Acute Pancreatitis

Question 1

What are functions of the exocrine system

Answer 1

They produce pancreatic juices and digestive enzymes

Question 2

What are digestive enzymes

Answer 2

Amylase
Lipase
Protease

Question 3

What are pancreatic juices

Answer 3

Water and bicarbonate

Question 4

What is trypsin

Answer 4

A proenzyme that protects the cells by preventing the activation of enzymes before they reach the duodenum

Question 5

What is endocrine

Answer 5

1-2% of cells found in the isles of langerhans and secretes hormones into the blood

Question 6

What’s the pancreatic duct

Answer 6

It joins the CBD at the duodenum, opens into duodenum through the sphincter of oddi

Question 7

What are risk factors for acute pancreatitis

Answer 7

Gall bladder disease

Excessive alcohol use

Question 8

What are less common risks of acute pancreatitis

Answer 8

Infection
Toxins
Trauma
Certain medications

Question 9

What’s the patho of acute pancreatitis

Answer 9

Autodigestion, cells are damaged causing trypsin to activate early resulting in enzymes digesting pancreatic cells.
Vascular permeability in erases causing edema, hemmorhage and necrosis

Question 10

If acute pancreatitis is left undiagnosed what is a complication

Answer 10

SIRS

MODS

Question 11

How is acute pancreatitis diagnosed

Answer 11

Serum amylase will be elevated more than 3 times the norm
Lipase will be elevated more than 3 times the norm
CT scan for moderate to severe cases
Bun/ Cr to evaluate for fluid volume status
LFT ( total bilirubin & AST)
Serum Ca to rule out hypercalcemia
Glucose, H&H, electrolytes, WBC/ diff

Question 12

What are signs and symptoms of acute pancreatitis

Answer 12

Severe abdominal pain
Signs and symptoms of hypovolemia
Signs and symptoms of hypoperfusion

Question 13

What should be monitored in the patient with acute pancreatitis

Answer 13

ICU,CVP, PAWP
Look for CULLENS sign ( bluish around umbilicus)
Look for grey- TURNERS sign ( bluish brownish around flanks)

Question 14

What can treatment can the nurse anticipate in acute pancreatitis

Answer 14

AGRESSIVE FLUID RESUSCITATION WITH INITIAL BOLUSES FOLLOWED BY INFUSIONS @ 150-200ml/ hr
T&C with transfusions 
Electrolyte supplements I.V
Use of vasopressors 
Antibiotics I.V

Question 15

What are complications of acute pancreatitis

Answer 15

MODS- watch for respiratory impairment and hypoxemia first
Overhydration and pulmonary edema
ARDS
cardiac dysrhythmias
Watch for SIRS especially 7-14 days after event

Question 16

What is imperative to preserve G.I mucosal barrier in acute pancreatitis

Answer 16

Early enteral nutritional support to preserve the G.I mucousal barrier is a must
Keep NPO jejunum feedings are best

Question 17

What may be needed to remove obstructions and create a pathway in acute pancreatitis

Answer 17

ERCP