Acute Pancreatitis

Question 1

what are clinical manifestations of acute pancreatitis?

Answer 1

1. severe, sudden onset, boring pain throughout the entire body. epigastric pain–> back, left flank, and left shoulder
2. anorexia causes weight loss
3. constipation and steatorrhea
4. tetany, chovestek’s, and trousseau’s
5. seepage of blood as a result of the autodigestion
6. hypoactive/no bowel sounds
7. hyperglycemia (fruity breath) because pancreas is not working

Question 2

when does the epigastric pain worsen and how can the patient lay to make them feel better?

Answer 2

this epigastric pain worsens when patient is lying down so the patient can try to relieve pain by sitting in fetal position or not moving at all

Question 3

how does tetany occur in acute pancreatitis and what does it indicate?

Answer 3

due to hypocalcemia which is a medical emergency and indicates severe disease and immediate intervention is needed NOW so administer calcium STAT

Question 4

what signs will the patient see if there is seepage of blood in acute pancreatitis?

Answer 4

cullens sign: bruising around the belly button

grey turner’s sign: bruising on the left flank

Question 5

what labs should the nurse watch for with acute pancreatitis?

Answer 5

amylase and lipase labs will be elevated with a decreased calcium and magnesium

Question 6

what are lab ranges for amylase?

Answer 6

60-160

Question 7

what are lab ranges of lipase?

Answer 7

20-180

Question 8

what is the priority for this patient?

Answer 8

ABCs first and then PAIN

Question 9

what interventions can the nurse provide to the patient to help treat acute pancreatitis?

Answer 9

1. NPO to rest pancreas
2. NG tube on low continuous suctioning to help reduce vomiting and gastric distention
3. FLUIDS IV to keep patient hydrated because there will be alot of diarrhea and vomiting
4. antibiotics such as imipenem if there is an infection present

Question 10

one the diet of the acute pancreatitis patient is resumed, what type of diet should they follow?

Answer 10

bland, high protein, low fat with not stimulants such as caffeine

Question 11

what complications can occur from acute pancreatitis?

Answer 11

1. hypovolemia that can turn into shock
2. infection
3. type 1 diabetes due to lack of insulin
4. MODS because the inflammation starts affecting other organs

Question 12

what can the nurse give after giving fluids to a patient with acute pancreatitis?

Answer 12

give dobutamine and norepinephrine after giving vasopressors