Exam 3 - Pancreatic Problems Flashcards
acute pancreatitis
- obstruction of the outflow of pancreatic enzymes usually related to pancreatic and bile duct obstruction
when does acute pancreatitis usually resolve
- usually mild and resolves spontaneously
pancreatic enzymes
- trypsin
- elastase
- phospholipase A
- kallikrein
- lipase
trypsin
- edema
- necrosis
- hemorrhage
elastase
hemorrhage
phospholipase A
fat necrosis
kallikrein
- edema
- vascular permeability
- smooth muscle contraction
- shock
lipase
fat necrosis
acute pancreatitis pain
- epigastric and SEVERE
- timing: sudden onset
- may radiate to back
- tenderness
symptoms of acute pancreatitis
- n/v
- abdominal distention
- hypoactive bowel sounds
- fever
- hypotension, tachycardia, jaundice
- amylase, lipase, glucose, WBC
clinical manifestations of acute pancreatitis
- cyanosis or green-yellow/brown discoloration of the abdomen
- ecchymoses
ecchymoses of acute pancreatitis
- flanks (grey turners sign)
- periumbilican (Cullens sign)
complications of acute pancreatitis
- pseudocyst
- abscess
- pulmonary complications
- hypotension -> shock
- tetany from hypocalcemia
pseudocyst
- fluid-filled cavity that surrounds the outside of the pancreas
- necrotic products and secretions
- results in inflammation and scarring of areas near the pancreas
what is the clinical presentation of a pseudocyst
similar to pancreatitis plus a palpable epigastric mass
what happens if a pseudocyst perforates
peritonitis (surgical intervention)
pancreatic abscess
- large fluid-filled cavity inside the pancreas
- result of extensive necrosis in the pancreas
- may become infected or perforate
clinical presentation of pancreatic abscess
similar to pancreatitis plus abdominal mass, high fever, and leukocytosis
chronic pancreatitis
progressive, fibrotic disease of the pancreas
what is the most common cause of acute pancreatitis
- alcohol abuse
- toxic metabolites release inflammatory cytokines and cause destruction of acing cells and islet of Langerhans
pancreatic cysts
walled-off areas of pancreatic juice, necrotic debris, or blood
clinical manifestations of chronic pancreatitis
- attacks of acute pancreatitis with progressive signs of dysfunction after attack subsides
- can lead to diabetes r/t loss of islet of Langerhans
- have issues with nutritional absorption (particularly fats)
what are the two major signs of chronic pancreatitis
- abdominal pain and weight loss
pancrelipase
- pancreatic enzyme replacement
- indication: reduced secretion of pancreatic enzymes
- SE: rare
- nursing implications: take with every meal and snack
