Description
• Only elevate in the first 24 hours!
Gastrointestinal System
[Pancreatitis]
Description
• Nonbacterial inflammation of pancreas
• Autodigestion of the pancreas by its own enzymes – primarily Trypsin
• Major causes:
o Alcohol
o Biliary tract disease
• Chronic pancreatitis = progressive, destructive disease (permanent)
• AVOID ALCOHOL CONSUMPTION
Assessment
• Acute:
o Severe mid-epigastric pain radiatesto back (worse after fatty meal/EtOH
consumption)
o Abdominal guarding, rigid, board-like = PEROTINITIS
o N/V
o Turner’ssign (bluish discoloration of flanks)
o Cullen’ssign (periumbilical area)
o Elevated:
▪ Amylase
▪ Lipase
▪ Triglycerides
▪ Glucose
o Low:
▪ Serum calcium (hypocalcemia)
• Chronic:
o Recurring attacks
o Steatorrhea
o Ascites/dark urine/jaundice (affectsliver)
o Weight loss/muscle wasting
o S/S of DM – hyperglycemia 2/2 lack of insulin
Interventions
• Acute:
o NPO
o NG tube to suction & TPN
o Hydromorphone (Dilaudid) or fentanyl for pain
o Antacids, H2 blockers, PPIs
o Position of comfort: on side with legs drawn to chest
o Teach:
▪ Avoid caffeine,spicey foods, fatty foods, alcohol
o Monitor BS/need for temporary insulin
o Monitor hypocalcemia (tetany, muscle twitching, cramping, grimacing,seizures,
increase DTRs, spasms, Trousseau’s and Chvsteks sign)
o Semi-fowlersto decrease pressure off abdomen
o Monitor for dysrhythmias
• Chronic:
o Administer analgesics
o Administer pancreatic enzymes (Creon) with meals or snacks
▪ Mix with fruit juice/apple sauce
o Monitor s/s of DM
HESI Hint
• Acute pancreatitis islocated retroperitoneally. Any enlargement of pancreases causes
peritoneum to stretch tightly –