Pancreas and Gallbladder Flashcards
What are normal amylase levels?
60—-120
High in pancreatitis
What are normal lipase levels?
0—–160 U/L
High in pancreatitis
What type of abnormal labs will point to pancreatitis?
Elevated: amylase, lipase, blood glucose, triglycerides
Decreased: Calcium
What is pathos in acute pancreatitis?
Pancreatic cells become injured, spill contents, auto digest.
Reflux of bile or obstruction can result in damage.
Signs of acute pancreatitis.
PAIN!! LUQ or mid epigastric, radiates to back. Sudden onset, severe, constant, eating worsens. Guarding, restless
N/V
Fever/leukocytosis
Hypotension/Tachycardia
Dyspnea, crackles, SOB
Decreased bowel sounds
Turner sign (bruising to flank)
Cullens sign (bruising around belly button)
Abdominal distention
Causes of pancreatitis.
Smoking
Alcoholism
Gallstones
Cancer
Hypertriglycerides
Trauma
Meds (steroids, diuretics, HIV meds)
What are the main complications of acute pancreatitis?
Cardiovascular (can cause thrombi to form)
Respiratory
Sepsis
What are goals in treating acute pancreatitis?
- Pain control
- Fluid/electrolyte balance
- Resting pancreas
- Prevent/treat infection
- Find and remove cause
How do we rest pancreas in acute pancreatitis?
- NPO
- NG suction
When begin to re-feed pancreatitis patient, what should diet be?
Low fat and protein
High carb
Slowly begin with small frequent meals
What are some nursing managements for treating acute pancreatitis?
Pain management
Hydration/fluid replacement (LR)
Supplemental O2/Watch respiratory status
Watch glucose levels
NPO/NG suction
Antibiotics
PPIs/Antacids
May need calcium gluconate in hypocalcemia
Antispasmodics (dicyclomine) to relax pancreas motility
What is pathos of chronic pancreatitis?
This is similar to liver cirrhosis.
Fibrosis of pancreas
Pancreatic tissue is chronically and slowly inflamed and destroyed.
What are common causes of chronic pancreatitis?
Alcoholism
Cancer
Gallstones
Lupus
Cystic fibrosis
Autoimmune
S/Sx of chronic pancreatitis
What are some chronic problems?
What disease has exactly the same symptoms?
Just like acute. Severe pain that will become recurrent and chronic. Episodes will become more frequent as damage progresses.
Chronic problems: Weight loss, diabetes, dark urine with jaundice, steatorrhea, constipation.
–Pancreatic cancer–
What labs will be abnormal in chronic pancreatitis?
Amylase and lipase may be normal
Bilirubin and ALP may be increased
Mild leukocytosis
High ESR
What is one med given in chronic pancreatitis?
Pancrelipase
This is a high powered enzyme complex to help them replace lipase, amylase, trypsin.
Taken with meals
What is stones in gallbladder called?
Cholelithiasis
What is inflammation of gallbladder called?
Cholecystitis
What is gallbladder removal called?
Cholecystectomy
Risk factors for gallbladder disease
Female
Over 40
Sedentary
Obese
Estrogen meds (BC or Replacement)
Mulitparous
Native American
S/Sx of cholecystitis.
Indigestion
Pain (RUQ referred to R shoulder)
Fever
Chills
Jaundice
Tachypnea
Tachycardia
Diaphoresis
What labs may be abnormal in cholecystitis?
Increased WBC
Liver enzymes elevated
Increased bilirubin
Where may referred pain from pancreas manifest?
Left shoulder/neck
High lumbar back
Mid epigastric
