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Lect 22. Pancreatitis Acute
Lect 22. Pancreatitis Acute
Prepared by
Ms. Maira Shaheen
LEARNING
OBJECTIVES
By the end of the session learners will be able
to:
• Review the anatomy and physiology of
Pancreas
• Discuss the causes, pathophysiology and
manifestation of the Acute Pancreatitis
• Discuss the diagnostic, medical and Nursing
management of the Acute Pancreatitis
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PANCREATITIS
Inflammation of the
Pancreas
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PANCREATITIS,
ACUTE
Pancreatitis (inflammation of the pancreas) is a
serious disorder that can range in severity from a
relatively mild, self limiting disorder to a rapidly
fatal disease that does not respond to any
treatment.
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ETIOLOGY AND PATHOPHYSIOLOGY
Pancreatic Ducts
become obstructed
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PROGRESSION OF DISEASE
• Autodigestion
Acute Inflammation of Pancreas
Necrosis of Pancreas
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ACUTE PANCREATITIS
DIAGNOSTIC STUDIES
Abdominal/endoscopic ultrasound
Endoscopic retrograde
cholangiopancreatography (ERCP)
Chest x-ray
CT of pancreas
Magnetic resonance cholangiopancreatography
(MRCP)
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MEDICAL MANAGEMENT:
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NURSING MANAGEMENT
Relieving Pain and Discomfort
• Administer analgesics as prescribed. Current
recommendation for pain management is parenteral
opioids, including morphine, hydromorphone, or
fentanyl via patient controlled analgesia or bolus.
• Frequently assess pain and the effectiveness of
the pharmacologic interventions.
• Maintain patient on bed rest to decrease
metabolic rate and to reduce secretion of
pancreatic enzymes 15
IMPROVING NUTRITIONAL
STATUS
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MONITORING AND MANAGING
COMPLICATIONS
Fluid and Electrolyte Disturbances
• Assess fluid and electrolyte status by noting
skin turgor and moistness of mucous membranes.
•Weigh daily; measure all fluid intake and output.
•Assess for other factors that may affect fluid and
electrolyte status, including increased body
temperature and wound drainage.
• Observe for ascites, and measure abdominal
girth.
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Administer intravenous (IV) fluids and blood or
blood products to maintain volume and prevent
or treat shock.
• Report decreased blood pressure, reduced urine
output, and low serum calcium and magnesium.
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1. PANCREATIC NECROSIS
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2. SHOCK AND MULTIPLE
ORGAN FAILURE
• Monitor patient closely for early signs of
neurologic, cardiovascular, renal, and
respiratory dysfunction.
• Prepare for rapid changes in patient status,
treatment, and therapies; respond quickly.
• Inform family of status and progress of
patient; allow time with patient.
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REFERENCE
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., &
Cheever, K. H. (2010). Brunner and Suddarth’s
textbook of medical-surgical nursing (12th ed.).
Philadelphia:Lippincott Williams & Wilkins.
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THANK YOU
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