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13 Cards in this Set
- Front
- Back
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Risk factors for pancreatic cancer
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exact cause unknown-risks are smoking, high fat protein caffeine alcohol diets, 10% inherited risk
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Complications of pancreatic cancer
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DVT, hypercoagulation, thrombophlebitis,
thromboembolism |
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s/s of pancreatic cancer
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vague, dull abdmonial pain, weight loss weakness, anorexia, n/v, glucose intolerance, flatulence, GI blleding, ascities, leg/calf pain, jaundice (if head of pancreas incvolved) -then clay colred stools, dark urine
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Whipple procedure consists of
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removal of pancreas head, duodenum, stomach (potion or all), portion of jejunum, gallbladder, spleen
also duct anastamoses: pancreatic, common bil eto jejunum |
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Post op mgmt of whipple
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will be in ICU, GI drainage and monitoring through NG tube (should be serous sanguenous not frank blood), NO PRESSURE ON SUTURE LINES, semi fowelers for lung expansion, F&E- sinificant blood loss during procedure, HOURLY GLUCOSE MONITORING b/c they can be hypo or hyperglycemic, fistula formation is serious, irritating to skin-irrigate with NS
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Risk factors for pancreatitis
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alcohol intake (5-10 yrs), prior biliary disease, abd sx or diagnostics, mostly middle aged men, trauma, recent viral infections, meds-thiazide diuretics, opiates, steroids, birth control
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S/S of acute pancreatitis
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sudden intense continuous mid epigastric or LUQ pain that may radiate to back L flank or shoulder
pain may be lessened in fetal or orthopnic positions, weight loss, n/v, jaundice Cullens sign-gray blue in abd and periumbilical area means enzymes have leaked into the tissue Turner's sign- gray blue in flank area- enzymes leaked decreased bowel sounds to paralytic ileus, palpable abd tenderness, palpable mass, ascities, fever, tachycardia, decrease BP |
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Clinical mgmt of acute pancreatitis
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let bowels rest by making pt NPO, IV fluids w/electrolytes, NGT to suction, antospasmotics/spasmolytics, anticholinergics to decrease vagal stimulation/GI motility and inhibit pancreatic secretions, somastatin or octreotide to decrease secretin, ORAL CARE
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Once PO what can they have?
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High carbs, high protein, low fat
bland, limit caffeine chocolate, no alcohol |
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S/S of chronic pancreatitis
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intense abd pain that is continous and burning or knawing, abd tenderness, ascities, possible LUQ mass if pseudocyst or abcess is present, adventitious or diminished breath sounds, dyspnea, orthopnea, steatorrhea, clay colored stools, weight loss, jaundice, dark urine, polyuria, polydipsia, polyphagia (DM)
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Surgical mgmt of pancreatitis:
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Not treatment of choice
exploratory laparotomy for obstructions, I&D if abcess or psuedocyst, cholecystectomy is biliary disease, partial pancreatotomy for pain relief, vagotomy to dec enzyme production |
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Post op care pancreatitis
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same as for other abd sx
immaculate skin care to prevent pancreatic enzymes from excoriating the tissues, enterostomal therapy consult |
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Pancreatic enzyme replacement
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Take WITH meals, administer after antacis or H2 blockers not at the same time, swallow tab w/out chewing, mix powdered enzymes in applesauce or fruit juice, DO NOT MIX IN PROTEIN CONTAINING FOODS, wipe lips after taking to avoid irritation, monitor uric acid with Pancrelipase
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