Pancreatitis: * can be severe or mild
Causes:
• Alocholism
• Hyperlipidemia
• Chronic NSAID & steroid use
• Trauma
• Gallbladder disease
• Peptic ulcers
• Biliary tract disease
Pathology: Enzymes of pancreas are released in digestive tract; Pancreatitis causes destruction of the digestive tract
Audodigestion: Digestive tract + bile ducts
*Can live without pancreas, but usually it isn’t removed. Would need lots of replacement therapy
Assessment:
• VERY PAINFUL!
• Do not want to eat anything. Eating releases more enzymes, making the pain worse
• History of alcoholism
• Problems with bile ducts, lots of hemorrhages, fever, necrosis
Planning:
• NPO status & pain relief initially; May eventually go to TPN
Implementation:
• Pain relief: IV pain meds – Morphine is drug of choice, NOT Demerol anymore, for comfort and physiological measures as well (more enzymes released otherwise)
*Turner’s sign: Blue area in flank portion of back
* Cullen’s sign: Blue area in umbilicus area
• Due to hemorrhaging
* Pancreatic CA has a higher incidence in men
More on Pancreatitis:
• Will need pancreatic enzyme replacement for the rest of life
• IV abx, culture drainage from cysts
• Small meals after recovery, may not be able to digest large meals
• At risk for respiratory infection (d/t abdomen pushing up to diaphragm
• Take steps to avoid pneumonia
• In acute phase, don’t overexert d/t resp. distress and pain
• Hyperglycemia during acute phase, short term insulin for coverage
Pancreatic CA
• Occurs more often after age 30, 30% higher rate in males
• Risk factors: Smoking, long-term DM, ETOH, industrial chemical exposure
• Not that treatable
• Cases: 37,680 Deaths: 34,290
• Doesn’t cause problems right away – late detection
• Head of pancreas, deep in tissue, clogs bile duct
• Occurs commonly before sx appear
• KNOW STAGE/GRADE
• Similar s/s as pancreatitis – testing needed to differentiate
Pain unrelated to meals...