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Med-Surg > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

pancreatitis

A

the inappropriate activation of pancreatic enzymes, inflammation of the pancreas resulting in autodigestion of the pancreas and damage to peri-pancreatic tissues and vascular network

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2
Q

______ response causes further damage to the pancreas

A

inflammatory response

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3
Q

causes and risk factors of pancreatitis

A
  • gallstones
  • alcohol
  • pregnancy
  • administration of TPN
  • surgery
  • AIDS
  • medication complications
  • hypercalcemia and or significant hypertriglyceridema
  • specific genetic mutations
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4
Q

chronic pancreatitis

A

progressive obstruction of exocrine functions
- irreversible
- may demonstrate diabetes
- malabsorption syndrom

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5
Q

why might chronic pancreatitis demonstrate diabetes

A

b/c of destruction of insulin producing cells

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6
Q

acute pancreatitis has a _____ onset

A

sudden onset

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7
Q

symptoms of acute pancreatitis

A
  • abdominal pain
  • abdominal tenderness
  • hypotension
  • respiratory distress
  • abdominal distention
  • poor urine output
  • tachycardia
  • signs of hypocalcemia
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8
Q

3 forms of acute pancreatitis are

A

mild form, more severe form, severe form

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9
Q

mild form of acute pancreatitis

A
  • called institutional or edematous pancreatitis
  • resolves in 5-7 days
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10
Q

more severe form of acute pancreatitis

A

extensive necrosis

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11
Q

severe form of acute pancreatitis

A
  • local and systemic complications
  • 25-30% mortality rate with complications and co morbidities
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12
Q

1st phase of pancreatitis

A

trypsin and other enzymes released

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13
Q

2nd phase of pancreatitis

A

intrapancreatic inflammation

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14
Q

3rd phase of pancreatitis

A
  • extrapancreatic / systemic injury
  • kallikrein
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15
Q

in pancreatitis hypocalcemia results from

A

necrosis

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16
Q

kallikrein is part of the _______ process

A

inflammatory process

17
Q

kallikrein causes

A

vasodilation and increases permeability of blood vessels, pain, and leukocyte invasion

18
Q

kallikrein is activated by

A

trypsin

19
Q

trypsin is responsible for

A

causing bradykinin formation and can lead to systemic hypotension and shock

20
Q

4 ways to diagnose pancreatitis

A

(1) pancreatic enzyme levels
(2) liver and gallbladder tests
(3) elevated C Reactive protein
(4) elevated WBC

21
Q

how to minimize pancreatic stimulation

A
  • GI tract rest
  • nutrition support (enteral, total parenteral)
  • psychosocial support
22
Q

what to look for on integumentary assessment on pt with pancreatitis

A
  • Cullens sign
  • Grey Turners sign
  • Jaundice
  • edema
  • pale, moist, cold
23
Q

what is Cullens sign

A

bruising around umbilical

24
Q

why does Jaundice occur in pt with pancreatitis

A

all enzymes are breaking down and extending the damage to the liver

25
Q

common fluid and electrolyte imbalances in pts with pancreatitis

A
  • hypocalcemia
  • hypokalemia
  • hypomagnesmia
26
Q

2 signs that occur with hypocalcemia

A

(1) chvostek’s sign
(2) trovsseau’s sign

27
Q

what is chvostek’s sign

A

facial nerve trapped in front of ear -
positive when muscles contract on same side of face

28
Q

trovesseau’s sign

A

bp cuff inflated on upper arm to a level directly above pt sbp for 2 min - hand flexes in response to test

29
Q

what renal assessments should be done on a pt with pancreatitis

A
  • monitor for acute tubular necrosis
  • urine output can become brownish and foamy
  • assess BUN and creatinine levels
30
Q

what endocrine signs may show in a pt with pancreatitis

A
  • hyperglycemia
  • high serum glucose levels
  • metabolic acidosis
31
Q

what neurological symptoms might a pt show with pancreatitis

A
  • confused, decreased LOC
  • restlessness
  • agitation
  • should assess GCS
32
Q

in pancreatitis it is important to correct the

A

underlying problem

33
Q

in some pancreatitis the underlying problem may subside with supportive therapy such as

A

binge drinking

34
Q

when the underlying problem of pancreatitis is a mechanical obstruction how may this be fixed

A

surgery
- cholecystectomy
- ERCP

35
Q

when the underlying problem of pancreatitis is infected pancreatic necrosis how may this be fixed

A

surgical debridement

36
Q

when the underlying problem of pancreatitis is a pancreatitis abscess how might this be fixed

A

drainage

37
Q

local complications of pancreatitis

A
  • pancreatic abscess
  • pancreatic necrosis
  • pseudocyst
  • abdominal compartment syndrome (ACS)
38
Q

pulmonary complications of pancreatitis

A
  • hypoxemia
  • respiratory failure
  • acute respiratory distress syndrome (ARDS)
  • pneumonia
  • pleural effusion (COMMON)
39
Q

systemic complications of pancreatitis

A
  • systemic inflammatory response syndrome (SIRS)
  • vasoactive substances (vasodilation, decreased systemic vascular resistance (hypotension), increased permeability of vessel linings)
  • hemorrhage
  • hypovolemia

Med-Surg (15 decks)

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