Pancreatitis Flashcards
What happens in pacreatitis?
autodigestion of the pancreas from premature activation of pancreatic digestive enzymes
Name the classic S/S of an acute pancreatic attack
severe, constant, knife-like pain; located in the LUQ; radiating to the back or midepigastiric;unrelieved by nausea and vomiting
What are the two primary causes of pancreatitis?
alcoholbiliary tract disease (gallstones causing blockage in the ducts)
Name other causes
complication of ERCPintake of large amounts of fat/alcoholgallbladder diseaseprimary cause of chronic pancreatitis is alcohol
A nurse is assessing a client for manifestations of pancreatitis. What will she find?
Sudden onset of severe pain in LUQ/epigastricRadiates to back, L shoulder, L flankNausea, vomiting; weight lossgeneralized jaundicehyperglycemiaparalytic ileustetany ascitesTurner's Sign - ecchymoses on the flanksCullen's sign - blush periumbilical discoloration
What is Turner's sign?
ecchymoses on the flanks
What is cullen's sign?
bluish periumbilical discoloration
A nurse is determining if the client has pancreatitis. The nurse asks, What makes the pain worse?
worse when lying down; or eating
What relieves the pain associated with pancreatitis?
lying in a fetal position
With pancreatitis, what labs are elevated?
serum amylase, serum lipaseWBCliver enzymes; bilirubin levelglucose
When does serum amylase rise? how long does it last?
within 12 hours; lasts 4 days
When does serum lipase rise? how long does it last?
rises slower but lasts longer --> 2 weeks
What levels are decreased with pancreatitis? why?
calcium and magnesium fat necrosis with pancreatitis
A nurse is caring for a client experiencing acute pancreatitis. The client asks the nurse, "What does the doctor mean by 'rest my pancreas'?" What is the nurse's best response?
Remain NPO --> no food until pain free*Administer anti-emetic as neededNG tube for gastric decompressionTPN or jejunal feedings (lower risk of hyperglycemia)
A client with acute pancreatitis is having his diet resumed. What food should the client eat?
bland, low-fat dietNO stimulants - caffeinesmall, frequent meals
What client education should the nurse advise the client with pancreatitis to avoid?
Avoid drinking, smokingLimit stress
Why should the nurse monitor blood glucose levels with acute pancreatitis patients?
decrease insulin production from the pancreas----> causing hyperglycemia
What opioid is recommended for acute pancreatitis?
morphine sulfate
What opioid is not recommended in older adults with pancreatitis? why?
meperidine; risk for seizures
A client is prescribed dicylomine, an anti-cholinergic, for pancreatitis. Why is this prescribed?
decreases intestinal motility ---> allows the flow of pancreatic enzymes
papaverine, a spasmolytic, is used in pancreatitis for what?
relaxes smooth muscle
What other medications will be prescribed for pancreatitis?
histamine 2 receptor blockerspancreatic enzymes
What symptoms require notification of the provider?
acute, abdominal painjaundiceclay-colored stoolsdark-colored urine