Unit 2: Pancreatitis

Question 1

3 Causes of Acute Pancreatitis
Which has the worst prognosis?

Answer 1

1. Obstruction (biliary tract disease-gallstones)
2. Trauma (surgery)
3. Alcoholism–WORST PROGNOSIS

Question 2

If our pancreas ain’t workin’, what ain’t happenin’?

Answer 2

NO DIGESTION = NO REGULATION of glucose

Question 3

Describe the pain associated with Acute Pancreatitis

Answer 3

Location: mid-epigastric region
Aggravating factors: worsened when supine or with activity
Quality: “boring” (like an alien trying to get out)
Severity: 10/10

Question 4

Grey-Turner’s Sign =

Answer 4

ecchymosis of the flanks (necrosis of pancreas)

Question 5

Cullen’s sign =

Answer 5

ecchymosis of lower belly (hemorrhagic pancreatitis)

Question 6

There are A LOT of complications r/t to Acute Pancreatitis. LET’S NAME ‘EM! (7)

Answer 6

1. Infection → SEPSIS, Pneumonia
2. Hemorrhage →Shock
3. Necrosis
4. ARDS/ALI: Acute Respiratory Distress Syndrome and Acute Lung Injury
5. Renal Failure
6. Paralytic ileus
7. Diabetes
   (Messer included Jaundice, but that’s a Sx..)

Question 7

2 priority Interventions r/t Acute Pancreatitis

Answer 7

1. ABCs!
2. Pain Mx

Question 8

Other Interventions r/t Acute Pancreatitis (4)

Answer 8

1. IV fluids
2. Electrolyte replacement
3. Antiemetics
4. NG tube (remove gastric contents)

Question 9

Best way to relieve pain r/t Acute Pancreatitis

Answer 9

NPO → Rest the stomach
NO FOOD FOR YOU!

Question 10

Pt Positioning r/t Acute Pancreatitis

Answer 10

Sitting up, Leaning forward
Lying on LEFT side in fetal position

Question 11

Describe the pain associated with Chronic Pancreatitis

Answer 11

Not as bad as acute pancreatitis, but that makes it hard to tell if the pt is experiencing an acute attack

Question 12

What’s the best intervention to Mx pain r/t Chronic pancreatitis?

Answer 12

Pancreatic enzymes + Antacids

Question 13

What extra S/S will you see r/t Pancreatic Cancer (5)

Answer 13

Gall bladder AAAAAND liver involvement!
1. Scleral jaundice
2. Pruritis
3. Fatigue
4. Loss of appetite (anorexia?)
5. Ascites

Question 14

What the heck is a Whipple?

Answer 14

pancreaticoduodenectomy (BIG surgery; 4-6 hrs)
-Removal of proximal head of pancreas, duodenum, part of jejunem, part or all of stomach and gallbladder
Anastomosis of pancreatic duct, common bile duct, stomach and jejunem

Question 15

Whipple complications (8)

Answer 15

1. Diabetes
2. Bleeding
3. Infection
4. Bowel obstruction
5. Abscess
6. Pneumonia
7. Fistula
8. Peritonitis

Question 16

Positioning post Whipple

Answer 16

Fowler’s

Question 17

Whipple Post-surgical Interventions (8)

Answer 17

1. ABC’s
2. Vital signs
3. Monitor blood glucose
4. Pain Management
5. IV Fluids
6. Electrolytes
7. NG tube
8. Fowler’s position