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From Flashcardlet > (2) Exam 3- Pancreas > Flashcards

(2) Exam 3- Pancreas Flashcards

0
Q

Acute pancreatitis

In the United States, what is the most common cause of injury to the pancreas

A

Gallbladder disease

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1
Q

Acute pancreatitis

What ethnicity is three times more likely to have pancreatitis

A

African Americans

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2
Q

Acute pancreatitis

Biliary sludge is a mixture of

A

Cholesterol crystals and calcium salts

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3
Q

Acute pancreatitis

What is the most common pathogenic mechanism of acute pancreatitis

A

Autodigestion of the pancreas

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4
Q

Acute pancreatitis

What is autodigestion of the pancreas

A

Pancreatic enzymes are activated in the pancreas rather than in the intestines

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5
Q

Acute pancreatitis

What is an in active proteolytic enzyme produced by the pancreas

A

Trypsinogen

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6
Q

Acute pancreatitis

In the small intestines, trypsinogen is activated to

A

Trypsin

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7
Q

Acute pancreatitis

In pancreatitis, activated trypsin in the pancreas can digest the pancreas and produce

A

Bleeding

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8
Q

Acute pancreatitis
Clinical manifestations

What is the predominant manifestation of acute pancreatitis

A

Abdominal pain

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9
Q

Acute pancreatitis
Clinical manifestations

In acute pancreatitis, in what quadrant is abdominal pain usually located in and because of its retroperitoneal location where does the pain radiate

A

LUQ

Commonly radiates to the back

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10
Q

Acute pancreatitis
Clinical manifestations

In acute pancreatitis the pain has a sudden onset and is described as

A

Severe, deep, piercing, and continues or steady

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11
Q

Acute pancreatitis
Clinical manifestations

In acute pancreatitis does eating relieve or aggravate the pain

A

Pain is aggravated by eating

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12
Q

Acute pancreatitis
Clinical manifestations

In acute pancreatitis is pain relieved by vomiting

A

It is not received by vomiting

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13
Q

Acute pancreatitis
Clinical manifestations

In acute pancreatitis, the pain may be accompanied by

A

Flushing, cyanosis, dyspnea

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14
Q

Acute pancreatitis
Clinical manifestations

Bowel sounds an acute pancreatitis

A

Decreased or absent

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15
Q

Acute pancreatitis
Clinical manifestations

Other manifestations of acute pancreatitis

A

Nausea and vomiting, low-grade fever, leukocytosis, hypotension, tachycardia, jaundice, abdominal tenderness with muscle guarding

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16
Q

Acute pancreatitis
Clinical manifestations

What circulating enzyme causes intravascular damage resulting in areas of cyanosis or greenish to yellow-brown discoloration of the abdominal wall

A

Trypsin

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17
Q

Acute pancreatitis
Complications

What are two significant local complications of acute pancreatitis

A

Pseudocyst and abscess

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18
Q

Acute pancreatitis
Complications

What are the manifestations of pseudocyst

A

Abdominal pain, palpable epigastric mass, nausea, vomiting, and anorexia

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19
Q

Acute pancreatitis
Complications

Serum amylase level with pseudocyst

A

Elevated

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20
Q

Acute pancreatitis
Complications

What are the treatment options for pseudocyst

A

Surgical drainage, percutaneous catheter placement and drainage, endoscopic drainage

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21
Q

Acute pancreatitis
Complications

What is a pancreatic abscess

A

Collection of pus

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22
Q

Acute pancreatitis
Complications

Where the manifestations of an abscess

A

Upper abdominal pain, abdominal mass, high fever, and leukocytosis

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23
Q

Acute pancreatitis
Complications

To prevent sepsis, what is required with pancreatic abscesses

A

Surgical drainage

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24
Q

Acute pancreatitis
Complications

The main systemic complication of acute pancreatitis are pulmonary and cardiovascular complications and tetany caused by

A

Hypocalcemia

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25
Q

Acute pancreatitis
Complications

When hypocalcemia occurs, it is a sign of

A

Severe disease

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26
Q

Acute pancreatitis
Complications

As a result of Intraabdominal hypertension and edema, patients with severe acute pancreatitis at risk for

A

Abdominal compartment syndrome

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27
Q

Acute pancreatitis
Diagnostic studies

What is the primary diagnostic tests for acute pancreatitis

A

Serum amylase and lipase

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28
Q

Acute pancreatitis
Diagnostic studies

Sarah and Emily’s level is usually elevated early and remains elevated for

A

24 to 72 hours

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29
Q

Acute pancreatitis
Diagnostic studies

Serum lipase level, which is also elevated in acute pancreatitis, is an important test because

