Pancreatitis Flashcards
What are two separate functions of the pancreas
- )Endocrine__insulin
2) Exocrine___ digestive___ enzymes
What are the 9 s/s of Pancreatitis
- )Pain
- )Abdominal distention/ascites
- )Abdominal mass
- )Rigid boardlike abdomen
- )Bruising around umbilical area/flank
- )Fever
- )N/V
- )Jaundice
- )Hypotension
Doe the pain increase with eating ?
Yes
Why do we have Abdominal distention/ascites ?
because we’re (losing protein rich fluids like enzymes and blood
Why do u have a Rigid boardlike abdomen (guarding or bleeding)
is the pancreas auto digest its self its destroying pancreatic tissue
so you’re also damaging blood vessels in the pancreas so now you have blood peritoneal cavity and this cause peritonitis and this what the rigid board like abdomen mean They have peritonitis
What is bruising around the umbilical are called ?
Cullen sign
What is bruising around the flank area called ?
Grey turner sign
What does fever mean ?
Inflammation
What does Jaundice tell us
The liver is involved
Why is does the client have hypotension?
Bleeding or ascites
Normal Amylase
30-220 u/L
Normal lipase
0-110 U/L
Normal AST
8-40
Normal ALT
10-30
What 7 things do use to dx Pancreatitis?
- )Serum lipase and amylase
- )WBCs
- )blood sugar
- ) ALT, AST liver enzymes
- )PT, PT
6) Serum bilirubin - )H/H (Hemoglobin & Hematocrit)
Why does the Serum lipase and amylase go up?
These are the digestive enzymes they are trying to go to the small intestines but they can’t get there because there’s an occlusion so they sit in the pancreas so long that the blood absorbed them.
What is the Lipase is most specific in diagnosing pancreatitis?
Lipase is the one that is most specific in diagnosing pancreatitis
What is the tx
- ) NPO_, NGT to suction, bed rest
- ) pain meds
- ) steroids
- )Anticholinergics
- )antacid
- ) proton pump inhibitor
- )h2 blockers
- )Maintain fluid and electrolyte balance
9) Maintain nutritional status → ease into a diet
10) Insulin
11) Daily weights - )Eliminate alcohol
13) Refer to AA if this is the cause of pancreatitis
Why is the client KEEP them NPO_, NGT to suction?
Keep stomach empty and dry. This is very important for these people because if anything gets in their stomach they going to think they need to make more enzymes and this is what makes them hurt
So this will help decrease gastric secretions
morphine sulfate
narcotics
hydromorphone
narcotics
fentanyl patches(
narcotics
Why do we give steroids?
used to decrease inflammation
Why do we give Anticholinergics meds?
They dry you up and we want the stomach empty and dry .
benztropine
(Cogentin®)
diphenoxylate/atropine
(Lonox®)
Anticholinergics drugs
What do you give to decrease stomach acid?
- ) proton pump inhibitors
- ) H2 blockers
- ) Antacid
How do you maintain nutrition status?
Ease into a diet
What do we give insulin ?
- because the The pancreas is sick so it may not be producing adequate insulin 2. They may be on steroids and steroids make your blood sugar go up
- The client may be getting TPN
Alt and ast are
Liver enzyme and they never go down there either normal or they go
If the pt, Pitt is long what does it mean
If they are short what does it mean ?
Long = bleeding
Short = clotting
If Hemoglobin & Hematocrit is up what does it mean ?
If they are down what does it mean ?
Up = dehydration
Down = bleeding
