Pancreatic Problems

Question 1

diabetes and pancreas

Answer 1

dysfunction of endocrine process of pancreas

Question 2

acute pancreatitis

Answer 2

–dysfunction of exocrine process of pancreas
–usually mild and resolves spontaneously

Question 3

cause of acute pancreatitis

Answer 3

obstruction of the outflow of pancreatic enzymes usually r/t pancreatic and bile duct obstruction

Question 4

additional causes of acute pancreatitis

Answer 4

–alcohol
–drugs
–viral infection

Question 5

what does the backup of enzymes cause?

Answer 5

leads to autodigestion of pancreatic cells –> causes inflammation = pancreatitis

Question 6

what does trypsin cause?

Answer 6

edema, necrosis, hemorrhage

Question 7

what does elastase cause?

Answer 7

hemorrhage

Question 8

what does phospholipase A cause?

Answer 8

fat necrosis

Question 9

what does kallikrein cause?

Answer 9

edema, vascular permeability, smooth muscle contraction, shock

Question 10

what does a distended abdomen usually indicate the presence of?

Answer 10

ascites

Question 11

what does lipase cause?

Answer 11

fat necrosis

Question 12

symptoms of acute pancreatitis

Answer 12

–severe epigastric pain
–N/V
–abdominal distention
–hypoactive BS
–fever
–hypotension
–tachycardia
–jaundice
–amylase
–lipase
–glucose
–WBC

Question 13

attributes of pain with acute pancreatitis

Answer 13

–sudden onset
–may radiate to back
–tenderness (caused by edema and irritation/inflammation)

Question 14

severe symptoms of acute pancreatitis

Answer 14

–cyanosis or green-yellow/brown discoloration of the abdomen
–ecchymoses

Question 15

ecchymoses characteristics

Answer 15

–flanks (Grey Turner’s sign)
–periumbilical (Cullen’s sign)

Question 16

complications of acute pancreatitis

Answer 16

–pseudocyst
–abscess
–pulmonary complications (PE)
–hypotension = shock
–tetany from hypocalcemia

Question 17

pseudocyst

Answer 17

–fluid-filled cavity that surrounds the outside of the pancreas
–results in inflammation and scarring of areas near the pancreas

Question 18

symptoms of pseudocysts

Answer 18

similar to pancreatitis plus a palpable epigastric mass

Question 19

complication of pseudocysts

Answer 19

may perforate –> peritonitis

Question 20

pancreatic abscess

Answer 20

–a large fluid-filled cavity inside the pancreas
–result of extensive necrosis in the pancreas
–may be infected or perforate

Question 21

symptoms of pancreatic abscesses

Answer 21

similar presentation to pancreatitis plus
–abdominal mass
–high fever
–leukocytosis

Question 22

chronic pancreatitis

Answer 22

–progressive, fibrotic disease of the pancreas
–attacks of acute pancreatitis with progressive signs of dysfunction after attack subsides

Question 23

most common cause of the chronic pancreatitis

Answer 23

alcohol abuse

Question 24

patho of alcohol abuse and chronic pancreatitis

Answer 24

toxic metabolites release inflammatory cytokines and cause destruction of acinar cells and islet of Langerhans

Question 25

risk factors for chronic pancreatitis

Answer 25

–genetics
–gallstone obstruction
–smoking

Question 26

pancreatic cysts

Answer 26

walled-off areas of pancreatic juice, necrotic debris, or blood

Question 27

symptoms of chronic pancreatitis

Answer 27

–abdominal pain
–weight loss
–can lead to diabetes
–have issues with nutritional absorption

Question 28

opioids and pancreatitis

Answer 28

relief of pain

Question 29

dicyclomine and pancreatitis

Answer 29

antispasmodic

Question 30

antacids and pancreatitis

Answer 30

decrease HCl secretion in the stomach, which decreases secretion of pancreatic enzymes

Question 31

H2-receptor antagonists and pancreatitis

Answer 31

decrease HCl secretion in the stomach, which decreases secretion of pancreatic enzymes

Question 32

pancrelipase and pancreatitis

Answer 32

replacement therapy for pancreatic enzymes

Question 33

insulin and pancreatitis

Answer 33

treatment for DM if it occurs

Question 34

classification of pancrelipase

Answer 34

pancreatic enzyme replacement

Question 35

indication of pancrelipase

Answer 35

reduced secretion of pancreatic enzymes

Question 36

adverse effects of pancrelipase

Answer 36

rare

Question 37

nursing implications of pancrelipase

Answer 37

take with every meal and snack