Pancreatitis

Question 1

what are the 2 separate functions of the pancreas?

Answer 1

endocrine and exocrine

Question 2

its endocrine function?

its exocrine function?

Answer 2

• produce insulin
• digestive enzymes

Question 3

the number 1 cause of acute and chronic pancreatitis is___

Answer 3

alcohol

Question 4

Why are the enzymes in the pancreas innactive?

Answer 4

because they are digestive enzymes, and we don’t wanna digest the pancreas.

Question 5

when the enzymes get ready to activate, they must go to the pancreatic ___ and then are secreted into the____ in order to activate.

Answer 5

duct; small intestine.

Question 6

How does alcohol damage the pancreas?

Answer 6

the alcohol irritates it and create scar tissue, therefore they can occlude the pancreatic duct and then the pancreatic enzymes have trouble passing through to be activated in the small intestine. when this happens, the enzymes get tired of waiting and they just go ahead and activate within the pancreas. (they start digesting the pancreas itself)

Question 7

1st sign is___

Answer 7

pain

Question 8

does the pain increase or decrease with eating? why?

Answer 8

increase because when you eat, you make more enzymes

Question 9

why is this patient prone to getting ascites?

Answer 9

damaged capillaries

Question 10

will you be able to feel an abdominal mass?

Answer 10

yes; it’s just the swollen pancreas

Question 11

if this patient is guarding their abdomen or have a rigid board-like abdomen, they may be____

Answer 11

bleeding internally

Question 12

bruising in pancreatitis around the umbilical area is called___

Answer 12

cullen’s sign

Question 13

bruising in the flank area is called____

Answer 13

gray turner’s sign

Question 14

T OR F? When 1 part of the GI tract gets sick, can you expect the other parts to get involved as well?

Answer 14

yes

Question 15

why would this patient experience hypotension?

Answer 15

bleeding and ascites

Question 16

serum ___ and___ will go up.

Answer 16

lipase; amylase (digestive enzymes)

you’re not suppose to have digestive enzymes in your blood. they are suppose to be in your intestines.

Question 17

why would you expect their blood sugar to increase?

Answer 17

because the pancreas is responsible to insulin secretions but it is dysfunctional now, so the glucose will go un-metabolized. you can be a diabetic forever now.

Question 18

SGOT and SGPT are both___

Answer 18

WHAT IS THE AST TEST? (liver enzymes) This blood test measures an enzyme called aspartate aminotransferase (AST). Enzymes are chemicals that help the cells of your body work. AST is found in red blood cells, liver cells, and muscle cells, including the heart. It is released into the blood when these cells are damaged. This enzyme is also called serum glutamic-oxaloacetic transaminase, or SGOT they’ll both increase

Question 19

would pt and ptt get shorter or longer? why?

Answer 19

longer; risk for bleeding

Question 20

Expect the serum billirubin to___

Answer 20

increase

Question 21

what could make this patient’s H & H go up?

go down?

Answer 21

up= dehydrated due to concentrated

down= bleeding (it would come right out with the blood)

Question 22

TREATMENT:

• Why would you keep this patient NPO?
• when it comes to pancreatitis, how do we want to keep the patient’s stomach’?
• why would we want bed rest?

Answer 22

• since they get increased pain when they eat, it would hurt less. plus, we would decrease gastric secretions.
• we want the stomach to be empty and dry. (NGT tube to suction)
• bed rest decreases stomach secretions

Question 23

THEEEE drug of choice for pancreatitis pain control (on NCLEX) is___

Answer 23

demerol (meripidine)- a narcotic

Question 24

Why would this patient be prescribed steroids?

why can this be a problem?

Answer 24

to decrease inflammation; they’ll have a higher chance of getting diabetes because steroid will increase the blood sugar even more (can also develop cushing’s syndrom)

Question 25

why would this patient be prescribed an anticholinergic like, atropine?

Answer 25

to keep the stomach dry

Question 26

why would this patient be prescibed protonix?

Answer 26

to decrease stomach acid (zantac, pepcid.. pph)

Question 27

what kind of diet do we want to start them up with ?

Answer 27

clear liquids to make sure they can tolerate it

Question 28

would this patient need insulin?

Answer 28

-yes; pancreas is sick so it’s not making adequate insulin and may be on steroids.