Pancreatitis Flashcards by Tassie Krigbaum

Normal function of the pancreas:

Involves the release of pancreatic enzymes in the duodenum to assist in the digestion of proteins, starches, and fatty acids

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T/F food entering the small intestine stimulates release of the pancreatic enzymes; however, in pancreatitis, the pancreatic enzymes are activated early and digest the pancreas and surrounding tissues, a process called auto digestion

True

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Auto digestion:

When the pancreatic enzymes are activated early and digest the pancreas and surrounding tissues

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Two types of pancreatitis

Acute or chronic

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Amylase breaks down

Starch

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Lipase breaks down

Fats into glycerol and fatty acids

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Acute Pancreatitis:

Inflammatory disorder that involves self destruction of the pancreas by its own enzymes through auto digestion

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Acute pancreatitis is most common in:

Middle-age adults

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What two issues account for the majority of the cases of acute pancreatitis in the U.S.

Gallstones and Alcholism

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Gallstones may activate what:

Pancreatic enzymes within the pancreas, leading to auto digestion, inflammation, edema, and/or necrosis.

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Chronic pancreatitis

Characterized by chronic inflammation, fibrosis, and gradual destruction of functional pancreatic tissue.

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Is acute pancreatitis reversible

Yes

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Is chronic pancreatitis reversible

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Chronic pancreatitis eventually leads to

Pancreatic insufficiency

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What is the primary risk factor for chronic pancreatitis

Alcoholism

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What is the world wide risk factor for chronic pancreatitis

Manutrition

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What occurs in chronic pancreatitis r/t alcoholism

Increased concentration of insoluble protein, protein calcify, forming plugs that black pancreatic ducts and the flow of pancreatic juices.
Leads in inflammation and fibrosis of tissues

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Who is more likely to develop pancreatic cancer

Ethnicity

Men

African Americans

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Acute pancreatitis

Clinical manifestations

Severe epigastric and abdominal pain
Nausea and vomiting
Abdominal distention and rigidity
Decreased bowel sounds
Tachycardia
Hypotension
Elevated temp
Cold and clammy skin

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Acute pancreatitis

Clinical therapies

NPO
IV Hydration
Analgesics
Antibiotics

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Chronic Pancreatitis

Clinical Therapies

Low fat diet
Abstaining from alcohol
Surgery to relieve obstruction
Pancreatectomy

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Chronic Pancreatitis

Manifestations

Gastric and left upper abdominal pain radiating to the back
Anorexia
Weight loss
Nausea and vomiting
Constipation
Steatorrhea

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Steatorrhea

Fatty, frothy, foul-smelling stools caused by a decrease in pancreatic enzyme secretion

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Pain in acute pancreatitis is relieved by

(Somewhat relieved) by sitting up and leaning forward

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Pain is often initiated by

Fatty meal or excessive alcohol intake

Diagnostic tests:

``` Ultrasound Endoscopic ultrasound Contrast enhanced CT scan MRCP ERCP Percutaneous fine-needle aspiration biopsy ```

Pancreatic enzyme replacement medication

Pancrelipase (Lipancreatin)

The nurse is caring for a client with late stage chronic pancreatitis. Which client symptom should the nurse expect to assess? Severe nausea Severe vomiting Severe epigastric pain Steatorrhea

Steatorrhea Others are more associated with acute

Acute pancreatitis | Avoid alcohol why

Alcohol causes swelling to occur in the duodenum, which results in an increase in pressure in the duodenum and entrance of the common bile duct and pancreatic duct. This increase in pressure reduces the outflow of pancreatic enzymes into the small intestine

Normal serum amylase level:

60-160 Somogyi units/dL

Serum lipase level:

20-180 international units/L

Amylase breaks down:

Starch

Lipase breaks down

Fat into glycerol and fatty acids

Acute pancreatitis can be aggravated by:

Eating

Lifestyle modification should the nurse recommend to reduce the risk of chronic pancreatitis

Avoidance of fatty foods | Low fat diet

``` Child with abdominal trauma Monitor for Bloating Jaundice Back pain Fever Vomiting ```

Bloating Jaundice Fever Vomiting

Prevention of pancreatitis | Primary risk factor

Age of older adult

Serum amylase levels would be increased within 2-12 hours after the onset of

Acute pancreatitis

What may develop as the result of complications of chronic pancreatitis

Diabetes mellitus Blood glucose levels are indicated to check

Intended action of pancrelipase

It enhances digestion of starches, proteins, and fats.

What kind of medication will you give to a patient to control pain with acute pancreatitis

Opioid analgesic Hrydromorphone

Diagnostic test for acute pancreatitis

Ultrasound CT scan MRCP

Is an abdominal x ray used to diagnose pancreatitis

Position to promote comfort

Side lying knees flexed and HOB 45 degrees

Assessment findings associated with pancreatitis

Weight loss Abdominal pain History of gallstones Nausea

Acute pancreatitis | Priority for the client

Acute pain Fluid volume deficient Nausea Less than body req imbalanced nutrition

Should pancreatic enzymes taken with meals or not?

Yes take with meals

Acute Pancreatitis | Grey Turner:

Flank discoloration

Cullens Sign:

Bluish preumbilical discoloration

What electrolyte would be decreased with acute pancreatitis

Calcium

Will bilirubin be increased

Yes

What would be surprised and how?

``` Gastric secretions NG tube NPO Antacids H2-Receptor Antagonist PPIs ```

What electrolyte will be increased with chronic pancreatitis

Phosphate

Diet for chronic pancreatitis

Low salt Low fat Veg diet High carbs

Why are antibiotics given with severe pancreatitis

To prevent infection

Chronic pancreatitis, expected finding during Pain assessment

Intermittent pain to mid abdomen and mid back

Common Risk factor for Suspected a cute pancreatitis

Alcohol intake

Acute pancreatitis potential complication

Renal failure

Acute pancreatitis physical assessment findings

Cold and clammy skin

Dietary intake for acute pancreatitis

Low fat

Finding of gray Turner that is positive

Flank area

Labs to monitor

Serum amylase and lipase

Pancreatitis:

Auto digestion of pancreas by enzymes

Risk Factors for pancreatitis

Bile tract disease Alcohol abuse GI surgery Trauma

S/S of pancreatitis

Severe left upper quad pain that can radiate to back or shoulder Nausea and vomiting Turner sign (flank) Cullens sign (umbilicus blue grey discoloration) Jaundice Ascites Tetany

Labs for pancreatitis

``` Increased amylase and lipase Increased bilirubin Increased glucose Increased WBC count Decreased calcium, mg, platelets ```

Nursing care

``` NPO NG tube Antiemetic Insulin to prevent hyperglycemia IV fluids and electrolytes Opioid analgesics Pancreatic enzymes with meals and snacks Progress to bland, low fat diet ```

Patient teaching

No alcohol consumption No smoking Reduce stress

Complications

Chronic pancreatitis Pseudocytes Type 1 diabetes

Pancreatitis Flashcards

(69 cards)