PANCREATITIS - PANCREATITIS Pancreatitis is a painful...

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PANCREATITIS Pancreatitis is a painful inflammatory condition in which the pancreatic enzymes are prematurely activated resulting in autodigestion of the pancreas. The most common cause of pancreatitis are biliary tract disease and alcoholism, but can also result from such things as abnormal organ structure, blunt trauma, penetrating peptic ulcers, and drugs such as sulfonamides and glucocorticoids. Pancreatitis may be acute or chronic, with symptoms mild to severe. CARE SETTING Inpatient acute medical unit for initial incident or exacerbations with serious complications; otherwise condition is managed at the community level. RELATED CONCERNS Alcoholism (acute); intoxication/overdose Substance dependence/abuse rehabilitation Diabetes mellitus/diabetic ketoacidosis Peritonitis Psychosocial aspects of care Renal failure: acute Sepsis/septicemia Total nutritional support; parenteral/enteral feeding Patient Assessment Database CIRCULATION May exhibit: Hypertension (acute pain); hypotension and tachycardia (hypovolemic shock or toxemia) Edema, ascites Skin pale, cold, mottled with diaphoresis (vasoconstriction/fluid shifts); jaundiced (inflammation/ obstruction of common duct); blue-green-brown discoloration around umbilicus (Cullen’s sign) from accumulation of blood (hemorrhagic pancreatitis) EGO INTEGRITY May exhibit: Agitation, restlessness, distress, apprehension ELIMINATION May report: Diarrhea May exhibit: Bowel sounds decreased/absent (reduced peristalsis/ileus) Dark amber or brown, foamy urine (bile) Frothy, foul-smelling, grayish, greasy, nonformed stool (steatorrhea) Polyuria (developing DM) FOOD/FLUID May report: Food intolerance, anorexia; frequent/persistent vomiting, retching, dry heaves Weight loss May exhibit: Diffuse epigastric/abdominal tenderness to palpation, abdominal rigidity, distension Hypoactive bowel sounds Urine positive for glucose NEUROSENSORY May exhibit: Confusion, agitation Coarse tremors of extremities (hypocalcemia) PAIN/DISCOMFORT May report: Unrelenting severe deep abdominal pain, usually located in the epigastrium and
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periumbilical regions but may radiate to the back; onset may be sudden and often associated with heavy drinking or a large meal Radiation to chest and back, may increase in supine position May exhibit: Abdominal guarding, may curl up on left side with both arms over abdomen and knees/hips flexed Abdominal rigidity RESPIRATION May exhibit: Tachypnea, with/without dyspnea Decreased depth of respiration with splinting/guarding actions Bibasilar crackles (pleural effusion) SAFETY May exhibit: Fever SEXUALITY May exhibit: Current pregnancy (third trimester) with shifting of abdominal contents and compression of biliary tract TEACHING/LEARNING May report: Family history of pancreatitis Diabetic ketoacidosis History of cholelithiasis with partial or complete common bile duct obstruction; gastritis, duodenal ulcer, duodenitis; diverticulitis; Crohn’s disease; recent abdominal surgery (e.g., procedures on the pancreas, biliary tract, stomach, or duodenum);
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PANCREATITIS - PANCREATITIS Pancreatitis is a painful...

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