Pancreatitis

Question 1

What are the 2 separate functions of pancreas?

Answer 1

Endocrine: Insulin

Exocrine: Digestive enzymes

Question 2

What are the 2 types of pancreatitis?

Answer 2

Acute (alcohol; gallbladder disease)

Chronic (alcohol)

Question 3

S/s

Pain when eating

Answer 3

Increase

Question 4

S/s

Abdominal area

Answer 4

-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)

Question 5

S/s

Bleeding in abdomen can lead to ___

Answer 5

Peritonitis

Question 6

S/s

Bruising

Answer 6

Around umbilical (Cullens sign)

Around flank area (Grey Turner sign)

Question 7

S/s

Fever why?

Answer 7

Inflammation

Question 8

S/s

GI

Answer 8

NV

Question 9

S/s

Liver involved

Answer 9

Jaundice

Question 10

S/s

BP

Answer 10

Hypotension = bleeding or ascites

Question 11

Diagnosis

Lipase and amylase

Answer 11

Increase

Serum lipase= most specific enzyme for pancreatitis

Question 12

Diagnosis

Normal lipase and amylase levels?

Answer 12

Lipase: 0-110

Amylase: 30-220

*these levels are ELEVATED with pancreatitis

Question 13

Diagnosis

WBC

Answer 13

Increased

Question 14

Diagnosis

Blood sugar

Answer 14

Increased

Question 15

Diagnosis

ALT and AST

Answer 15

Increase

Question 16

Diagnosis

PT, aPTT

Answer 16

Longer (bc liver dysfunction)

Question 17

Diagnosis

Bilirubin

Answer 17

Increased

Question 18

Diagnosis

H&H

Answer 18

Increased or decreased

Increased with dehydration
Decreased with bleeding

Question 19

Treatment

Goal?

Answer 19

Control pain

Question 20

Treatment

How to control pain?

Answer 20

Decrease gastric secretions (NPO, NGT to suction, bed rest)—want stomach empty and dry

Pain meds: PCA narcotics (morphine, hydromorphone); fentanyl patches

Question 21

Treatment

Why give steroids?

Answer 21

To decrease inflammation

Question 22

Treatment

Why give anticholinergics?

Answer 22

To dry up secretions

*benztropine, diphenozylate/atropine

Question 23

Treatment

GI protectants?

Answer 23

PPI, H2 blockers, antacids

Question 24

Treatment

Maintain ?

Answer 24

F&E balance

Question 25

Treatment

Clients with pancreatitis–keep stomach?

Answer 25

Empty and dry

Question 26

Treatment

Why give insulin?

Answer 26

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)

Question 27

Treatment

Other

Answer 27

Daily weights
Eliminate alcohol
Refer to AA if this is the cause