Pancreatitis

Question 1

What are the two functions of the pancreas?

Answer 1

• Endocrine: insulin

- Exocrine: Digestive enzymes

Question 2

What are the two types of pancreatitis?

Answer 2

Acute and chronic

Question 3

What are the 2 main causes of pancreatitis?

Answer 3

1. Gallbladder disease

2. Alcohol

Question 4

What are s/s of pancreatitis?

Answer 4

• Pain that increases with eating
• Abdominal distention/ascites
• Abdominal mass (swollen pancreas)
• Rigid board-like abdomen with guarding (indicates bleeding that can lead to peritonitis)
• Bruising around umbilical area (Cullen’s signs, Grey-Turner’s sign)
• Fever
• N/V
• Jaundice (indicates liver involvement)
• Hypotension (could be d/t bleeding or ascites)

Question 5

What is a Cullen’s sign?

Answer 5

Bruising around umbilical area

Question 6

What is a Grey-Turners sign?

Answer 6

Bruising in the flank area

Question 7

What are the labs changes/diagnosis for pancreatitis?

Answer 7

• ↑ serum lipase and amylase
• ↑ WBC
• ↑ blood sugar
• ↑ ALT, AST
• longer PT, aPTT
• ↑ serum bilirubin
• ↑ or ↓ H/H (↑ d/t dehydration; ↓ d/t bleeding)

Question 8

What is the goal of treatment for pancreatitis?

Answer 8

Control pain by decreasing gastric secretions (NPO, NGT to suction, bedrest)

*We want the stomach dry and empty.

Question 9

What pain meds may be used for pancreatitis?

Answer 9

• morphine sulfate
• hydromorphone
• fentanyl patches

Question 10

Why is anticholinergics used for pancreatitis?

Answer 10

To dry the stomach

Question 11

What anticholinergics could be used?

Answer 11

• benzotropine

- diphenoxylate/atropine

Question 12

What GI protectants could be used for pancreatitis?

Answer 12

• Pantoprazole (proton pump inhibitor)
• Antacids
• Famotidine (h2 receptor antagonist)

Question 13

What is the treatment for pancreatitis?

Answer 13

• Control pain (NPO, NGT to suction, bedrest) : to keep stomach dry and empty.
• Pain meds (morphine sulfate, hydromorphone, fentanyl patches)
• Anticholinergics (benztropine, diphenoxylate/atropine) : to dry the stomach
• GI protectants (Pantoprazole (proton pump inhibitor), Antacids, Famotidine (h2 receptor antagonist))
• Maintain fluid and electrolyte balance.
• Maintain nutritional status.
• Insulin
• Daily weights
• Eliminate alcohol.
• Refer to AA if alcohol is the cause.

Question 14

Normal Lab Values:

Amylase

Answer 14

30-220 U/L

Question 15

Normal Lab Values:

Lipase

Answer 15

0-160 U/L

Question 16

Why is insulin given to a client with pancreatitis?

Answer 16

• Pancreas is sick

- on TNA (aka TPN)