Chronic Pancreatitis

A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? SATA A. I plan to eat small, frequent meals B. I will eat easy to digest foods with limited spice C. I will use skim milk when cooking D. I plan to drink regular cola E. I will limit alcohol intake to 2 drinks a day.

A, B, C

A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? ​​​​​​​ Select all that apply. A. "I plan to eat small, frequent meals." B. "I will eat easy-to-digest foods with limited spice." C. "I will use skim milk when cooking." D. "I plan to drink regular cola." E. "I will limit alcohol intake to two drinks per day."

A, B, C,

A nurse is planning care for an older adult client who has pancreatitis. Which of the following actions should the nurse plan to take? Drag and drop each action to the whether they should plan to take action (Yes) or should not plan take action (No). Administer meperidine to the client for acute pain. Monitor the client's blood glucose. Encourage client to decrease alcohol intake Ensure the client remains NPO. Place client in a side-lying or semi-Fowler's position.

Administer meperidine to the client for acute pain. -No Monitor the client's blood glucose. Yes Encourage client to decrease alcohol intake-No Ensure the client remains NPO.- Yes Place client in a side-lying or semi-Fowler's position.-Yes abstaining from alcohol. meperidine is contraindicated in older adult clients due to the risk of seizures.

Health Promotion:

Avoid excessive alcohol consumption. No smoking. Limit Stress. Eat a low-fat diet. No greasy, fatty foods

A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take? A. Instruct the client to chew the medication before swallowing. B. Offer a glass of water following medication administration. C. Administer the medication 30 min before meals. D. Sprinkle the contents on peanut butter.

B

A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take? A. Instruct client to chew the medication before swallowing. B. Offer a glass of water following med administration. C. Administer the med 30 minutes before meals. D. Sprinkle the contents on peanut butter.

B

A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions?* A. "It will be hard but I will eat a diet low in fat and avoid greasy foods." B. "It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week." C. "I will concentrate on eating complex carbohydrates rather than refined carbohydrates." D. "I will purchase foods that are high in protein."

B

For Rico who has chronic pancreatitis, which nursing intervention would be most helpful? A. Allowing liberalized fluid intake B. Counseling to stop alcohol consumption C. Encouraging daily exercise D. Modifying dietary protein

B

A nurse is assessing a client who has pancreatitis. Which of the following findings should the nurse identify as a manifestation of pancreatitis? A. Generalized cyanosis B. Hyperactive bowel sounds C. Gray-blue discoloration of the skin around the umbilicus D. Wheezing in the lower lung fields

C gray-blue discoloration in the periumbilical area, generalized jaundice, absent or decreased bowel sounds, and diminished breath sounds as well as dyspnea or orthopnea as manifestations of pancreatitis.

A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? A. Weight loss B. Relief of heartburn C. Reduction of steatorrhea D. Absence of abdominal pain

C.

Which teaching will the nurse provide when discharging a client with chronic pancreatitis? a. Weight reduction and daily exercise regimen b. Constipation precautions including daily laxative use c. Dietary adjustments to include avoiding high-fat foods, caffeine, and alcohol d. Relaxation techniques and stress management

C.

Progressive, destructive disease of inflammation & fibrosis of the pancreas. IRREVERSIBLE Caused by repeated episodes of acute episodes, cystic fibrosis or long term alcohol abuse (most common)

CHRONIC PANCREATITIS

A client has been placed on enzyme replacement for treatment of chronic pancreatitis. In teaching the client about this therapy, the nurse advises the client not to mix enzyme preparations with foods containing which element? a. Carbohydrates b. High fat c. High fiber d. Protein

D

During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink is safe for the patient to mix the beads with?* A. Pudding B. Ice cream C. Milk D. Applesauce

D

Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective? A. There is no skin breakdown. B. Her appetite improves. C. She lost more than 10 lbs. D. Stools are less fatty and decrease in frequency.

D

Nursing measures for pain relief for pancreatitis include: A. Encouraging bed rest to decrease metabolic rate. B. Teaching the patient about the correlation between alcohol intake and pain. C. Withholding oral feedings to limit the release of secretin. D. All of the above.

D

The nurse is preparing to instruct a client with chronic pancreatitis who is to begin taking pancrelipase (Cotazym). Which instruction does the nurse include when teaching the client about this medication? a. Administer pancrelipase before taking an antacid. b. Chew tablets before swallowing. c. Take pancrelipase before meals. d. Wipe your lips after taking pancrelipase.

D

A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? A. Pain in right upper quadrant radiating to right shoulder B. Report of pain being worse when sitting upright C. Pain relieved with defecation D. Epigastric pain radiating to the left shoulder

D client who has pancreatitis will report severe, boring epigastric pain that radiates to the back, left flank, or left shoulder.

MEDICATIONS used for Chronic Pancreatitis:

Opioid analgesics Antibiotics Histamine receptor antagonists Proton Pump Inhibitors Pancreatic enzymes

Client Education:

Pancreatitis induced by alcohol use disorder- abstain from further alcohol intake. Alcohol use support groups Avoid high-fat foods or heavy meals

Nutrition:

Low fat, high protein & high carb diet (complex carbs) Provide supplements of Vitamin C & B-complex vitamins Bland small meals Limit sugars and refined carbs

Opioid analgesics:

Morphine or hydromorphone for acute pain. Ketorolac- NSAID for mild to moderate pain. Nsg action: Meperidine is discouraged to risk of seizures, esp. in older

Pancreatic enzyme replacements are ordered for the client with chronic pancreatitis. When should the nurse instruct the client to take them to obtain the most therapeutic effect? 1. Three times daily between meals. 2. With each meal and snack. 3. In the morning and at bedtime. 4. Every 4 hours, at specified times.

2

The client with chronic pancreatitis should be monitored closely for the development of which of the following disorders? 1. Cholelithiasis. 2. Hepatitis. 3. Irritable bowel syndrome. 4. Diabetes mellitus.

4.

Proton Pump Inhibitors:

Omeprazole- Decrease gastric acid secretion Nsg action: Monitor for hypomagnesemia

Pancreatic enzymes:

Pancrelipase - Aids in digestion of fats & proteins when taken w/meals & snacks. Client education: capsule contents can be sprinkled on nonprotein foods. Mix with acidic foods- applesauce, do not mix with alkaline foods: milk, pudding, ice cream Drink full glass of water - Wipe lips & rinse mouth to prevent skin breakdown/irritation. Take after antacid or histamine receptor antagonists. Take with every meal and snack.

Histamine receptor antagonists:

Ranitidine- Decreases gastric acid secretion Nsg action: Take 1 hr before or 1 hr after antacid.