T13: Pancreatitis

Question 1

pancreatitis

Answer 1

inflammation of the pancreas, with associated escape of pancreatic enzymes in to the surrounding tissue

Question 2

the pancreas is responsible for creating

Answer 2

insulin

Question 3

Necrotizing pancreatitis

Answer 3

autodigestion of the pancreas (pancreas eats itself)
o If it “eats” the islet of Langerhans they may need glycemic control

Question 4

clinical manifestations of pancreatitis

Answer 4

o Midepigastric pain to LUQ pain with radiation to the back
o Pain aggravated by fatty meal, alcohol or lying in recumbent position
o N/V, low grade fever
o Cullen’s sign
o Turners sign

Question 5

cullen signs

Answer 5

o discoloration of the abdomen and periumbilical area

Question 6

Turner’ sign

Answer 6

bluish discoloration of the flanks

Question 7

diagnostics for pancreatitis

Answer 7

o ELEVATED amylase and lipase
o ELEVATED WBCs
o ERCP

Question 8

ERCP

Answer 8

endoscopic retrograde cholangiopancreatography)

Question 9

interventions for pancretitis

Answer 9

o NPO!! Maintain hydration with IV fluids as prescribed
o Semi/high fowlers
o Morphine for pain relief
o Side lying position
o Instruct patient the IMPORTANCE OF AVOIDING ALCOHOL
o Instruct to notify HCP with acute abdominal pain, jaundice, clay-colored stool, and dark-urine

Question 10

pancreatic cancer

Answer 10

highly malignant, rapidly growing adenocarcinoma

Question 11

clincial manifestations of pancreatic cancer

Answer 11

o Dull aching abdominal pain
o Anorexia and progressive weight loss
o N/V
o Jaundice
o Clay-colored stools
o Glucose intolerance

Question 12

interventions for pancreatic cancer

Answer 12

o Chemotherapy and radiation
WHIPPLE PROCEDURE

Question 13

Whipple procedure

Answer 13

pancreaticoduodenectomy which involved the resection of the pancreas, adjoining duodenum, distal stomach and distal bile duct

Question 14

pre-op for whipple

Answer 14

ask about advanced directives and clients wishes

Question 15

post op care for whipple

Answer 15

similar to those with pancreatitis and following gastric surgery
· Monitor blood glucose levels for transient hyper/hypoglycemia
· Listen to bowel sounds (at risk or ileus)
· Watch for peritonitis (we are worried about anastomosis)
· PPN or TPN for HEALING
· Pancreatic enzymes are SPRINKLED ON FOOD
· NO FATTY FOOD FOR 6 WEEKS (diet change for removal of gallbladder)

Question 16

pancreatic enzymes

Answer 16

sprinkle on food or swallowed whole. given with all meals.

Question 17

after a whipple no fatty foods for

Answer 17

6 weeks (diet change because of the gallbladder)