Pancreatitis Overview for Nursing Students

[Music] pancreatitis pancreatitis is the inflammation of the pancreas so the pancreas you know has endocrine function where it helps regulate our blood sugar but it also has this exocrine function where it releases these enzymes in response to the foods that we eat to help digest the foods that we eat so what happens in pancreatitis is that instead of these enzymes being activated in the dadum as they are supposed to they are activated in the organ itself so the organ literally eats itself so this process is called autodigestion so the Cardinal symptom for the pancreatitis patient is pain the patient's in severe pain left upper quadrant pain left shoulder pain it is excruciating I had a student describe it to me once and he said it was the worst pain in his life most cases go on and they are self-limiting you keep the patient in and eventually the inflammation subsides and the process reverses itself about 10% of the cases go on to form this more life-threatening form of pancreatitis or this autodigestion continues to re re havoc on the system so what happens is that the patient goes into a form of hypmic shock those proteases that are so proficient at breaking down the proteins that we eat are now going to break down the blood vessels the capillary permeability of the blood vessels intravascular fluids are allowed to leak out an inflammatory process causes vasod dilation and manam we don't have a blood pressure also this fibrinogen and prothrombin is activated as a result of these enzymes circulating systemically and now we have diffuse Venus thrombus formation pulmonary emite DIC could form a lipolytic process takes place binds with calcium drives that calcium level down so now the patient has hypocalcemia on top of it we'll go through the other labs that we need to pay attention to but this is also a good time um for you to review the evaluation of the patient who hypocalcemic so you remember that sign where you put a blood pressure cuff on the patient's arm and causes carpopedal spasm of the wrist that's true cell also that other evaluation that we do is that we tap on the patient's face in front of the ear and we could see that twitching of the muscles of the face as a result so that one is called the trost sign so make sure you're familiar with those ways to evaluate hypocalcemia okay so remember we talked about with r it's how there's the indirect and then there's the indirect way to kind of assault either the pulmonary capillary bed or the alval life it's a direct rout well in pancreatitis we are able to indirectly cause inflamat Ator process to occur in the pulmonary capillary bed and that's how pancreatitis induces adult respiratory distress syndrome so now we have those very potent acids actually affecting the pulmonary capillary bed and then the alvioli itself causing that indirect form of pulmonary edema other labs we want to look at is serum liase serum amas levels are going to be elevated serum lipase is going to confirm the diagnosis even better a white blood cell count either from a subsequent infection or just the inflammatory process elevated blood sugars from those beta cells of the pancreas being affected elevated liver function test because of that surrounding organ of the liver elevated Billy Ruben for the same reason and the gallbladder being tucked under the liver like that could also cause that an elevation in that conjugated Billy ruin level talked about the um diminished calcium other cardinal signs is called the gray Turners and the colon sign so with gray Turners you have to turn the patient to actually see it but that's a result of the pancreas having this seepage settle in on that left side and the colon sign is that seepage from the pancreas that's affected affected settling in around the umbilicus treatment what do we do well the most important intervention is to keep the patient NPO rest the gut no Foods in fact do an NG tube to low wall suction to try to um suction out any stomach contents also control stomach acid with either H2 blockers like grenadine or proton pump inhibitors like protonex um positioning is another independent action fetal position sideline position uh any place whether they're not supine pain control opioid relief so Hydromorphone or deled are good choices but the pain is is severe nausea with whatever antiemetic zrin chronic pancreatitis patient is when um often that the patient has these vacations to the point where it permanently affects the tissue of the pancreas and now there're scarring and Scar Tissue laid down instead of viable pancreatic tissue so these patients may suffer from malabsorption syndromes as they're not able to digest the foods normally with the release of these enzymes they also could suffer from diabetes as the endocrine portion of the pancreas is affected as well um statera could occur seeria is definition by definition fatty stools so that occurs because you're you don't have the sufficient amalay to actually emulsify the food that they eat and the fats will come out kind of the same way they went in so that's called statera also look for signs of jaundice as there is pressure inflammation on that surrounding gallbladder diet so when the patient does begin to eat it's important to recommend the proper diet no alcohol so alcohol causes spasms of the sphincter of OI and inflammation of the sphincter of OI no stimulants no Starbucks also Bland Foods no spicy you know hot sauce on whatever they're eating would also stimulate and attack to occur lowfat is the easiest to digest so that's the recommended diet and high carbohydrates complex carbohydrates because they may have diabetes cuz carbohydrates are the easiest to digest

Channel: Gail Lupica

Views: 41,465

Keywords: nurse, nursing school, csn, csn nursing, unlv, unlv nursing, kaplan nursing, chamberlain nursing, Michael Linares, Osmosis, Nursing student, nursing help, patient care, roseman nursing, NCLEXRN, how to pass nursing school, Pancreatitis, pre licensure, pre-licensure, nclex, columbia nursing, everest nursing, RN, RN help

Id: ecuu4bgQdM4

Length: 6min 42sec (402 seconds)

Published: Tue Jul 25 2017