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Med Surg 2 > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

Normal function of the pancreas:

A

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

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2
Q

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

A

True

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3
Q

Auto digestion:

A

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

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4
Q

Two types of pancreatitis

A

Acute or chronic

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5
Q

Amylase breaks down

A

Starch

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6
Q

Lipase breaks down

A

Fats into glycerol and fatty acids

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7
Q

Acute Pancreatitis:

A

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

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8
Q

Acute pancreatitis is most common in:

A

Middle-age adults

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9
Q

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

A

Gallstones and Alcholism

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10
Q

Gallstones may activate what:

A

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

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11
Q

Chronic pancreatitis

A

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

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12
Q

Is acute pancreatitis reversible

A

Yes

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13
Q

Is chronic pancreatitis reversible

A

No

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14
Q

Chronic pancreatitis eventually leads to

A

Pancreatic insufficiency

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15
Q

What is the primary risk factor for chronic pancreatitis

A

Alcoholism

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16
Q

What is the world wide risk factor for chronic pancreatitis

A

Manutrition

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17
Q

What occurs in chronic pancreatitis r/t alcoholism

A

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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18
Q

Who is more likely to develop pancreatic cancer

Ethnicity

A

Men

African Americans

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19
Q

Acute pancreatitis

Clinical manifestations

A 
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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20
Q

Acute pancreatitis

Clinical therapies

A

NPO
IV Hydration
Analgesics
Antibiotics

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21
Q

Chronic Pancreatitis

Clinical Therapies

A

Low fat diet
Abstaining from alcohol
Surgery to relieve obstruction
Pancreatectomy

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22
Q

Chronic Pancreatitis

Manifestations

A 
Gastric and left upper abdominal pain radiating to the back
Anorexia
Weight loss
Nausea and vomiting
Constipation
Steatorrhea
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23
Q

Steatorrhea

A

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

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24
Q

Pain in acute pancreatitis is relieved by

A

(Somewhat relieved) by sitting up and leaning forward

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25
Q

Pain is often initiated by

A

Fatty meal or excessive alcohol intake

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26
Q

Diagnostic tests:

A 
Ultrasound 
Endoscopic ultrasound
Contrast enhanced CT scan 
MRCP
ERCP
Percutaneous fine-needle aspiration biopsy
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27
Q

Pancreatic enzyme replacement medication

A

Pancrelipase (Lipancreatin)

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28
Q

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

A

Steatorrhea

Others are more associated with acute

29
Q

Acute pancreatitis

Avoid alcohol why

A

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

30
Q

Normal serum amylase level:

A

60-160 Somogyi units/dL

31
Q

Serum lipase level:

A

20-180 international units/L

32
Q

Amylase breaks down:

A

Starch

33
Q

Lipase breaks down

A

Fat into glycerol and fatty acids

34
Q

Acute pancreatitis can be aggravated by:

A

Eating

35
Q

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

A

Avoidance of fatty foods

Low fat diet

36
Q 
Child with abdominal trauma
Monitor for 
Bloating
Jaundice
Back pain
Fever 
Vomiting
A

Bloating
Jaundice
Fever
Vomiting

37
Q

Prevention of pancreatitis

Primary risk factor

A

Age of older adult

38
Q

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

A

Acute pancreatitis

39
Q

What may develop as the result of complications of chronic pancreatitis

A

Diabetes mellitus

Blood glucose levels are indicated to check

40
Q

Intended action of pancrelipase

A

It enhances digestion of starches, proteins, and fats.

41
Q

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

A

Opioid analgesic

Hrydromorphone

42
Q

Diagnostic test for acute pancreatitis

A

Ultrasound
CT scan
MRCP

43
Q

Is an abdominal x ray used to diagnose pancreatitis

A

No

44
Q

Position to promote comfort

A

Side lying knees flexed and HOB 45 degrees

45
Q

Assessment findings associated with pancreatitis

A

Weight loss
Abdominal pain
History of gallstones
Nausea

46
Q

Acute pancreatitis

Priority for the client

A

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

47
Q

Should pancreatic enzymes taken with meals or not?

A

Yes take with meals

48
Q

Acute Pancreatitis

Grey Turner:

A

Flank discoloration

49
Q

Cullens Sign:

A

Bluish preumbilical discoloration

50
Q

What electrolyte would be decreased with acute pancreatitis

A

Calcium

51
Q

Will bilirubin be increased

A

Yes

52
Q

What would be surprised and how?

A 
Gastric secretions
NG tube
NPO
Antacids
H2-Receptor Antagonist 
PPIs
53
Q

What electrolyte will be increased with chronic pancreatitis

A

Phosphate

54
Q

Diet for chronic pancreatitis

A

Low salt
Low fat
Veg diet
High carbs

55
Q

Why are antibiotics given with severe pancreatitis

A

To prevent infection

56
Q

Chronic pancreatitis, expected finding during Pain assessment

A

Intermittent pain to mid abdomen and mid back

57
Q

Common Risk factor for Suspected a cute pancreatitis

A

Alcohol intake

58
Q

Acute pancreatitis potential complication

A

Renal failure

59
Q

Acute pancreatitis physical assessment findings

A

Cold and clammy skin

60
Q

Dietary intake for acute pancreatitis

A

Low fat

61
Q

Finding of gray Turner that is positive

A

Flank area

62
Q

Labs to monitor

A

Serum amylase and lipase

63
Q

Pancreatitis:

A

Auto digestion of pancreas by enzymes

64
Q

Risk Factors for pancreatitis

A

Bile tract disease
Alcohol abuse
GI surgery
Trauma

65
Q

S/S of pancreatitis

A

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

66
Q

Labs for pancreatitis

A 
Increased amylase and lipase
Increased bilirubin
Increased glucose
Increased WBC count
Decreased calcium, mg, platelets
67
Q

Nursing care

A 
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
68
Q

Patient teaching

A

No alcohol consumption
No smoking
Reduce stress

69
Q

Complications

A

Chronic pancreatitis
Pseudocytes
Type 1 diabetes

Med Surg 2 (22 decks)

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