Unit 1 Chapter 54 Gastrointensinal Acute and Chronic Pancreatitis Flashcards
What is Acute Pancreatitis
Abrupt disruption and inflammation in the pancreas to perform duties that is reversible
-cannot excrete pancreatic enzymes to small intestine to absorb nutrients from the food
Duties
-break down fats and proteins through excreated enzymes
-excretion of insulin to control blood sugar
-occurs mainly in adults
What is the #1 risk factor of Acute Pancreatitis?
Alcohol abuse or consumption
also ..
* Biliary disease (gallstones)
* Abdominal trauma,
viral infections,
-drugs(opiates, sulfonamides, thiazides, steroids, and
oral contraceptives (less common)
-cystic fibosis
and tumors
-trauma
Should you administer fat soluable vitamins to a patient with Acute Pancreatitis
A.No
B.Yes
A.No , due to dysfunction in pancrease to perform its natural function like excreting pancreatic enzymes to break down fats and proteins
What diet is best for patients with Acute Pancreatitis?
A. low fat , low protein, low carbs
B. high fat , low protein, low carbs
A. low fat , low protein, low carbs
SMALL FREQUENT MEALS
Signs and symptoms of Acute Pancreatitis
SEVERE Abdominal Pain
EPIGASTRIC PAIN
pain that radiates to the back,left flank, or left shoulder.**
LEFT UPPER QUADRANT PAIN
* Abdominal tenderness
*tentany due to hypocalcemia
* Nausea/ vomiting / weight loss
** Jaundice**
* Gray-blue discoloration around umbilical area (Cullen’s sign )
* Gray-blue discoloration on thigh and peritoneal cavity area (Turner’s
sign)
Steathrea (fatty stools)
-weight loss
-acities
-constipation
-diabetes melitis
-hypoxemia
-metabolic acidosis
Is the pain worsened or relieved when assuming a supine position for Acute Pancreatitis?
A. relived
B. worsened
PAIN IS worsened by lying in the supine position.
What position would you see a patient in during pain in Acute Pancreatitis to relieve their pain?
A. Prone
B.Fetal
C. Supine
D. Sims
B.Fetal
Often the patient finds relief by assuming the fetal position (with the knees drawn up to the chest and the spine flexed) or by siing upright and bending forward.
What labs would you suspect to be elevated for Acute Pancreatitis?
Pancreatic enzymes, liver labs, glucose,esr
esr normal range
Male: 15 mm/hr
Female: up to 20 mm/hr
Amalyse Normal range and function
-digest carbohydrates
elevation in amalyse: lack on energy due to inability to digest carbohydrates
56-190 IU/L
Lipase Normal range and function
- digest fat
elevation in lipase: Fatty stools steatorrhea. 0-110 IU/L
Chymotrypsin and Trypsin function
-digest proteins
Elevation: poor wound healing
Endocrine dysfuction
elevation
-increased glucose
Your patient with Acute Pancreatitis, is displaying polyuria and is complaining of being hungry all the time which lab value will indicate the patients current condition?
A. Glucose 190ml
B. Lipase 100
C. Amalyse 70
D. Troponin 0.1
A. Glucose 190ml
Polyuria, polydipsia, polyphagia (diabetes mellitus)
Emergency Medical Management of Acute Pancreatitis
NPO(NOTHING BY MOUTH)
PAIN MANAGEMENT
IV HYDRATION
What is the medication of choice for a patient experiencing SEVERE abdominal pain with Acute Pancreatitis?
A. Allopurinol
B. Morphine
C. Acetaminophen
D. Ketorolac
B. Morphine
Are patients with Acute Pancreatitis at risk for Hemrohhage
Monitor and record vital signs frequently to assess for elevated temperature, tachycardia, and decreased blood pressure, or assign and closely supervise this activity. Auscultate the lung fields for adventitious sounds or diminished breath sounds and observe for dyspnea or orthopnea.
-For the patient with acute pancreatitis, monitor for significant changes in vital signs that may indicate the life-threatening complication of shock. Hypotension and tachycardia may result from pancreatic hemorrhage,
Maintenance Interventions for Patients with Acute Pancreatitis
-promote rest due to fatigue from maldigestion of carbs
-Sprinkle pancreatic enzymes on all snacks and food
-monitor for constipation, pancreatic enzymes decrease frequency of fatty stools
Complications of Acute Pancreatitis
Hypovolemia – can lead to hypovolemic shock or acute kidney failure
(pre-renal)
* Hemorrhage *
Paralytic ileus – due to hypovolemia causing peristalsis to slow down
to absorb more fluid from stool
Pleural effusion
*respiratory distress syndrome,**
pneumonia
* Multi-system organ failure
*DIC -Disseminated intravascular coagulation (DIC) involves hypercoagulation of the blood, with consumption of clo ing factors and the development of microthrombi.
- Diabetes mellitus
Can Acute Pancreatitis Affect all organs in the body?
A. Yes
B. No
A. Yes
REQUIRED MULTIDISCIPLINARY APPROACH
-DIETICIAN
-* Respiratory care
* Nutritional consult
What is the lab value that is the indicator for nutritional status?
Albumin (3.5-5)
Your patient with a history of alcohol abuse has been admitted and diagnosed with Acute pancreatitis. Which statement from the patient required further teaching?
A. I will drink 1 alcoholic drink a day since I’m used to drinking 4 a day.
B. I will eat small frequent meals
C. I will eat a bland diet
D. The pancreatic enzymes will help decrease my constipation
A. I will drink 1 alcoholic drink a day since I’m used to drinking 4 a day.
-refer to AA
-NO ALCOHOL AT ALL
What diagnostic test is best to confirm pancreatic stones?
stones are best diagnosed through ERCP.
What is the most common sign of Pancreatitis?
boring
Severe continuous “boring” abdominal pain is the most common symptom of pancreatitis
-The patient often states that the pain had a sudden onset and radiates to the back, left flank, or left shoulder. The pain is described as intense, boring (feeling that it is going through the body), and continuous,