Acute Pancreatitis

How often would the nurse measure the abdominal girth of a patient with severe acute pancreatitis? Every __ hours.

4 Patients with severe acute pancreatitis can develop ascites and coagulation abnormalities. Abdominal girth should be measured at least every 4 hours to detect internal bleeding.

Which patient has the greatest risk of developing pancreatitis? A patient who consumes 12 beers per day A patient who uses smokeless tobacco daily for five years A patient who is 62 years old A patient who uses testosterone replacement therapy

A patient who consumes 12 beers per day Alcohol consumption and biliary disease are the most common cause of pancreatitis.

Which is an accurate statement about nasogastric (NG) tubes? An NG tube can help patients feel better by increasing pancreatic secretions. An NG tube can help patients feel better by decreasing nausea, vomiting, and abdominal pain. NG tubes are used to treat all patients with pancreatitis. Providers who prescribe using an NG tube as the gold standard for treating pancreatitis are following the latest information on nutritional management

An NG tube can help patients feel better by decreasing nausea, vomiting, and abdominal pain. NG suctioning is used to decompress the stomach, which helps decrease nausea, vomiting, and abdominal pain.

In educating a patient with acute pancreatitis about CARS, which statement would the nurse include in the teaching? An excessive CARS response decreases the risk of infection. An excessive CARS response increases the risk of infection. A CARS response increases the risk of autodigestion. A CARS response decreases the risk of autodigestion.

An excessive CARS response increases the risk of infection. The body attempts to counteract pancreatic inflammation and autodigestion by triggering a CARS response. Excessive CARS can overwhelm the immune system with proinflammatory cytokines which increase the risk of infection, sepsis, and death.

Which nursing intervention is the priority when caring for a patient with severe acute pancreatitis? Assess patient's cultural and spiritual needs. Administer pain medications as prescribed. Assess respiratory rate and oxygen saturation. Auscultate bowel sounds every shift.

Assess respiratory rate and oxygen saturation. Respiratory assessment and management are the priority because respiratory dysfunction increases the risk for critical illness and death in severe acute pancreatitis. Assessment of respiratory function must occur before pain medication is administered.

Which condition indicates the need to hold the next dose of calcium and contact the provider? Increasing nausea and fatigue Experiencing muscle spasms in the hands and feet Lengthening QT interval on ECG Decreasing nausea and fatigue

Increasing nausea and fatigue Increasing nausea and lethargy are symptoms of calcium toxicity, therefore the nurse should hold the next dose of calcium and contact the provider.

Which assessment finding would the nurse identify as a sign of abdominal compartment syndrome (ACS)? Cullen's sign Grey Turner's sign Ascites Intraabdominal pressure 25 mm HG

Intraabdominal pressure 25 mm HG ACS is defined as intraabdominal pressure greater than 20 mm Hg with new-onset organ failure.

For a nurse caring for four patients with acute pancreatitis, which patient would the nurse see first? The patient with ascites The patient with CARS The patient with cardiogenic shock The patient with lengthening QT interval on ECG

The patient with cardiogenic shock Cardiogenic shock is a grave indicator of mortality, making this the priority patient.

For a nurse is caring for four patients with pancreatitis, which patient has the greatest mortality risk? The patient with metabolic acidosis The patient with coagulation abnormalities The patient with hyperglycemia The patient with multiple organ failure

The patient with multiple organ failure Severe acute pancreatitis has many complications that can ultimately lead to organ failure and death. Multiple organ failure poses the greatest mortality risk.

Which statement would a nurse make to a patient reporting severe abdominal pain and ascites, who has a history of pancreatitis, and asks, "Why has the medical provider ordered this test?" "Blood tests are the gold standard for diagnosing the severity of pancreatitis." "Testing is necessary because pain is not a symptom of pancreatitis." "Testing is necessary because ascites is not a symptom of pancreatitis." "A CT scan with contrast is the gold standard for diagnosing the severity of pancreatitis."

