Show Definition
Risk Factors
Pathophysiology and Etiology
Assessment/Clinical Manifestations/Signs and Symptoms
Diagnostic Evaluation
Medical ManagementDuring the acute phase, management is symptomatic and directed toward preventing or treating complications.
Complications
Nursing Diagnosis
Nursing ManagementThe client should avoid oral intake to inhibit pancreatic stimulation and secretion of pancreatic enzymes.
Maintain fluid and electrolyte balance.
Promote adequate nutrition.
Maintain optimal respiratory status.
Institute measures to prevent complications of immobility, such as impaired skin integrity, constipation, and deep vein thrombosis.Monitor for complications, which may include fluid and electrolyte disturbances, pancreatic necrosis, shock, and multiple organ failure.Administer prescribed medications, which may include opioid or nonopioid analgesics, histamine receptor antagonists, and proton-pump inhibitors.Maintain patent nasogastric suctioning to relieve nausea and vomiting, decrease painful abdominal distention, and remove hydrochloric acid.
In this article, we’ll talk about pancreatitis nursing interventions and assessment…two skills you’ll use regularly as a bedside RN. Pancreatitis is an inflammatory condition involving the pancreas. It can be acute or chronic, and is associated with a lot of other disorders such as alcoholism, disorders of the biliary tract, and use of certain medications like glucocorticoids. It can also be considered “idiopathic” which simply means it occurs because it occurs and we don’t really know why. Even though it’s pretty common does not mean it cannot be very serious. Acute pancreatitis has a 10% mortality rate and can lead to serious respiratory complications ranging from hypoxia to ARDS. Chronic pancreatitis, on the other hand, can cause permanent damage to the pancreas. Because it’s a pretty common condition, chances are you’ll see in your Med/Surg clinicals and definitely on your GI exam. So, let’s go through it using the Straight A Nursing LATTE method. If you’re not sure what the LATTE method is, check out this post. L: How does the patient LOOK?The patient with pancreatitis will be complaining of severe upper or epigastric abdominal pain that may radiate to the back. This pain could be worse after eating high-fat foods, or drinking alcohol. In many cases the patient will have nausea with or without vomiting. Many times these patients are thin due to either chronic weight loss secondary to the condition or chronic alcohol use (many patients who are dependent on alcohol drink their calories instead of eating real meals, so many times these patients are significantly malnourished). A: How will you ASSESS this patient?
T: What TESTS will be ordered?
T: What TREATMENTS will be provided?
E: How will you EDUCATE the patient?
I hope this quick overview helps you take excellent care of your patients with pancreatitis whether they be real patients in the hospital or hypothetical ones on your exams! Get this on audio on the Straight A Nursing Podcast – Episode 66References Ahmed, A., Azim, A., Gurjar, M., & Baronia, A. K. (2016). Hypocalcemia in acute pancreatitis revisited. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine,20(3), 173–177. https://doi.org/10.4103/0972-5229.178182 Browne, G. W., & Pitchumoni, C. (2006). Pathophysiology of pulmonary complications of acute pancreatitis. World Journal of Gastroenterology : WJG, 12(44), 7087–7096. https://doi.org/10.3748/wjg.v12.i44.7087 Cleveland Clinic. (2017, November 29). Best and Worst Foods for Pancreatitis Pain. Retrieved from Health Essentials from Cleveland Clinic website: https://health.clevelandclinic.org/best-and-worst-foods-for-pancreatitis-pain/ Dreiling, D. A., & Janowitz, H. D. (1960). Inhibitory effect of new anticholinergics on the basal and secretin-stimulated pancreatic secretion in patients with and without pancreatic disease. The American Journal of Digestive Diseases, 5(7), 639–654. https://doi.org/10.1007/BF02290198 Ingelfinger, F. J. (1963, June). Anticholinergic Therapy of Gastrointestinal Disorders | NEJM. Retrieved from The New England Journal of Medicine website: https://www.nejm.org/doi/pdf/10.1056/NEJM196306272682608 National Headache Foundation. (2007, October 25). Demerol®. Retrieved from National Headache Foundation website: https://headaches.org/2007/10/25/demerol/ facebook linkedin twitter pinterest
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