pancreatitis

Question 1

patho pancreatitis

Answer 1

pancreas has two separate functions

• endocrine insulin
• exocrine digestive enzymes
• Acute caused by alcohol or gallbladder disease
• Chronic caused by alcohol usually

Question 2

S/S pancreatitis

Answer 2

• pain that increases w/eating
• abdominal distention/ascites
• abdominal mass-swollen pancreas
• rigid board-like abdomen(guarding or bleeding/ poss peritonitis
• bruising around umbilical Cullon’s sign; flank area Gray turner’s sign roll them over during assess
• Fever
• nausea,vomiting
• jaundice(liver involvement)
• hypotension=bleeding or ascites (fluid is in peritoneal cavity not where it should be

Question 3

diagnosis

Answer 3

-serum lipase(most specific) &amylase 
elevated
-WBC elevated
-Blood sugar elevated (pancreas not producing insulin)
-ALT & AST liver enzymes increase
-PT &PTT high clotting is prolonged
-serum bilirubin increase
-H&H could be increased or decreased
(down w/bleeding, up w/blood concentration/dehydration

Question 4

Treatment

Answer 4

main goal is pain control
-decrease gastric secretions (NPO, NG suction, bedrest
-want the stomach to be dry/empty
-pain medications: pca narcotics includind morphine and dilaudid fentanyl patches
-steroids to decrease inflammmation
-Anticholinergic drugs/decrese secretions
-protonix ppi inhibitor
-Zantac &pepcid H2 antagonist to decrease acid
-antacids
-maintain fluid/electrolyte balance
-maintain nutritional status ease into diet
-

Question 5

Why insulin as treatment

Answer 5

• corticosteroids
• pancreas not producing insulin
• TPN

Question 6

other nrsg mngmt

Answer 6

-daily weights to check for fluid overload or deficit
-eliminate alcohol
refer to AA