Pancreatitis

Question 1

What’s the major exocrine function of the pancreas?

Answer 1

Facilitate digestion through the secretion of enzymes and hormones into proximal duodenum

Question 2

What enzymes/hormones are secreted by the pancreas?

Answer 2

Secretin, Cholecytokinin-pancreozymin (CCK and PCZ) and protein/fat digestion

Question 3

What is pancreatitis?

Answer 3

Inflammation of the pancreas from autodigestion

Question 4

Obstruction of pancreatic duct, hypersection of the exocrine enzymes of the pancreas, which enter the bile duct and reflux into the pancreatic duct causes what?

Answer 4

Pancreatitis

Question 5

What is the chief complaint in acute pancreatitis?

Answer 5

PAIN

Question 6

What is autodigestion?

Answer 6

Process where the pancreatic enzymes destroy its own tissue leading to inflammation

Question 7

What is acute pancreatitis?

Answer 7

Digestion of the pancreas by trypsin, usually from long-term alcohol use or can be from trauma or a viral infection

Question 8

What’s the nursing assessment for acute pancreatitis?

Answer 8

Severe abd pain, acute and more severe after meals, abd guarding, N/V, hypotension, resp. distress and hypoxia

Question 9

Serum amylase and lipase, elevated WBC and H/H are what?

Answer 9

Lab studies performed

Question 10

What diagnostics can be performed?

Answer 10

CT scans or ultrasounds

Question 11

What is done to establish pancreatic drainage or debride a necrotic pancreas?

Answer 11

Surgical intervention

Question 12

What type of dressing are ordered for necrotic wounds that are left OPEN?

Answer 12

Wet-to-dry

Question 13

What postacute management is done for acute pancreatitis?

Answer 13

Antacids and oral feedings (low fat, proteins)

Question 14

What is Endoscopic Retrograde Cholangipancreatography (ERCP)?

Answer 14

Is to diagnose chronic pancreatitis and to differentiate inflammation and fibrosis from cacrinoma

Question 15

Nursing measures to reduce pain and discomfort in a pt w/ acute pancreatitis?

Answer 15

Admin Meperidine (Demoral)*, Dilaudid or morphine; NPO TPN instead; NGT suction if needed; bed rest; report sudden increase in pain bc of possible perforation

Question 16

Nursing measures to improve breathing pattern in a pt w/ acute pancreatitis?

Answer 16

Semi-fowlers; anticholinergic meds; pulse ox; C/DB exercises and useing IS

Question 17

Nursing measures to improve nutritional status?

Answer 17

Daily weights and nutritional labs (albumin/protein); TPN; diet high in carbs and low in fats/protein; ne heavy meals or alcohol

Question 18

What should be checked if a pt is on TPN and how often?

Answer 18

Glucose; q6hr

Question 19

Nursing measures to prevent F/E imbalances?

Answer 19

I/O; wts; monitor for ascities; IVF; blood transfusions; be alert for s/s of shock

Question 20

What can cause F/E imbalances?

Answer 20

N/V; NGT suction; fever

Question 21

What are s/s of shock?

Answer 21

Hypotension; tachycardia and pale skin

Question 22

Nursing measures to prevent pancreaticc necrosis?

Answer 22

Monitor VS; IV’s; and possible ventilatory support

Question 23

What is the major cause of morbidity and mortality?

Answer 23

Pancreatic necrosis

Question 24

What are risks from pancreatic necrosis?

Answer 24

Hemorrhage, septic shock, multiple organ failure

Question 25

Nursing measures to prevent shock and multiple organ failure?

Answer 25

Monitor CV, renal and resp. s/s

Question 26

Nursing measures to improve skin integrity?

Answer 26

Assess wounds and drain sites; consult w/ ET/WOC nurse; turn q2h; use specialty beds and assess for poor wound healing

Question 27

What is chronic pancreatitis?

Answer 27

Inflammatory disorder characterized by progressive anatomic and functional destruction of the pancreas

Question 28

Chronic alcohol abuse, hereditary disorders of the pancreas, cystic fibrosis, hypercalcemia, hyperlipidemia, meds, autoimmune conditions and either unknown are causes of what?

Answer 28

Chronic pancreatitis

Question 29

Modify behaviors that may exacerbate the natural history of the disease; enable the pancreas to heal itself; determine the cause of the abd pain and alleviate it; detect pancreatic exocrine insufficiency and restore digestion and absorption to normal and diagnose and treat endocrine insufficiency is what?

Answer 29

Th goals of medical treatment for chronic pancreatitis

Question 30

Pancreatic pseudocyst; abscess; fistula; ascities; fixed obstruction of the intrapancreatic portion of the distal common bile duct; stenosis of the duodenum w/ gastric outlet observation and variceal hemorrhage due to splenic vein thrombosis are all indications of what?

Answer 30

Surgical management

Question 31

What are pseudocysts?

Answer 31

Encapsulated collections of fluid that may develop w/in the pancreas and in the abd cavity

Question 32

What is a fistula?

Answer 32

An abnormal connection b/t organs