Pancreatic Problems Flashcards
diabetes and pancreas
dysfunction of endocrine process of pancreas
acute pancreatitis
–dysfunction of exocrine process of pancreas
–usually mild and resolves spontaneously
cause of acute pancreatitis
obstruction of the outflow of pancreatic enzymes usually r/t pancreatic and bile duct obstruction
additional causes of acute pancreatitis
–alcohol
–drugs
–viral infection
what does the backup of enzymes cause?
leads to autodigestion of pancreatic cells –> causes inflammation = pancreatitis
what does trypsin cause?
edema, necrosis, hemorrhage
what does elastase cause?
hemorrhage
what does phospholipase A cause?
fat necrosis
what does kallikrein cause?
edema, vascular permeability, smooth muscle contraction, shock
what does a distended abdomen usually indicate the presence of?
ascites
what does lipase cause?
fat necrosis
symptoms of acute pancreatitis
–severe epigastric pain
–N/V
–abdominal distention
–hypoactive BS
–fever
–hypotension
–tachycardia
–jaundice
–amylase
–lipase
–glucose
–WBC
attributes of pain with acute pancreatitis
–sudden onset
–may radiate to back
–tenderness (caused by edema and irritation/inflammation)
severe symptoms of acute pancreatitis
–cyanosis or green-yellow/brown discoloration of the abdomen
–ecchymoses
ecchymoses characteristics
–flanks (Grey Turner’s sign)
–periumbilical (Cullen’s sign)
complications of acute pancreatitis
–pseudocyst
–abscess
–pulmonary complications (PE)
–hypotension = shock
–tetany from hypocalcemia
pseudocyst
–fluid-filled cavity that surrounds the outside of the pancreas
–results in inflammation and scarring of areas near the pancreas
symptoms of pseudocysts
similar to pancreatitis plus a palpable epigastric mass
complication of pseudocysts
may perforate –> peritonitis
pancreatic abscess
–a large fluid-filled cavity inside the pancreas
–result of extensive necrosis in the pancreas
–may be infected or perforate
symptoms of pancreatic abscesses
similar presentation to pancreatitis plus
–abdominal mass
–high fever
–leukocytosis
chronic pancreatitis
–progressive, fibrotic disease of the pancreas
–attacks of acute pancreatitis with progressive signs of dysfunction after attack subsides
most common cause of the chronic pancreatitis
alcohol abuse
patho of alcohol abuse and chronic pancreatitis
toxic metabolites release inflammatory cytokines and cause destruction of acinar cells and islet of Langerhans
risk factors for chronic pancreatitis
–genetics
–gallstone obstruction
–smoking
pancreatic cysts
walled-off areas of pancreatic juice, necrotic debris, or blood
symptoms of chronic pancreatitis
–abdominal pain
–weight loss
–can lead to diabetes
–have issues with nutritional absorption
opioids and pancreatitis
relief of pain
dicyclomine and pancreatitis
antispasmodic
antacids and pancreatitis
decrease HCl secretion in the stomach, which decreases secretion of pancreatic enzymes
H2-receptor antagonists and pancreatitis
decrease HCl secretion in the stomach, which decreases secretion of pancreatic enzymes
pancrelipase and pancreatitis
replacement therapy for pancreatic enzymes
insulin and pancreatitis
treatment for DM if it occurs
classification of pancrelipase
pancreatic enzyme replacement
indication of pancrelipase
reduced secretion of pancreatic enzymes
adverse effects of pancrelipase
rare
nursing implications of pancrelipase
take with every meal and snack
