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56 Cards in this Set
- Front
- Back
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What is a brief definition of Pancreatitis?
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Inflammation of the Pancrease
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How many types if any are there or Pancreatitis and what are they?
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2 - Chronic and Acute
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How severe is Pancreatitis?
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Can range from Mild to severe.
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Describe Acute Pancreatitis and how long does it last?
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Interstitial or edematous pancreatitis. Pancreatic Edema or Inflammation. Last approx 6 months.
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List 3 Risk factors of Mild Acute Pancreatitis
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Risk for schock, Risk for fluid electrolyte imbalances, Risk for sepsis.
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Acute Pancreatitis is also known as?
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Necrotizing or hemorrhagic pancreatitis.
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Acute Pancreatitis occurs because what is taking place?
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The pancreas is digesting itself causing tissue necrosis.
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In Acute Pancreatitis what tissue is involved?
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Retroperitoneal
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In Acute Pancreatitis Systemic complications occur...what are the three?
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ARDS, DIC, and Pleural Effusion
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Mortality is very high due to these three complicationsin ?
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Shock, anoxia, and fluid electrolyte imbalance.
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What are 5 causes for Acute Pancreatitis?
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Bile flow obstructed at the ampulla of vater.
Digested by own enzymes, mainly trypsin. Biliary Tract Disease (80%) Gallstones (5%) Long-term alcoholic abuse (Common cause) |
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What are 6 more possible caues for Acute Pancreatitis?
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Bacterial or viral infections (mumps)
Spasms of Ampulla of Vater (due to Duodenititis) Blunt Abdominal Trauma Use of corticosteroids Thiazide Diuretics Oral Contraceptives |
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What are 6 Side Effects of Acute Pancreatitis?
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Severe Abdominal Pain
Abdominal Guarding Rigid, board-like abdomen Ecchymotic Umbilicus or flank Nausea and Vomiting Bulky, pale, foul smellling stools (increased fat) |
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What are 3 causes of pain in Acute Pancreatitis?
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Nerve endings effected by irritation and edema of tissues.
Tension increase of pancreatic capsule. Obstruction of pancreatic ducts |
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How is the blood pressure affected in Acute Pancreatitis?
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Hypotension occurs r/t volume deficit with moving to the tissues and peritoneum
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In Acute Pancreatitis what happens to the kidneys?
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Acute Renal failure and it is very common.
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In Acute Pancreatitis something happens with the tissues getting oxygen what does this lead to?
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Hypoxia
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How does Acute Pancreatitis affect the cardiovascular system?
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It can cause Myocardial
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Which fluid electrolytes can be affected by Acute Pancreatitis?
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Calcium and Glucose. Calcium decreases and glucose can increase.
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Another complication of Acute Pancreatisis is DIC and is one of the leading causes of death due to Acute Pancreatitis. What does DIC stand for?
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Disseminated Intravascular Coagulopathy
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In a client with Acute Pancreatitis two serum enzymes can be measured for diagnostic purposes, which are they?
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Lipase and Amylase
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When testing Amylase the nurse should know that the peak of this enzyme usually occurs after how many hours?
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24 hours
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When testing for Lipase the nurse should know that the peak of this serum enzyme usually occurs after how many hours?
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48 hours.
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Is the amylase in the urine increased or decreased during Acute pancreatitis?
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Increased
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In Acute pancreatitis what is the name for the lab to be drawn covering glucose and bilirubin?
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CBC Laps
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True or False C-Reactive Protein, Fibrinogen and Trypsin levels are checked in client with Acute Pancreatitis?
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False just CR protein and Fibrinogen.
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Which 3 diagnostic test are usually performed in a client with Acute Pancreatitis?
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CT Scan, Ultrasound and Abdominatl X-Ray
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In Acute Pancreatitis sometimes this diagnostic test is necessary but is rarely used, it examines the duodenum and pancreatic/common bile ducts.
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ERCP
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The main goal for managing Acute pancreatisis is what?
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Treat symptoms and prevent complications.
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What are 5 ways in which the nurse will treat symptoms and prevent complications in a patient with Acute Pancreatitis?
