Acute GI DIsorders2_student notes

Acute GI DIsorders2_student notes - Acute GI Disorders AMY...

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Acute GI Disorders AMY L. HUFF, MSN, RN MARTIN METHODIST COLLEGE SPRING 2015
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Acute Pancreatitis Inflammation of the pancreas Enzymes “kick in” early and result in autodigestion and fibrosis Range of severity Mild to necrotizing hemorrhagic pancreatitis (NHP) NHP = diffuse bleeding and tissue death
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What does the pancreas do? Exocrine gland Secretes enzymes that break down starches, proteins, and fats Secreted as inactive; becomes activated in small intestine Endocrine gland Disorder – diabetes mellitus
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Pathophysiology of acute pancreatitis Lipolysis Fatty acids released and combined with ionized calcium – results in HYPOCALCEMIA (Consider: what are s/sx of hypocalcemia?) Proteolysis Protein broken down – leads to THROMBOSIS and GANGRENE of the pancreas Necrosis of blood vessels Results in BLEEDING of pancreatic tissue (minor to massive) Inflammation Possible pancreatic ABSCESS
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Bottom Line… Patients with severe acute pancreatitis are critically ill, with major problems including: - hypocalcemia - thrombosis & gangrene -bleeding - infection Major of deaths from acute pancreatitis are due to irreversible shock
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Causes Sometimes unknown Most common – biliary tract disease, gallstones Trauma from surgery or ERCP (endoscopic retrograde cholangiopancreatography) Other trauma Pancreatic cysts, abscesses, tumors (obstructions) Alcoholism Other potential causes
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Complications Jaundice (bile flow obstructed) Hyperglycemia (decreased release of insulin) Left lung pleural effusions Multi-organ system failure (due to NHP) ARDS Coagulation defects (DIC – disseminated intravascular coagulation) Shock (consider: what are s/sx of shock?) Paralytic ileus
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Timing of attacks During holidays When alcohol consumption is high After cholelithiasis (gallstones) or other biliary tract disorders
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Assessment PAIN!!!
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