Pancreatitis: This is - ✔✔ auto-digestion of the pancreas
Pancreatitis: The pancreas has 2 separate functions - ✔✔ 1. endocrine
... [Show More] (insulin)
2. exocrine (digestive enzymes)
Pancreatitis: There are 2 types of pancreatitis - ✔✔ 1. acute
2. chronic
Pancreatitis: What is the #1 cause? - ✔✔ gallbladder disease
Pancreatitis: What is the #2 cause and why? - ✔✔ alcohol because it causes scar tissue to build up
Pancreatitis: Signs/Symptoms - ✔✔ -pain
-abdominal distention/ascites
-abdominal mass
-rigid/board-like abdomen (with guarding)
-Cullen's sign
-Grey-Turner's sign
-fever
-N/V
-jaundice
-hypotension
Pancreatitis Signs/Symptoms: Pain increases with - ✔✔ eating
Pancreatitis Signs/Symptoms: Abdominal distention and ascites occur because - ✔✔ losing protein rich fluids like enzymes and blood into the abdomen which lead to ascites
Pancreatitis Signs/Symptoms: Why would there be an abdominal mass? - ✔✔ because the pancreas is swollen
Pancreatitis Signs/Symptoms: What does it mean when the client has a rigid, board-like abdomen (with guarding)? - ✔✔ bleeding that can lead to peritonitis
Pancreatitis Signs/Symptoms: What is Cullen's sign? - ✔✔ bruising around the umbilical area
Pancreatitis Signs/Symptoms: What is Grey-Turner's sign? - ✔✔ bruising in the flank area
Pancreatitis Signs/Symptoms: Why does fever occur? - ✔✔ inflammation
Pancreatitis Signs/Symptoms: Why would jaundice occur? - ✔✔ liver involvement
Pancreatitis Signs/Symptoms: Why would hypotension occur? - ✔✔ bleeding or ascites
Pancreatitis Diagnosis: Labs will show - ✔✔ -increased serum lipase and amylase
-increased WBCs
-increased blood sugar
-increased ALT, AST (liver ezymes)
-longer PT and aPTT times
-increased serum bilirubin
-increased OR decreased hemoglobin &
hematocrit
Pancreatitis Diagnosis: What are the most specific diagnostic labs and why? - ✔✔ serum lipase and amylase because they aren't being used so they go to the blood
Pancreatitis Diagnosis: Why would the serum bilirubin be increased? - ✔✔ the liver is affected
Pancreatitis Diagnosis: Why would the hemoglobin and hematocrit be increased? - ✔✔ dehydration
Pancreatitis Diagnosis: Why would the hemoglobin and hematocrit be decreased? - ✔✔ bleeding
Pancreatitis Diagnosis: Normal amylase values - ✔✔ 30-220 U/L (SI)
Pancreatitis Diagnosis: Normal lipase values - ✔✔ 0-160 U/L (SI)
Pancreatitis Diagnosis: Normal AST values - ✔✔ 0-35 U/L (SI)
Pancreatitis Diagnosis: Normal ALT values - ✔✔ 10-36 U/L (SI)
Pancreatitis Diagnosis: Normal hemoglobin values - ✔✔ Male: 14-18 g/dL
Female: 12-16 g/dL
Pancreatitis Diagnosis: Normal hematocrit values - ✔✔ Male: 42-52%
Female: 37-47%
Pancreatitis: Treatment Includes - ✔✔ -pain control
-pain medications
-anticholinergics
-GI protectants
-maintain fluid and electrolyte balance
-maintain nutritional status
-insulin
-daily weights
-eliminate alcohol
-refer to AA if needed
Pancreatitis Treatment: Goal is to - ✔✔ control pain
Pancreatitis Treatment: To control pain we want to - ✔✔ decrease gastric secretions
Pancreatitis Treatment: How do we decrease gastric secretions and why? - ✔✔ -NPO
-NGT to suction
-bed rest
We want the stomach EMPTY and DRY
TESTING STRATEGY: Client with pancreatitis = - ✔✔ keep stomach empty and dry
Pancreatitis Treatment: Pain medications include - ✔✔ -PCA narcotics
-fentanyl patches (Duragesic)
Pancreatitis Treatment: PCA narcotics include - ✔✔ -morphine sulfate (Morphine)
-hydromorphone (Dilaudid)
Pancreatitis Treatment: Why do we give anticholinergics? - ✔✔ dry them up
Pancreatitis Treatment: Anticholinergics include - ✔✔ -benztropine (Cogentin)
-diphenoxylate/atropine (Lonox)
Pancreatitis Treatment: GI Protectants include - ✔✔ -proton pump inhibitors
-H2 receptor antagonists
-antacids
Pancreatitis Treatment: Proton pump inhibitor given - ✔✔ pantoprazole (Protonix)
Pancreatitis Treatment: H2 receptor antagonists - ✔✔ -ranitidine HCl (Zantac)
-famotidine (Pepcid)
-cimetadine (Tagamet)
Pancreatitis Treatment: We need to maintain client's nutritional status by - ✔✔ easing them into a diet
Pancreatitis Treatment: Why do we give insulin? - ✔✔ because the pancreas is sick and the patient is receiving TPN [Show Less]