Chapter 30, Problem 1CS

(1)

Summary Introduction

To determine:

How does the octreotide (Sandostatin) work to control VIPoma-related diarrhea?

Case summary:

J.R. is a 56-year-old beautician, is diagnosed with a vasoactive intestinal peptide-producing tumor (VIPoma). She was scheduled for her surgery to treat cancer but developed severe diarrhea. She became dehydrated after two days of profuse, watery diarrhea, hence, she has been hospitalized. She has not taken food for several days. Also, she has nausea and facial flushing and lost five pounds in two days. Intravenous fluid replacement with saline has been started. J.R. will be receiving octreotide (Sandostatin). Eight years ago her gallbladder was removed and she has no other history of illness.

(2)

Summary Introduction

To predict:

J.R. begins the octreotide (Sandostatin) therapy, what parameters the nurse should assess.

Case summary:

J.R. is a 56-year-old beautician, is diagnosed with a vasoactive intestinal peptide-producing tumor (VIPoma). She was scheduled for her surgery to treat cancer but developed severe diarrhea. She became dehydrated after two days of profuse, watery diarrhea, hence, she has been hospitalized. She has not taken food for several days. Also, she has nausea and facial flushing and lost five pounds in two days. Intravenous fluid replacement with saline has been started. J.R. will be receiving octreotide (Sandostatin). Eight years ago her gallbladder was removed and she has no other history of illness.

(3)

Summary Introduction

To determine:

What is an explanation for this elevation?

Case summary:

J.R. is a 56-year-old beautician, is diagnosed with a vasoactive intestinal peptide-producing tumor (VIPoma). She was scheduled for her surgery to treat cancer but developed severe diarrhea. She became dehydrated after two days of profuse, watery diarrhea, hence, she has been hospitalized. She has not taken food for several days. Also, she has nausea and facial flushing and lost five pounds in two days. Intravenous fluid replacement with saline has been started. J.R. will be receiving octreotide (Sandostatin). Eight years ago her gallbladder was removed and she has no other history of illness. After two days of octreotide (Sandostatin) therapy, the episodes of diarrhea have been reduced. The nurse records that her blood glucose levels are elevated.