"A CT scan with contrast is the gold standard for diagnosing the severity of pancreatitis." A CT with contrast is the most widely accepted test for identifying pancreatic necrosis and determining disease severity.

For a patient complaining of nausea, vomiting, and epigastric pain, which question would the nurse ask to assess for pancreatitis? Select all that apply. One, some, or all responses may be correct. "How much alcohol do you drink each day?" "Have you had an ERCP recently?" "Do you have a history of gallstones?" "Do you have a history of high potassium?" "Have you had your appendix removed?"

"How much alcohol do you drink each day?" Alcohol consumption is the most common cause of acute pancreatitis. "Have you had an ERCP recently?" Having a biliary disease, obstructions, gallstones, or undergoing an ERCP procedure increase the risk of developing pancreatitis. "Do you have a history of gallstones?" Patients who develop gallstones have an increased risk for developing pancreatitis.

Which condition is a pulmonary complication of acute pancreatitis? Select all that apply. One, some, or all responses may be correct. Acute respiratory distress syndrome (ARDS) Pulmonary embolism (PE) Asthma Emphysema Pneumonia

Acute respiratory distress syndrome (ARDS) ARDS is a severe pulmonary complication of severe acute pancreatitis, often resulting in intubation. Pulmonary embolism (PE) Severe acute pancreatitis causes alterations in coagulation, gas exchange, and cardiovascular status, which can cause a PE to form. Pneumonia Acute pancreatitis can cause immobility, edema, pleural effusions, atelectasis and ultimately pneumonia.

Which nursing intervention would be a priority when caring for a patient with pancreatitis? Administer prescribed pain medications. Educate patient on use of laxatives. Administer 2 units of packed red blood. Activate seizure precautions.

Administer prescribed pain medications. Pain is the most common symptom of acute pancreatitis and pain management is a priority.

Which assessment finding is a complication of acute pancreatitis? Select all that apply. One, some, or all responses may be correct. Blood glucose 200 mg/dL (11.1 mmol/L) Abnormal cardiac rhythm Calcium 12 mg/dL (3 mmol/dL) Blood pH 7.5 GI bleed 88% oxygen saturation

Blood glucose 200 mg/dL (11.1 mmol/L) Acute pancreatitis causes tissue damage and organ dysfunction, resulting in hyperglycemia. Abnormal cardiac rhythm Acute pancreatitis causes alterations in fluid and electrolytes and may cause cardiac dysfunction. GI bleed Acute pancreatitis causes alterations in coagulation and digestion leading to GI bleed. 88% oxygen saturation Acute pancreatitis causes alterations in fluid and electrolytes, which can lead to pulmonary dysfunction, hypoxemia, atelectasis, and ARDS.

Which test is used for diagnosing pancreatic necrosis and grading acute pancreatitis? CT with contrast ERCP C-reactive protein Serum triglycerides

CT with contrast A CT with contrast is the gold standard for diagnosing pancreatic necrosis and grading acute pancreatitis.

Which term would the nurse use to document the bluish discoloration around the umbilicus of a patient with acute pancreatitis? Romberg sign Cullen's sign Battle's sign Babinski sign

Cullen's sign Cullen's sign is the bluish discoloration around the umbilicus and indicates blood in the area.

Which lab value would the nurse expect to find when caring for a patient with acute pancreatitis? Select all that apply. One, some, or all responses may be correct. Decreased WBC count Decreased serum albumin levels Increased serum amylase levels Increased serum lipase levels Increased calcium levels

Decreased serum albumin levels Serum albumin decreases as it follows the fluid shift out into the extracellular space. Increased serum amylase levels Elevated serum amylase levels are one of the most specific indicators of acute pancreatitis. Amylase is one of the enzymes released into the circulatory system as the pancreatic cells are damaged. Increased serum lipase levels Elevated serum lipase levels are one of the most specific indicators of acute pancreatitis. Lipase is one of the enzymes released into the circulatory system as the pancreatitis cells are damaged.

