Pancreatic Cancer

Question 1

Pancreatic Cancer

Answer 1

Originates from epithelial cells of the pancreatic ductal system.
Tumors are often discovered late.
Adenocarcinoma
Rapid growing, quick metastasis.

Question 2

Etiology and Risk Factors of Pancreatic Cancer

Answer 2

Age
Smoker
Diabetes
Chronic Pancreatitis
High intake of red meat or processed meat (bacon).
Obesity

Question 3

Clinical Manifestations of Pancreatic Cancer

Answer 3

Abdominal Pain
Jaundice
Hepatomegaly- Enlargement of the liver..
Weight Loss
Clay Colored Stool
Ascites
Weakness, Fatigue
Metastasis to retroperitoneum, liver, spine, colon, stomach.
DVT/PE related to necrotic products produced by the tumor- causes hypercoagulability.

Question 4

Diagnosis of Pancreatic Cancer

Answer 4

Patient History
Abdominal Assessment
Pain intensity, quality, location.
Lab Values- Amylase, lipase, alkaline, phosphorus, bilirubin.
Ultrasound of abdomen.
Abdomen/pelvis CT
ERCP- Endoscopic retrograde cholangiopancreatography

Question 5

Medical and Surgical Treatment of Pancreatic Cancer

Answer 5

Treatment is geared at the prevention of further metastasis, not cure.
Chemotherapy, radiation
Biliary Stents
**Whipple Procedure

Question 6

Pre-Op Nursing Care for Whipple

Answer 6

Initiation of TPN for nutritional support.
Patient is NPO
Pain Management
Patient Education
Psychosocial Support

Question 7

Post-Op Nursing Care for Whipple

Answer 7

The patient is NPO with NGT
Monitor output from biliary drains.
Assess drainage from JP drains if present.
Assessment of surgical incision.
Maintain fluid and electrolyte balance.
TPN
Monitor vital signs
Monitor blood glucose
Assess for routine pose-op complications (infection, atelectasis, hemorrhage, fistula).
Intake and output