Pancreatitis Flashcards
What are the 2 separate functions of pancreas?
Endocrine: Insulin
Exocrine: Digestive enzymes
What are the 2 types of pancreatitis?
Acute (alcohol; gallbladder disease)
Chronic (alcohol)
S/s
Pain when eating
Increase
S/s
Abdominal area
-Distention/ascites
(Loosing protein rich fluids like enzymes and blood into the abdomen= ascites)
- Abdominal mass (swollen pancreas)
- Rigid board like abdomen (guarding or bleeding)
S/s
Bleeding in abdomen can lead to ___
Peritonitis
S/s
Bruising
Around umbilical (Cullens sign)
Around flank area (Grey Turner sign)
S/s
Fever why?
Inflammation
S/s
GI
NV
S/s
Liver involved
Jaundice
S/s
BP
Hypotension = bleeding or ascites
Diagnosis
Lipase and amylase
Increase
Serum lipase= most specific enzyme for pancreatitis
Diagnosis
Normal lipase and amylase levels?
Lipase: 0-110
Amylase: 30-220
*these levels are ELEVATED with pancreatitis
Diagnosis
WBC
Increased
Diagnosis
Blood sugar
Increased
Diagnosis
ALT and AST
Increase
Diagnosis
PT, aPTT
Longer (bc liver dysfunction)
Diagnosis
Bilirubin
Increased
Diagnosis
H&H
Increased or decreased
Increased with dehydration
Decreased with bleeding
Treatment
Goal?
Control pain
Treatment
How to control pain?
Decrease gastric secretions (NPO, NGT to suction, bed rest)—want stomach empty and dry
Pain meds: PCA narcotics (morphine, hydromorphone); fentanyl patches
Treatment
Why give steroids?
To decrease inflammation
Treatment
Why give anticholinergics?
To dry up secretions
*benztropine, diphenozylate/atropine
Treatment
GI protectants?
PPI, H2 blockers, antacids
Treatment
Maintain ?
F&E balance
Treatment
Clients with pancreatitis–keep stomach?
Empty and dry
Treatment
Why give insulin?
Pancreas is sick (not making insulin like it should)
Steroids increased BS (on steroid as tx for the inflamm)
TPN (lots of dextrose in it)
Treatment
Other
Daily weights
Eliminate alcohol
Refer to AA if this is the cause
