurse should identify the need to educate the patient on the procedure. Ask when the patient last ingested food or water. Additionally, considering the patient’s recent delivery of twins, it is crucial to ask about blood loss or any abnormal experience with the delivery. Furthermore, questioning the adequacy of the current medication regimen and considering the need for IV fluids and pain medication or hospitalization should be discussed with the healthcare team.