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Nur 326 > Exam 2 - Pancreatic Problems > Flashcards

Exam 2 - Pancreatic Problems Flashcards

1
Q

Acute pancreatitis

A

usually mild and resolves spontaneously. Only 20% lead to hopitalization

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2
Q

cause of acute pancreatitis

A

OBSTRUCTION of the outflow of pancreatic enzymes, usually related to pancreatic and bile duct obstruction (usually gallstones)

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3
Q

acute pancreatitis can also be caused by

A

alcohol, drugs, viral infection

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4
Q

Backup of enzymes

A

leads to autodigestion of pancreatic cells - causes inflammation

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5
Q

pancreatitis leads to

A

vascular damage
coagulopathy
necrosis
fat necrosis

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6
Q

Trypsin leads to

A

Edema, necrosis, hemorrhage

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7
Q

Elastase leads to

A

hemorrhage

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8
Q

Phospholipase A leads to

A

fat necrosis

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9
Q

Kallikrein leads to

A

Edema, vascular permeability, smooth muscle contraction (pain), shock

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10
Q

Lipase leads to

A

Fat necrosis (breakdown)

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11
Q

Acute pancreatitis manifestations

A

SEVERE EPIGASTRIC PAIN

Sudden onset
may radiate to back
tenderness/guarding

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12
Q

Where does the pain come from?

A

Edema plus irritation and inflammation of space around it

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13
Q

Accompanying symptoms

A

N/V, abdominal distention, hypo BS

fever
hypotension, tachycardia, jaundice
Decreased BP and Increased HR

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14
Q

Lab symptoms of pancreatitis

A

amylase, lipase, glucose, WBS

Monitor glucose!

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15
Q

Other clinical manifestations

A

cyanosis or green/yellow/brown discoloration of abdomen

ecchymoses

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16
Q

what is ecchymoses

A

flanks - grey turners
periumbilical - cullens sign

hemorrhagic pooling. very rare.

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17
Q

acute pancreatitis complications

A

pseudocyst
abscess
pulmonary complications
hypotension - shock (hypovolemic)
tetany from hypocalcemia

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18
Q

pulmonary complications

A

pain, pleural effusion - edema

19
Q

pseudocyst complications

A

fluid filled cavity that surrounds the outside of the pancreas - necrotic products and secretions

results in inflammation and scarring of areas near the pancreas

20
Q

clinical presentation of pseudocyst

A

similar to pancreatitis plus a palpable epigastric mass

21
Q

if pseudocyst perforate

A

peritonitis

22
Q

complications of pancreatic abscess

A

large fluid filled cavity INSIDE pancreas. Results of extensive necrosis in the pancreas

23
Q

Pancreatic abscess may

A

become infected or perforate

24
Q

clinical presentation of pancreatic abscess

A

similar to pancreatitis plus abdominal mass, high fever, and leukocytes (INFECTION)

25
Q

chronic pancreatitis

A

progressive, fibrotic disease of the pancreas

26
Q

most common cause chronic pancreatitis

A

alcohol abuse

27
Q

progress of chronic pancreatitis

A

toxic metabolites release inflammatory cytokines and cause destruction of acinar cells and islet of Langerhans

28
Q

other risk factors chronic pancreatitis

A

genetics, gallstone obstruction, smoking

29
Q

pancreatic cysts

A

walled off areas of pancreatic juice, necrotic debris, or blood

30
Q

chronic pancreatitis clinical manifestations

A

attacks of acute pancreatitis with progressive signs of dysfunction after attack subsides

31
Q

two major signs of chronic pancreatitis

A

abdominal pain and weight loss

32
Q

chronic pancreatitis can

A

lead to diabetes related to loss of islet of Langerhans

33
Q

chronic pancreatitis have

A

issues with nutritional absorption - particularly fats

34
Q

opioids

A

relieve pain

35
Q

number one purpose of medication for pancreatitis

A

control pain

36
Q

dicyclomine

A

antispasmodic - decrease spasms

37
Q

antacids

A

decrease HCl secretion in the stomach, which decreases secretion of pancreatic enzymes (decreases secretions)

38
Q

H2 receptor antagonists

A

decrease secretions

39
Q

Pancrelipase

A

replacement therapy for pancreatic enzymes (chronic only)

40
Q

insulin

A

treatment for DM if it occurs

41
Q

pancrelipase

A

pancreatic enzyme replacement

42
Q

indication for pancrelipase

A

reduced secretion of pancreatic enzymes

43
Q

adverse effects for pancrelipase

A

rare

44
Q

nursing implications for pancrelipase

A

take with every meal and snack (every time you eat)

Nur 326 (6 decks)

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