Exam 2: Pancreatic Cancer Flashcards
What are the risk factors for pancreatic cancer?
increased age Hx of DM, pancreatitis alcohol and smoking high-fat diet exposure to environmental chemicals black people
Early signs and symptoms of pancreatic cancer
Pain – vague, RUQ pain that radiates and most severe at night
impaired glucose intolerance: glucosuria, hyperglycemia, and abnormal glucose tolerance
Late signs and symptoms of pancreatic cancer
- meals cause epigastric pain (worse when lying down. better upright)
- jaundice & pruritus
- profound rapid weight loss
Other signs of pancreatic cancer
Clay colored stools, dark urine, fatigue, anorexia, N/V
diagnostic test for pancreatic cancer
- spiral CT
- ERCP (endoscopic retrograde cholangiopancreatography)
- cancer antigen 9-19 and 242
- DU-PAN-2 tumor marker
Prognosis of pancreatic cancer
grim if found late (only limited to palliative Tx)
chemotherapy agents used with pancreatic cancer
Gencitabine (standard if mets)
Leucovorin
5-FU
pre-op management for pancreatic cancer
- diet high in protein & pancreatic enzymes
- vit K (correct PT deficiency)
- treat anemia
- enteral or parenteral nutrition
- blood components
- biliary stents (relieve jaundice)
What is Whipple procedure?
6-10 hr procedure where: head of pancreas, gallbladder, duodenum, proximal jejunum, portion of stomach and distal common bile duct are removed
what is a distal pancreatectomy?
removal of tumors in the tale of the pancreas with removal of the spleen
what is a total pancreatectomy?
removal of the entire pancreas if no mets
post-op complications (pancreatic cancer)
hemorrhage, vascular collapse, and hepatorenal failure
GI: paralyric ileus, BO, NGT
post-op nursing care
pancreatic cancer
- at risk for pruritis: meticulous skin care
- refer to hospice
- monitor mechanical ventilation. IVs, arterial lines
- assess vital and ABG’s freq