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NPO (inhibit pancreatic secretion)
NG suctioning TPN Medications Respiratory Pain |
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In a client with Acute Pancreatitis the nurse should expect to find what medications ordered?
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Antiemetic, Pain Reliever, Antibiotics, and Antidiabetics
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Sometimes in a client with Acute Pancreatitis, Invasive Mangement is required. What are the three Invasive Managment Techniques that may be sued?
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ICU with hemodynamic Monitoring
Biliary drains and stents for drainage. May have diagnostic Laparotomy |
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Does the client with Acute Pancreatitis experience any pain?
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Yes
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What complications of Acute Pancreatitis would make the nurse be concerned about the patient's skin integrity?
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Jaundice, drainage, and bed rest.
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How is a client with Acute Pancreatitis's diet individualized?
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No caffine or alcohol
Placed on TPN for a while and monitored. May be increased to low fat and low protein diet. |
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In a client with Chronic Pancreatitis what causes the ultimate destruction of the pancrease?
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Progressive Inflammation
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When cells are destroyed in Chronic Pancreatitis they are replaced with what?
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Fibrous Tissue.
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In Chronic Pancreatitis Mechanical obstruction occurs where?
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Pancreatic Ducts, Common Bile Duct and Duodenum
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What are two common causes of Chronic Pancreatitis?
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Alcohol Abuse and Malnutrition
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How does Alcohol eventually lead to Chronic Pancreatitis?
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Increases protein content of pancreatic secretions which has a toxic effect on pancreatic cells.
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Malnutrition induced Chronic Pancreatitis has an increased incidence in men or women?
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Men
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In chronic pancreatitis the patient suffers from extreme recuring bouts of pain. Where is this pain typically felt?
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Upper abdominal and back pain.
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A patient wants to know if his pain medication will provide relief what should the nurse tell the client?
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Pain relief is often hard to achieve in clients with Chronic Pancreatitis
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The cause for malabsorption in client's with Chronic Pancreatis is due to what?
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Digestion of fat and protein is reduced.
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What is a term used to describe fatty stools with mucous?
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Steatorrhea
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What are 6 side effects a client with Chronic Pancreatitis might have?
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Weight Loss
Malabsorption of proteins and fats Pain that is difficult to relieve Recuring bouts of pain in Upper abdomen and back Steatorrhea Vomitting |
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What are 6 side effects a client with Acute Pancreatitis might have?
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Severe abdominal Pain
Abdominal guarding Rigid, board-like abdomen Echymottic umbilicus or flank N and V Bulky, Pale, Foul smelling Stools (increased fat) |
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What are 7 complications that can occur with Acute Pancreatitis?
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Hypotension
Hyperglycemia Hypocalcemia Disseminated Intravascular Coagulopathy(DIC) Myocardial Depression Hypoxia Acute Renal Failure (COmmon) |
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What are 12 Diagnosit Test that may be done in a client with Acute Pancreatitis?
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CBC, glucose and Serum Bili
Serum Amylase Serum Lipase Urinary Amylase Fibrinogen, C-Reactive protein Abdominal X-Ray, CT, Ultrasound ERCP |
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What are three visual diagnostic test that may be done in a client with Chronic Pancreatitis?
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ERCP
CT Ultrasonography |
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Which diagnostic test is usually done to diagnose Chronic Pancreatitis?
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ERCP
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What is another test that the patient may take if Chronic Pancreatitis suspected or diagnosed to determine how well sugar is being handled by body?
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Glucose Tolerance Test
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What effect does Chronic Pancreatitis have on Serum Amylase and the WBC?
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Sometimes nothing and may be normal
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What are 4 ways in which Chronic Pancreatitis is Managed?
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Pain Relief
Prevent and Control attacks Pancreatic enzyme replacements Surgical Intervention (Individualized) |
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What are a two surgeries that may be done oon a client with Chronic Pancreatitis?
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Pancreatifojejunostomy - To promote drainage to jejunum.
Autotransplantation of own tissue - still under study. |
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Patient Education for a client suffering from Chronic Pancreatitis should include what 4 things?
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Pain Relief and the addiction Risk
Nutrition: Malabsorption and the chance of weight loss Lifestyle: no alcohol and dietary changes Medications: will include insulin and pancreatic enzymes |