Which intervention for pain would the nurse perform when caring for a patient with severe acute pancreatitis? Select all that apply. One, some, or all responses may be correct. Avoid administering morphine sulfate or meperidine. Educate patient on use of patient-controlled analgesia (PCA) pump. Administer pain medications when the patient complains of severe pain. Position patient using pillows for comfort and encourage frequent position change. Insert NG tube and educate patient on NPO status.

Educate patient on use of patient-controlled analgesia (PCA) pump. Opioid medications are frequently prescribed for severe acute pancreatitis by using PCA pumps to achieve adequate pain control. Patients must be educated on the safe use of this device. Position patient using pillows for comfort and encourage frequent position change. Patients should be educated on positioning with pillows for comfort and to change positions frequently to avoid complications. Insert NG tube and educate patient on NPO status. Patients with severe acute pancreatitis can experience decreased pain with NG suctioning and bowel rest.

Which clinical finding is a sign of hypocalcemia in a patient with acute pancreatitis? Select all that apply. One, some, or all responses may be correct. Lengthening QT intervals on ECG Negative Chvostek sign Muscle spasms of the hands and feet Negative Trousseau sign Seizure activity

Lengthening QT intervals on ECG Hypocalcemia decreases cardiac contractility and lengthening of the QT interval on ECG. Muscle spasms of the hands and feet Muscle spasms, or tetany, are signs of severe hypocalcemia. Seizure activity Severe hypocalcemia can lead to tetany, seizure, and death.

Which data indicate adequate fluid replacement when caring for a patient with severe acute pancreatitis? Urine output decreased from 50 mL/hr to 30 mL/hr MAP 65 mm Hg Systolic blood pressure 90 mm Hg Heart rate 110 beats/min

MAP 65 mm Hg MAP > 60 mm Hg indicates adequate fluid replacement.

Which nursing intervention is most important during aggressive fluid replacement therapy when caring for a patient with severe manifestations of acute pancreatitis? Assess level of pain. Assess level of consciousness. Monitor vancomycin levels. Monitor pulmonary artery pressure.

Monitor pulmonary artery pressure. Fluid replacement is a high priority in the treatment of acute pancreatitis. Patients with severe disease require pulmonary artery pressure monitoring to evaluate fluid status and response to treatment because hypovolemia and shock are major causes of death early in the disease process.

Which statement about Ranson criteria is correct? Patients with <3 criteria have the greatest chance of dying. Ranson criteria is the same as the APACHE III criteria. Patients who consume alcohol have different criteria values from patients who don't consume alcohol. Ranson criteria are best assessed within the first 72 hours after hospital admission.

Patients who consume alcohol have different criteria values from patients who don't consume alcohol. Criteria values for nonalcoholic acute pancreatitis differ from those in alcohol-related disease. Patients who consume alcohol typically have different baseline indicators as well as prognostic indicators than those of patient who do not consume alcohol.

Which condition would indicate the need for surgery when caring for a patient with severe acute pancreatitis? Hypocalcemia Hyperglycemia Autodigestion Pseudocyst

Pseudocyst Surgical intervention may be indicated if the patient's condition continues to worsen despite conventional treatment and the pseudocyst becomes infected or perforated.

Which symptom is the most common presentation of acute pancreatitis? Fever Diarrhea Severe abdominal pain Organ failure

Severe abdominal pain Most patients with acute pancreatitis develop severe abdominal pain due to edema, irritation, inflammation, or obstruction of the biliary tract.

Which treatment modality would be appropriate for a patient with abdominal compression syndrome (ACS)? Surgical decompression Application of an abdominal binder ERCP Home monitoring

Surgical decompression ACS is an emergency condition that requires immediate surgical intervention. Surgical decompression of ACS is used to relieve edema, ascites, ileus, and overly aggressive fluid therapy.

Which classification tool is used to determine the prognosis of a patient with severe acute pancreatitis? The FAST scale The ABCs The Braden scale The Ranson criteria

The Ranson criteria The prognosis of pancreatitis is based on classification criteria developed by J. C. Ranson, called the Ranson criteria.