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NURS 3512 - Class 1-6 > Week 6 - Pancreatitis > Flashcards

Week 6 - Pancreatitis Flashcards

1
Q

what is the function of the pancreas

A
  • secrete enzymes that aide in digestion and insulin production for glucose regulation
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2
Q

what is pancreatitis

A
  • inflammation of the pancreas
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3
Q

the degree of inflammation during pancreatitis can range from..

A
  • mild edema to severe hemorrhagic necrosis `
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4
Q

what are the most common causes of acute pancreatitis

A
  • alcohol abuse

- gallbladder disease (gallstones)

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5
Q

what are other causes of pancreatitis (10)

A
  • hypertriglyceridema
  • trauma
  • viral infections
  • penetrating duodenal ulcer
  • cysts
  • abscesses
  • CF
  • drugs
  • metabolic disorders
  • vascular disease
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6
Q

what are some meds that can cause pancreatitis (6)

A
  • corticosteroids
  • thiazides
  • estrogens
  • sulphonamides
  • HIV meds
  • anti-inflammatories
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7
Q

briefly describe the patho of pancreatitis

A
  • autodigestion of the pancreas d/t pancreatic enzymes

- can be life-threatening

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8
Q

what are symptoms of pancreatitis (11)

A
  • abdominal pain
  • NV
  • low-grade fever
  • leukocytosis
  • hypotension
  • tachy
  • jaundice
  • flushing
  • dyspnea
  • abdominal tenderness w guarding
  • bruising
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9
Q

where is the abdominal pain located in pancreatitis (3)

A
  • midepigastrium
  • LUQ
  • radiates to back (d/t retroperitoneal location of pnacreas)
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10
Q

describe the characteristics of pain in pancreatitis (7)

A
  • sudden onset
  • severe
  • deep
  • piercing
  • continuous
  • aggravated by eating & when pt recumbent
  • not relieved by vomitting
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11
Q

where is bruising noted in pancreatitis (2)? what are these called

A
  • flanks = grey turner

- periumbilical area = cullen’s sign

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12
Q

what are 2 complications of pancreatitis

A
  • pseudocyst

- abscess

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13
Q

what is a pancreatic pseudocyst

A
  • cavity continuous with or surrounding the outside of the pancreas
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14
Q

what is the pseudocyst filled w (4)

A
  • necrotic products
  • plasma
  • pancreatic enzymes
  • inflammatory exudates
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15
Q

describe what occurs w a pancreatic pseudocyst

A
  • as pancreatic enzymes escape, the serosal surfaces next to the pancreas become inflamed
    = formation of granulation tissue
    = encapsulation of exudate
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16
Q

what are symptoms of a pancreatic pseudocyts (5)

A
  • abdominal pain
  • palpable epigastric mass
  • NVA
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17
Q

describe the resolution of pancreatic pseudocyst

A
  • usually resolve on its own within a few weeks
18
Q

what is a potential complication of a pancreatic pseudocyst

A
  • may perforate = peritonitis
19
Q

what is a pancreatic abscess

A
  • large fluid containing cavity within the pancreas d/t extensive necrosis of the pancreas
20
Q

what are symptoms of a pancreatic abscess (4)

A
  • upper abdominal pain
  • abdominal mass
  • fever
  • leukocytosis
21
Q

what is treatment for a pancreatic abscess

A
  • must be surgically drained promptly to prevent sepsis
22
Q

what can a pancreatic abcess lead to (2)

A
  • perforation into adjacent organs

- may become infected

23
Q

what are the main systemic complications of acute pancreatitis

A
  • pulmonary
  • CVS –> hypotension
  • ## tetany (d/t hypocalcemia)
24
Q

what pulmonary complications are associated w pancreatitis (3)

A
  • pleural effusion
  • atelectasis
  • pneumonia
  • risk of intravascular thrombi, PE, disseminated intravascular thrombi
25
Q

what causes the pulmonary complication

A
  • passage of exudate thru the transdiaphragmatic lymph channels
26
Q

what causes atelectasis as a comp of pancreatitis

A
  • enzyme induced inflammation of the diaphragm = reduced diaphragm movement
27
Q

what causes the increased risk of thrombi w pancreatitis

A
  • trypsin activates prothrombin
28
Q

what is the treatment of pancreatitis (3)

A
  • identify cause
  • reduce or supress secretion of enzymes
  • decrease pancreatic stimulation
29
Q

what are the main goals of treatment for pancreatitis (5)

A
  • relief of abdominal pain r/t distension (NG tube)
  • prevent or alleviation of shock (fluids)
  • reduce pancreatic secretions (NPO)
  • fluid and electrolyte balance
  • removal of precipitating cause
30
Q

what does chronic pancreatitis lead to

A
  • fibrosis, strictures, calcifications

- progressively destroyed pancreas

31
Q

range of severity of pancreatitis ranges from

A
  • milk to severe (necrotizing pancreatitis)
32
Q

if you have severe pancreatitis, what can this lead to (3)

A
  • perm decrease in endocrine and exocrine function
  • increased mortality rate
  • self-destructs
33
Q

what is included in acute intervention of pancreatitis (5)

A
  • monitor VS
  • IV fluids (aggressive rehydration d/t emesis & decreased intake)
  • assess resp function (pancreatic enzymes move thru lymph channels)
  • pain mngmt (thru narcotics and positioning)
  • monitor for signs of hypocalcemia (combo of calcium and fatty acids during fat necrosis)
34
Q

why is pain mngmt imp in pancreatitisa

A
  • pain = restlessness = pancreatic stimulation
35
Q

a nursing diagnosis r/t pancreatitis is acute pain. what interventions can be done for this

A
  • assess pain
  • provide optimal pain relief w prescribed analgesics
  • eval effectiveness of pain-control measures
  • teach use of nonpharmacological measures
  • notify physician if measures successful or not
36
Q

a nursing diagnosis r/t pancreatitis is deficient fluid volume d/t vomitting. what are some nursing interventions for this (2)

A
  • antiemetic meds

- measure or estimate emesis volume

37
Q

a nursing diagnosis r/t pancreatitis is deficient fluid vol. what fluid and electrolyte mngmt can be used (3)

A
  • monitor electrollyte lvls
  • maintain IV solution w electrolytes at constant flow rsate
  • consult physician if S&S of electrolyte or fluid imbalances occur
38
Q

a nursing diagnosis r/t pancreatitis is imbalanced nutrition. what nursing interventions can be done for this (5)

A
  • monitor lab values
  • admin enteral (maybe parental) nutrition for carbs, lipids, and amino acids
  • provide oral care before meals to decrase foul taste
  • ensure availability of progressive therapeutic diet
  • provide needed nourishment
  • weight pt at approp intervals
39
Q

a nursing diagnosis r/t pancreatitis is risk of hypocalcemia. what are some nursing interventions for this (7)

A
  • monitor for S&S of hypocalcemia
  • monitor for CNS manifestations of hypocalcemia
  • monitor labs
  • monitor for electrolyte imbalances associated w hypocalcemia (increased PO4, low mg)
  • admin prescribed calcium salt , calcium dilutes in D5W
  • monitor pts response to treatment
  • consult physician if S&S of fluid or electrolyte imbalance persist or worsen
40
Q

a potential complication of pancreatitis is hypovolemia/shock. what nursing interventions can be done for this (5)

A
  • monitor circulatory status
  • strict NPO status to reduce or stop secretion of pancreatic enzymes
  • maintain patency of gastric suction
  • monitor electrolyte status
  • monitor for renal insufficiency

NURS 3512 - Class 1-6 (47 decks)

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