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NUR 326 > Pancreas > Flashcards

Pancreas Flashcards

1
Q

acute pancreatitis severity

A

mild edema to severe hemorrhagic necrosis

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2
Q

risk factors for acute pancreatitis

A

middle age
african americans more likely

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3
Q

come causes of acute pancreatitis

A

biliary tract disease (women)
ETOH abuse (men)
others like GI procedures

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4
Q

pathogenesis of pancreatitis

A

pancreatic cells are injured
pancreatic enzymes are activated
autodigestion
causes mild to severe pancreatitis

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5
Q

what does trypsin cause

A

edema
necrosis
hemorrhage

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6
Q

what does elastase cause

A

hemorrhage

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7
Q

what does phospholipase A cause

A

fat necrosis

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8
Q

what does kallikrein cause

A

edema
vascular permeability
smooth muscle contraction
shock

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9
Q

what does lipase cause

A

fat necrosis

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10
Q

clinical manifestation of acute pancreatitis

A
  • LUQ or epigastric pain: sudden onset, may radiate to back, tenderness
  • accompanying sx: NV, abdominal distention, hypo BS, fever, hypotension, tachycardia, jaundice
  • amylase, lipase, glucose, WBC all increase
  • cyanosis or green-yellow/brown discoloration of the abdomen
  • ecchymoses: Flanks (grey turner), Periumbilical (cullen)
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11
Q

complications of acute pancreatitis

A

pseudocyst
abscess
pulmonary complication
hypotension
tetany from hypocalcemia
increase risk for clotting

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12
Q

why do pulmonary complication occur with acute pancreatitis

A

fluid can build up
enzymes that leak cause damage –> pain and makes deep breaths hard

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13
Q

why does tetany from hypocalcemia occur with acute pancreatitis

A

lipase casuses fat necrosis which generates fatty acids that bind to Ca and deposit into peritoneum

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14
Q

what is a pseudocyst

A

fluid filled cavity that surrounds the OUTSIDE of the pancreas

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15
Q

what is the fluid of a pseudocyst composed of

A

necrotic products and secretions

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16
Q

what is the result of a pseudocysts

A

inflammation and scarring of areas near the pancreas

17
Q

clinical manifestations of pseudocyst

A

same as pancreatitis but with a palpable epigastric mass

18
Q

can a pseudocyst perforate

A

yes, all the necrotic contents spill out and lead to peritonitis –> rigid abdomen

19
Q

what is a pancreatic abscess

A

large fluid filled cavity INSIDE the pancreas

20
Q

what is the cause of a pancreatic abscess

A

extensive necrosis

21
Q

what are further complications of a pancreatic abscess

A

infection or perforation

22
Q

clinical manifestations of pancreatic absess

A

pancreatitis sx plus abdominal mass, high fever, and leukocytosis

23
Q

what is chronic pancreatitis

A

inflammation in the pancreas that persists over weeks to months

24
Q

main cause of chronic pancreatitis

A

ETOH abuse

25
Q

what happens to the pancreas during chronic pancreatitis

A

destruction of tissue/necrosis
fibrosis
loss of pancreatic enzymes and insulin
may continue even after the ETOH stops

26
Q

chronic pancreatitis clinical manifestations

A
  • attacks of acute pancreatitis with progressive signs of dysfunction after attack subsidies
  • chronic pain
  • DM, malabsorption of fat, wt loss
27
Q

drug therapy for pancreatitis

A
  • morphine: pain
  • dicyclomine: antispasmodic
  • antacids: dec HCl, which dec pancreatic enzymes
  • H2 receptor antagonist: dec HCl which dec pancreatic enzymes
  • pancrelipase: replacement therapy for pancreatic enzymes
  • insulin: treatment for DM
28
Q

pancrelipase classification

A

pancreatic enzyme replacement

29
Q

pancrelipase indications

A

reduced secretion of pancreatic enzymes

30
Q

pancrelipase adverse effects

A

well tolerated

31
Q

pancrelipase nursing implications

A

take with every meal and snack

32
Q

a pt diagnosed with pancreatitis is receiving the following meds

A

IV fluids: inc BP
fentanyl: pain
protonix: PPI, blocks HCl
stool softner: limits strains
lovenox: dec risks for clotting

NUR 326 (20 decks)

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