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MS 2 > PANCREATITIS > Flashcards

PANCREATITIS Flashcards

1
Q

Inflammation of the pancreas

A

Pancreatitis

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2
Q

Medical emergency with high mortality rate

A

Acute Pancreatitis

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3
Q

Undetectable in early stage

A

Chronic Pancreatitis

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4
Q

What is the main problem of Acute Pancreatitis?

A

The main problem in Acute Pancreatitis is AUTODIGESTION OF PANCREAS

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5
Q

Digests CHO

A

Amylase

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6
Q

Digests fats

A

Lipase

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7
Q

Digests CHON

A

Trypsin

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8
Q

More common yet milder form

A

Interstitial Edematous Pancreatitis

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9
Q

(-) necrosis but pancreas become enlarged due to inflammatory edema

A

Interstitial Edematous Pancreatitis

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10
Q

Patient at risk for hypovolemic shock, F&E imbalances, and sepsis

A

Interstitial Edematous Pancreatitis

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11
Q

(+) Necrosis within and/or around the pancreas

A

Necrotizing Pancreatitis

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12
Q

More widespread and complete enzymatic digestion of gland

A

Necrotizing Pancreatitis

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13
Q

Acute Pancreatitis causes “I GET SMASHED”

A

I- idiopathic
G- Gall stones
E- Ethanol (Alcohol)
T- Trauma
S- Steroids
M- Mumps/Malignancy
A- Autoimmune
S- Scorpion stings
H- Hypercalcemia/Hypertriglyceridemia
E- ERCP
D- Drugs

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14
Q

Obstruction of the common bile duct

A

Acute Pancreatitis

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15
Q

Acute Pancreatitis Clinical Manifestations

A

C- Cullen’s sign
H- Hyperglycemia, Hypocalcemia
A- Abdominal Pain (main symptom)
G- Grey-turner’s sign
S- Sympathetic Nervous System Stimulation

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16
Q

Medical Management of Acute Pancreatitis

A
  • NPO – to inhibit pancreatic stimulation
  • Nasogastric suction if with abdominal distention and paralytic ileus
  • Enteral feeding (preferred route to meet nutritional needs)
    -Total Parenteral Nutrition (TPN), if enteral route is not tolerated
17
Q

Pain management for Acute Pancreatitis

A
  • Opiod analgesics, as ordered
  • Antibiotics, if with infection only
  • Intensive insulin therapy/continuous insulin infusion if with hyperglycemia
  • IV calcium gluconate if with tetany
18
Q

What medications do we need to give if hypovolemic shock is present in Acute Pancreatitis?

A

-Give plasma or plasma volume expanders (e.g dextran or albumin) (the purpose is to increase blood volume)
- Dopamine IV (to increase systemic vascular resistance)
- PLR (fluid of choice to correct electrolyte imbalance

19
Q

Surgical Management of Acute Pancreatitis

A
  • ERCP with/without lap chole if gall stones are the cause
  • Laparotomy
  • Pancreatic Surgery
20
Q

Performed by making a large incision in the abdomen to gain access to the peritoneal cavity.

A

Laparotomy

21
Q

Resect or debride an infected, necrotic pancreas

A

Pancreatic surgery

22
Q

Nursing Management of Acute Pancreatitis (GOAL: Pain Control)

A

-Assess pain score regularly
Administer opioids, as ordered

-Institute non- pharmacologic pain relief interventions

  • Facilitate and maintain NPO
    Institute bed rest - to decrease the metabolic rate and reduce the secretion of pancreatic and gastric enzymes.

-Refer increasing severity of pain to physician ASAP

23
Q

Nursing Management of Acute Pancreatitis (GOAL: Improvement of Breathing Pattern)

A
  • Place in semi- Fowler’s position (to decrease pressure on the diaphragm by a distended abdomen and to increase respiratory expansion)

-Change positions frequently (to prevent atelectasis and pooling of secretions)

-Facilitate DBE and coughing, instruct on use of incentive spirometry

24
Q

Nursing Management of Acute Pancreatitis (GOAL: Improvement of Nutritional Status)

A
  • Monitor daily weights
  • Administer enteral/parenteral nutrition, as prescribed
  • Monitor blood glucose q4-6H or as ordered
  • Facilitate high protein, low fat diet once acute symptoms subside
  • Instruct to avoid heavy meals and alcoholic beverages
25
Q

Nursing Management of Acute Pancreatitis (GOAL: Maintaining Skin Integrity)

A

-Assess surgical wound, drainage sites, and skin for signs of infection, inflammation, and breakdown
- Provide wound care as prescribed
- Prevent contact of intact skin with drainage
- Facilitate turning to sides q2H
Use specialty beds as indicated to prevent skin breakdown

26
Q

What is the causes of Chronic Pancreatitis?

A

-Alcohol Consumption
- Smoking

27
Q

Chronic Pancreatitis Clinical Manifestations (PAWIS)

A

P- Pain (upper abdominal and back)
A- Anorexia/ Avoidance behavior
W- Weight loss
I- Impaired CHON and fat metabolism
S- Steatorrhea

28
Q

WHO three-step Ladder for Chronic Pain

A

Step 1: Non-opiod analgesic + adjuvant

Step 2: Weak opiod + non-opiod + Adjuvant

Step 3: Strong opioid + non opioid + Adjuvant

29
Q

What is the other alternatives of medical management of Chronic Pancreatitis?

A

PERT (Pancreatic Enzyme Replacement Therapy)

30
Q

If with malabsorption and steatorrhea what appropriate medical management must be administer?

A

Pecutaneous Enzyme Replacement Therapy (PERT)

31
Q

Nursing Care for Patients Taking Pancreatic Enzyme Replacement (PERT

A
  • Swallow capsules with cold or room temperature liquid
  • DO NOT crush or chew capsules
  • Taken with the first bite of each meal and snack
  • The only foods that do not require you to take enzymes are fruit juice and fruit (fresh and dried fruit) when eaten alone.
  • DO NOT stop taking PERT even when symptoms persist
32
Q

Surgical Management of Chronic Pancreatitis

A

-Roux-en–Y
- Whipple Resection

33
Q

Also known as pancreaticoduodenectomy

A

Whipple Resection

34
Q

Pancreaticojejunostomy with side-to-side anastomosis

A

Roux-en-Y

MS 2 (27 decks)

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