And this is actually what causes their extreme pain or their pancreatic attacks

And this is actually what causes their extreme pain

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when they eat, what is released but the pancreatic enzymes. And this is actually what causes their extreme pain or their pancreatic attacks, because they eat, the enzymes release and they have this very significant pain. So we’ll make them NPO for some time. When you make somebody NPO when they are not able to exercise, the use of their GI system, it can become still and doesn’t move. The GI or the gut does not move, that is what is known as a paralytic ileus. Other complications that have been associated with acute pancreatitis are actually pleural effusion, significant respiratory factors, even as far as ARDS can occur; multisystem organ failure, DIC can occur and this is going to be definitely relative to the necrosis of the blood vessels that happens with the release of elastase, diabetes as we know the pancreas has an exocrine or endocrine function associated with it and is responsible for insulin production. So things that we will assess for are going to be generalized jaundice that can occur with pancreatitis. Cullen’s and Turner’s signs I have some pictures in these slides for you to look at. The Cullen’s sign is the area of discoloration at the abdomen usually around umbilicus. And turner’s sign is that same discoloration, gray, purple area, looks like bruising and this occurs at the flanks and this of course is going to be relative to pancreatic enzyme leakage into the cutaneous tissue; not necessarily associated with
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clotting factors. However, those things can complicate because a lot of clients who have pancreatitis also have some degree of liver disease also. A lot of times those things compliment or I should say exist with each other. Laboratory assessment is going to be amylase and lipase, looking at those pancreatic or enzymes. Trypsin is something, we talked about trypsin kind of activating the process of enzyme release, this is something we assess for the amount of but it is not a lab result that is done routinely or typically of someone who has pancreatitis in part because the cost is high and a lot of facilities do not do them on campus or on their campus, that is something that may have to be sent out to a special lab; may be several days before you get the result of your trypsin and by the time the several days go by we are really well into our treatment of the symptoms that are associated with it. So we don’t really rely on results of the trypsin. Though if we could, they would be most accurate as far as determining degree of pancreatitis. ALT also may be elevated, WBC as associated with inflammation process. Glucose is going to be elevated, we already talked about the impairment of the pancreas and its role as far as insulin production. Calcium and magnesium levels again going to be on the low side. Risk factors really is no known or causative risk factor that is very particular, however as I previously stated, there is a very strong association with the excessive use of alcohol which can attribute to acute
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  • Winter '16
  • Nursing, acute pancreatitis, pancreatic enzymes

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