A

Other disorders may increase serum amylase levels

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30
Q

Acute pancreatitis
Diagnostic studies

What is the best imaging test for pancreatitis and related complications

A

CT scan

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31
Q

Acute pancreatitis
Diagnostic studies

In acute pancreatitis, serum amylase, serum lipase, urinary amylase, blood glucose, serum calcium, and serum triglycerides are elevated except

A

Serum calcium

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32
Q

Acute pancreatitis
Collaborative care

Goals of collaborative care for acute pancreatitis

A

1) relief of pain
2) prevention or alleviation of shock
3) reduction of pancreatic secretions
4) Direction of fluid and electrolyte imbalances

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33
Q

Acute pancreatitis
Collaborative care

Treatment is primarily focused on

A

Aggressive hydration, pain management, management of metabolic complications, and minimization of pancreatic stimulation

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34
Q

Acute pancreatitis
Collaborative care

What medication may be used to control pain

A

IV morphine

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35
Q

Acute pancreatitis
Collaborative care

What agent may be combined with pain medications

A

Antispasmodic agent

36
Q

Acute pancreatitis
Collaborative care

When should atropine and other anticholinergic drugs be avoided

A

When paralytic ileus is present

37
Q

Acute pancreatitis
Collaborative care

Supplemental oxygen is provided to maintain oxygen saturation greater than

A

95%

38
Q

Acute pancreatitis
Collaborative care

In patients with severe pancreatitis, serum glucose levels are closely monitored for

A

Hyperglycemia

39
Q

Acute pancreatitis
Collaborative care

What is used if shock is present

A

Blood volume replacements

40
Q

Acute pancreatitis
Collaborative care

How are fluid and electrolyte imbalance corrected

A

Lactated ringers solution or other electrolyte solutions

41
Q

Acute pancreatitis
Collaborative care

To reduce or suppress pancreatic enzymes to decrease stimulation of the pancreas and allow it to rest, what actions need to be taken

A

Patient is NPO

NG suction maybe used to reduce vomiting and gastric distention

Drugs to suppress a gastric acid secretion

42
Q

Acute pancreatitis
Collaborative care

For patients with severe acute pancreatitis who do not resent oral intake, what may be initiated

A

Enteral nutrition via nasojejunal tube

43
Q

Acute pancreatitis
Collaborative care

In patients with acute necrotizing pancreatitis, what is the leading cause of morbidity and mortality

A

Infection

44
Q

Acute pancreatitis
Collaborative care

When the acute pancreatitis is related to gallstones, what may be done

A

And urgent ERCP

45
Q

Acute pancreatitis
Collaborative care

When food is allowed and small frequent feedings are given, what type of diet is ordered because it is the least stimulating to the exocrine portion of the pancreas

A

High carbohydrate

46
Q

Acute pancreatitis
Collaborative care

When should you suspect intolerance to oral foods

A

Patient reports pain, has increasing abdominal girth, or has elevations in serum amylase and lipase levels

47
Q

Acute pancreatitis
Nursing Assessment

What respiratory changes may be present with acute pancreatitis

A

Tachypnea

48
Q

Acute pancreatitis
Nursing Assessment

What cardiovascular changes may be present with acute pancreatitis

A

Tachycardia and hypotension

49
Q

Acute pancreatitis
Nursing Assessment

What general findings may accompany Acute pancreatitis

A

Restlessness, anxiety, low-grade fever

50
Q

Acute pancreatitis
Nursing Assessment

What integumentary changes May be present with acute pancreatitis

A

Flushing, diaphoresis, discoloration of abdomen and flanks, cyanosis, jaundice, decreased skin turgor, dry mucous membranes

51
Q

Acute pancreatitis
Nursing Assessment

What gastrointestinal changes may occur with acute pancreatitis

A

Abdominal distention, tenderness, muscle guarding, diminished bowel sounds

52
Q

Acute pancreatitis
Nursing Management

What are the overall goals for the patient with acute pancreatitis

A

1) relief of pain
2) normal fluid and electrolyte balance
3) minimal to no complications
4) no reoccurrence attacks

53
Q

Acute pancreatitis
Nursing Implementation

What may develop in the patient with severe acute pancreatitis

A

Respiratory failure

54
Q

Acute pancreatitis
Nursing Implementation

What may be required if ARDS develops

A

Intubation or mechanical ventilatory support

55
Q

Acute pancreatitis
Nursing Implementation

Because hypocalcemia can occur, what symptoms do you want to observe for

A

Tetany

56
Q

Acute pancreatitis
Nursing Implementation

What should be given to treat symptomatic Hypocalcemia

A

Calcium gluconate

57
Q

Acute pancreatitis
Nursing Implementation

Assuming what positions may decrease pain

A

Positions that flex the trunk and draw the knees up to the abdomen

58
Q

Acute pancreatitis
Nursing Implementation

What is essential to prevent parotitis

A

Oral care

59
Q

Acute pancreatitis
Nursing Implementation

Dietary teachings for acute pancreatitis

A

Restriction of fats

Encourage carbohydrates

Avoid crash dieting and binging

60
Q

Chronic pancreatitis
Etiology and pathophysiology

What is chronic pancreatitis

A

A continued, prolonged, inflammatory, and fibrosing process of the pancreas

61
Q

Chronic pancreatitis
Etiology and pathophysiology

The most common cause of obstructive pancreatitis is associated with cholelithiasis and is inflammation of the

