Pancreatitis Flashcards
Pancreatitis
What kind of pancreatitis is this?
- Reversible
- d/t activated pancreatic enzymes auto digesting the pancreas ranging from mild to necrotizing hemorrhagic pancreatitis
Acute pancreatitis
What kind of pancreatitis is this?
- Irreversible
- Defined as persistent inflammation that causes scarring and damage to the pancreas and surrounding tissue.
Chronic pancreatitis
Causes of Acute pancreatitis
Gallstones, alcohol, infection, tumor, medications, trauma
Causes of chronic pancreatitis
Repeated episode of pancreatitis, excessive and prolonged consumption of alcohol, cystic fibrosis
S/S of Chronic pancreatitis
- Chronic epigastric pain / no pain
- Pain ↑ after drinking etoh
- Weight loss
- Jaundice
- DM
- Dark urine
S/S of acute pancreatitis
- Sudden severe pain ( LUQ )
- N/v
- ↑ HR and ↓ BP
- ↑ glucose
- confusion and agitation
- ABD guarding / rigid board like ABD
- Grey- turner’s sign
- Cullens sign
bluish discoloration of flank
Grey-turners sign
bluish discoloration of umbilicus
Cullens sign
The following are S/S of what kind of pancreatitis?
- Chronic epigastric pain / no pain
- Pain ↑ after drinking etoh
- Weight loss
- Jaundice
- DM
- Dark urine
Chronic pancreatitis
All of the following are S/S of what kind of pancreatitis
Sudden severe pain ( LUQ )
N/v
↑ HR and ↓ BP
↑ glucose
Mental confusion and agitation
ABd guarding / rigid board like ABd
Grey- turner’s sign
Cullens sign
Acute pancreatitis
Expected labs for a patient with pancreatitis
- Amylase → rapid increase ↑ d/t pancreatic enzyme
- AST → elevated ↑ d/t bile flow obstruction
- Alt → elevated ↑ d/t gallstone pancreatitis
- Direct bilirubin → elevated ↑ d/t biliary obst
- Lipase → elevated ↑ d/t pancreatic enzyme
- WBC → elevated ↑ d/t inflammation
- Calcium → decreased ↓ d/t fat necrosis, hypoalbunemia, malnutrition, common w/ etoh,
- Albumin → decreased ↓ d/t poor nutrition
Risk factors for pancreatitis
- Gender: male
- Race: African American
What does kind of diet is a patient with pancreatitis put on after dx?
- Initially NPO status
- Carbs-containing foods (stimulate pancreas less)
- Avoid fatty foods and protein-rich foods (stimulates pancreas more)
- Small, frequent amounts (fist-sized) initially, advancing as pain subsides
- Vitamin supplements
A patient with pancreatitis requires gastic decompression, what needs to be done?
NG tube
Medications used to treat acute Pancreatitis
- Opioid analgesics
- Anticholinergics
- Antibiotic
- histamine blocker: cimetidine
- Proton pump inhibitor
- Pancreatic enzymes
If pancreatitis is severe how is nutrition provided?
enteral or parental nutrition
Procedures to treat pancreatitis
- Ercp
- Cholecystectomy/sphincterectomy/ endoscopic pancreatic necrosectomy
- Pancreaticjejunostomy
How should a patient with pancreatitis be positioned in bed
semi-fowlers position or fetal position to relieve ABD pressure
Breaks down carbs to glucose
Amylase
Breaks down proteins
Protease
Breaks down fat
Lipase
Medicaition given to acute pancreatitis patients for acute pain
Morphine and dilauded
Medication given to acute pancreatitis patients for moderate pain
Ketorolac or other NSAIDs
Medications given to patients with acute pancreatitis to dry up secretions
Anticholinergics
Examples of Anticholinergics
Hyoscyamine (levsin)
Scopolamine