Presentation on theme: "Inflammation of the Pancreas"— Presentation transcript:
1 Inflammation of the Pancreas PancreatitisInflammation of the Pancreas
2 Acute PancreatitisFunction of the pancreas is to release proteolytic enzymes that assist in the breaking down food products so that nutrients can be absorbed.
3 Acute Pancreatitis Etiology and Pathophysiology Pancreatic Ducts become obstructedHypersecretion of the exocrineenzymes of pancreasThese enzymes enter the bile duct, where they are activated and with bile back up into the pancreatic ductPancreatitis
4 Acute Pancreatitis Etiology and Pathophysiology Trypsinogen- (a proteolytic enzyme)Normally released into the small intestine, where it is activated to trypsinIn AP, activated to trypsin in the pancreas causing autodigestion of pancreas
5 Progression of Disease AutodigestionAcute Inflammation of PancreasNecrosis of PancreasDigestion of vascular wallsThrombus and HemorrhageDeath
6 Precipitating Factors TraumaUse of alcohol *Biliary tract diseaseViral or Bacterial diseaseCholelithiasis *Peptic Ulcer Disease*most common causes
7 Acute Pancreatitis Clinical Manifestations Severe Abdominal pain is predominant symptomPain located in LUQ and mid-epigastriumCommonly radiates to the backSudden onsetSevere, deep, piercing, steadyAggravated by fatty meal or lying recumbent positionNot relieved by vomiting
8 Acute Pancreatitis Clinical Manifestations Cyanosis, DyspneaBowel sounds decreased or absentLow-grade fever, LeukocytosisHypotension, TachycardiaJaundiceFlushingAbnormal lung sounds - CracklesDiscoloration of abdominal wall – Turner’s or Cullen’s signSIGNS OF SHOCK
9 Acute Pancreatitis Diagnostic Studies History and physical examinationLaboratory testsSerum amylase- hallmark testSerum lipase – also elevatedBlood glucoseSerum calciumTriglycerides
10 Acute Pancreatitis Diagnostic Studies Flat plate of abdomenAbdominal/endoscopic ultrasoundEndoscopic retrograde cholangiopancreatography (ERCP)Chest x-rayCT of pancreasMagnetic resonance cholangiopancreatography (MRCP)
11 Acute PancreatitisCan be a medical emergency associated with a risk for life-threatening complications
17 Acute Pancreatitis Goals of Care Relief of painPrevention or alleviation of shockDecrease respiratory failure↓ of pancreatic secretionsMaintain Fluid/electrolyte balance
18 Treatment and Nursing Care 1. Pain managementIV morphine or DilaudidAntispasmodic agentBentylPro-BanthineSpasmolytics – NitroglycerinePositioning – sitting up and leaning forwardWhy is it important to relieve pain?
19 Treatment 2. Prevention of Shock – hemodynamic stability * Administer Blood, Plasma expanders, Albumin* LR solution