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Pancreatitis, Cirrhosis, and Liver failureMedical-Surgical Nursing-7th edition

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C-reactive protein levels greater than _______ in the first 72 hours of an acute pancreatic attack suggests necrosis.
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150 mg/L
What is Grey Turner's spots?
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Bluish flank discoloration/ecchymosis associated with pancreatitis
Deaths that occur early in a course of acute pancreatitis are usually due to...
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multiple organ failure
What are the most common causes of acute pancreatitis?
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Biliary tract disease (i.e. gallstones) and alcohol intake. *Can be caused by trauma, ulcers, viruses, drugs, etc.
What scoring systems allow for predictions of acute pancreatitis and its severity?
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Ranson criteria and APACHE II
What 2 things have a close relationship to the development of pancreatitis?
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Biliary tract disease and heavy alcohol intake.
Deaths that occur later in a course of acute pancreatitis are usually due to...
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necrotizing pancreatitis
_______ is a scale used to indicate the severity of a patient's acute pancreatitis within 48 hours of admission using BP, HR, temp, etc.
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APACHE II (*Data gathered in 1st 24 hours of admission)
When should you suspect a patient diagnosed with acute pancreatitis is not tolerating oral feedings?
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Increased abdominal girth and increased amylase and lipase.
What is the general thought regarding what causes acute pancreatitis?
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Activation of enzymes in the pancreatic acinar cells leads to inflammation of the surrounding tissues.
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Patients with mild-moderate pancreatitis should be given infusions of fluid and NPO for _______.
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48 hours from admission
What is Cullen's sign?
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Bluish, periumbilical discoloration from pancreatitis.
How is acute pancreatitis diagnosed?
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History; current findings: pain, n/v (acute onset); ultrasound; Ranson/Apache; CBC, serum lipase, amylase, CRP, calcium, liver enzymes and triglycerides.
What enzymes are specific and sensitive for the measurement of pancreatic enzyme levels?
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Trypsin, Elastase, and Phospholipase A2.
ACG guidelines recommend starting nutritional support for patients with mild to moderate pancreatitis when they...
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don't tolerate oral intake within a week.
What are the main systemic complications of pancreatitis?
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Pulmonary: pleural effusion, atelectasis, pneumonia; CV: hypotension, thrombi, PE, DIC; and tetany from decreased Ca+.
What are the 2 major goals of nutritional support for a patient with acute pancreatitis?
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Maintain a (+) nitrogen balance without over stimulating the secretion of pancreatic fluids.
Severe Pancreatitis: Apache score greater than _______ ; Ranson criteria greater than: _______
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Apache = 8; Ranson = 3
What should a patient with a history of acute pancreatitis avoid?
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Caffeine, fats, crash dieting/bingeing, alcohol, smoking, and stress.
What is used to treat decreased Ca+ associated with pancreatitis?
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Calcium gluconate
What is an early indicator of decreased Ca+?
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Numbness/tingling around the lips and fingers.
  
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