General Knowledge
What are the two types of pancreatitis?
Acute and chronic
Explain the pathophysiology of cholecystitis.
Excess bile in the gallbladder causing edema and inflammation
What is Cullen Sign and what is Turner Sign?
Cullen-bruising around umbilicus
Turner-bruising in flank area
Name the 3 main nursing interventions for acute pancreatitis.
NPO, IV fluids, pain control
What type of education is imperative for the client with pancreatitis?
Alcohol and smoking cessation
Pancreatic enzymes are secreted by what cells in the pancreas?
Acinar
Stones that form when bile is supersaturated with cholesterol
What is steatorrhea?
Fatty/oily/greasy stools
What is the recommended positioning for a client with acute pancreatitis?
High-fowlers, slightly forward-leaning, and side-lying
A patient is being discharged after an acute bout of pancreatitis. The nurse educates the patient to proceed with what type of diet?
Low-fat diet
The most common cause of acute cholecystitis is:
Cholelithiasis or gallstones
Explain how a gallstone can cause acute pancreatitis.
A gallstone can block the common bile duct and obstruct the flow of pancreatic enzymes.
In pancreatitis, where is pain typically located and radiate to?
IV analgesics (morphine, hydromorphone, ketorolac)
After surgical intervention for gallbladder removal, to avoid respiratory complications, the nurse must educate the patient on:
Coughing and deep breathing exercises
What is the primary function of the gallbladder?
To store bile produced by the liver
Explain how the bile system works after a cholecystectomy.
The gallbladder is removed; there is no longer bile storage; bile is continuously secreted in the duodenum.
In cholecystitis, where is pain typically located and where can it radiate to?
RUQ with radiation to right scapula or shoulder
The nurse knows that she should contact the provider for T-tube drainage greater than ___ml in the first 24 hours.
500
A patient scheduled for an ERCP ask the nurse what does "ERCP" stand for, and then asks what occurs during the procedure. How should the nurse respond?
Endoscopic retrograde cholangiopancreatography; the surgeon uses a scope to inspect the pancreas, gallbladder, and biliary system.
What is choledocholithiasis?
A gallstone in the common bile duct
Explain the pathophysiology of acute pancreatitis.
Pancreatic enzymes are triggered and oversecreted causing the enzymes to "digest" the pancreas. Also known as "autodigestion."
What are the typical sign/symptoms of chronic cholecystitis?
Heartburn, indigestion, and flatulence
The provider has placed an order for a gallstone dissolution medication. The name of this medication is:
Ursodiol
When educating the patient with pancreatitis about pancrelipase, what MUST the nurse explain about this medication?
Must be take with EVERY meal and swallowed whole or sprinkled over food.