A

Sphincter of Oddi

62
Q

Chronic pancreatitis
Etiology and pathophysiology

In the United States what individual is chronic pancreatitis excessively found in

A

Individuals who abuse alcohol

63
Q

Chronic pancreatitis
Clinical Manifestations

As with acute pancreatitis, the pain is located in the same area but is usually described as

A

Heavy, gnawing feeling, burning and cramping

64
Q

Chronic pancreatitis
Clinical Manifestations

Is abdominal pain relieved with food or antacids

A

Pain is not relieved with food or antacids

65
Q

Chronic pancreatitis
Diagnostic Studies

What lab values may be elevated with chronic pancreatitis

A

Serum amylase and lipase

Serum bilirubin

Alkaline phosphase

66
Q

Chronic pancreatitis
Diagnostic Studies

What imaging study is used to visualize the pancreatic and common bile ducts

A

ERCP

67
Q

Chronic pancreatitis
Diagnostic Studies

What are stools samples examined for

A

Fecal fat content

68
Q

Chronic pancreatitis
Collaborative Care

If dietary measures and enzyme replacement are not affected, what analgesics sometimes takes frequent doses to relieve pain

A

Morphine or Fentanyl patch

69
Q

Chronic pancreatitis
Collaborative Care

What diet is recommended to decrease pancreatic stimulation

A

Small, bland, frequent meals that are low in fat content

70
Q

Chronic pancreatitis
Collaborative Care

What are ways to control the pancreatic insufficiency

A

Diet, pancreatic enzyme replacement, and control of diabetes

71
Q

Chronic pancreatitis
Collaborative Care

What beverages do you want to teach the patient not to consume

A

Alcohol and caffeinated beverages

72
Q

Chronic pancreatitis
Collaborative Care

What medication has been shown to reduce the neuropathic pain associated with chronic pancreatitis

A

Antidepressants such as nortriptyline

73
Q

Chronic pancreatitis
Nursing Management

What treatment measures are essential for chronic pancreatitis

A

Dietary control along with consistency of other treatment measures such as taking pancreatic enzymes

74
Q

Chronic pancreatitis
Nursing Management

To control gastric acidity when should antacids be taken

A

After meals and at bedtime

75
Q

Pancreatic Cancer

More than half of the tumors occur in what area of the pancreas

A

The head

76
Q

Pancreatic Cancer

Signs and symptoms of pancreatic cancer are often similar to those of

A

Chronic pancreatitis

77
Q

Pancreatic Cancer

After the initial diagnosis, the majority of patients with pancreatic cancer die within

A

5 to 12 months

78
Q

Pancreatic Cancer

What is the most firmly established environmental risk factor for pancreatic cancer

A

Cigarette smoking

79
Q

Pancreatic Cancer
Clinical Manifestations

What are common manifestations of pancreatic cancer

A

Abdominal pain, anorexia, rapid and progressive weight loss, nausea, and jaundice

80
Q

Pancreatic Cancer
Clinical Manifestations

How is the abdominal pain described and pancreatic cancer

A

Dull and aching

81
Q

Pancreatic Cancer
Clinical Manifestations

What may accompany obstructive jaundice

A

Pruritus

82
Q

Pancreatic Cancer
Diagnostic Studies

What diagnostic study involves imaging the pancreas with the use of an endoscope position in the stomach and the duodenum and also allows for fine needle aspirate shin of the tumor

A

EUS

83
Q

Pancreatic Cancer
Diagnostic Studies

Pancreatic secretions and tissue can be collected for analysis of different time or markers from what diagnostic study

A

ERCP

84
Q

Pancreatic Cancer
Collaborative Care

What provides the most effective treatment of cancer of the pancreas

A

Surgery

85
Q

Pancreatic Cancer
Collaborative Care

What is the classic surgery for pancreatic cancer

A

Radical pancreaticoduodenectomy or Whipple procedure

86
Q

Pancreatic Cancer
Collaborative Care

Radiation therapy alone has no effect on survival, but may be effective for

A

Pain relief

87
Q

Pancreatic Cancer
Nursing Management

Due to impaired vitamin K production, what do you want to assess for him pancreatic cancer

A

Assess for bleeding

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