Disorders of the pancreas (MEDICAL MANAGEMENT (Medical management of mild…
Disorders of the pancreas
is a sudden attack causing inflammation of the pancreas and is usually associated with severe upper abdominal pain
Heavy alcohol drinking for a long time
Certain hereditary conditions, such as cystic fibrosis
Conditions such as high triglycerides and lupus
High triglyceride levels in the blood (possibly Familial Chylomicronemia Syndrome)
High triglyceride levels in the blood
High calcium levels in the blood
Heavy alcohol consumption
Acute pancreatitis is a potentially life-threatening condition primarily associated with gallstones or prolonged and excessive alcohol intake. Although the initial triggers of the condition can vary, the resulting pathophysiology is broadly similar irrespective of the cause. This article explores the pathophysiology of the main causes of acute pancreatitis, and discusses nursing management of the condition in the acute setting and the long-term issues to consider
. It also outlines the conservative management of the condition, which includes pain management, provision of fluids and nutritional care. In the management of acute pancreatitis, nursing care can often overlap with medical management, especially as the condition deteriorates. Therefore, it is important that nurses develop comprehensive knowledge of the management of acute pancreatitis.
Fever (76%) and tachycardia (65%) are common abnormal vital signs; hypotension may be notedext*
Occasionally, in the extremities, muscular spasm may be noted secondary to hypocalcaemia.
A minority of patients exhibit jaundice (28%).
Nausea and vomiting
Medical management of mild acute pancreatitis is relatively straightforward. The patient is kept NPO (nil per os—that is, nothing by mouth), and intravenous (IV) fluid hydration is provided
Analgesics are administered for pain relief
Antibiotics are generally not indicated
Feeding should be introduced enter ally as the patient’s anorexia and pain resolves
Expect to withhold oral intake during the acute phase. As prescribed, administer antiemetics to relieve nausea and vomiting
The physician may order placement of a nasogastric tube to decompress the stomach.
Enteral feeding also is cheaper and causes fewer complications than TPN. However, severe ileus may necessitate TPN.
Necrotizing pancreatitis can be distinguished from interstitial pancreatitis on incremental dynamic bolus CT scan.
Infected necrosis can be diagnosed by guided percutaneous aspiration with Gram stain and culture.
Patient education plays an important role in preventing recurrent acute pancreatitis.
Educate about the risks of certain medications if implicated in the initial episode should also be provided with careful monitoring
. Lifestyle measures, such as cessation of alcohol consumption, are critical.