Pancreatitis

The nurse is caring for a patient with pancreatitis who just consulted with the dietician. Which menu selection indicates effective patient understanding of the prescribed diet? a. A pancake with syrup and 2% milk b. Vegetable omelet with bacon and potatoes c. Roast turkey, mashed potatoes, and carrots d. Salad with ham, cheese, and hard-boiled egg

a. A pancake with syrup and 2% milk

The nurse is completing an assessment on a patient being treated for pancreatitis and notes a blood pressure that has remained around 80/60 mmHg for a few days despite fluid resuscitation. The patient has pale, clammy skin; a heart rate of 100 bpm; and reports dizziness. Which order from the primary care provider does the nurse anticipate receiving? a. Administer dopamine b. Insert nasogastric tube c. Administer morphine sulfate d. Give intravenous fluids LR 150 mL/hour

a. Administer dopamine

Following assessment of a patient, the nurse notes a bluish discoloration in the periumbilical area. How would the nurse correctly document this finding? a. Cullen's sign b. Grey-Turner's spots c. Rebound tenderness d. Costovertebral angle pain

a. Cullen's sign

The nurse is evaluating a patient in the emergency department for suspected pancreatitis. Which factors, if present in the patient history or current assessment, would increase the risk for pancreatitis? (Select all that apply) a. History of gallstones b. Type 1 diabetes c. Presence of biliary sludge d. African American ethnicity e. 30 pack year history of smoking

a. History of gallstones c. Presence of biliary sludge d. African American ethnicity e. 30 pack year history of smoking

Which assessment finding would demonstrate the efficacy of pancreatic enzyme replacement? a. No evidence of steatorrhea b. Green-colored bowel movements c. Amylase and lipase within normal range d. Fasting blood glucose levels less than 100 mg/dL

a. No evidence of steatorrhea

The nurse is caring for a patient with diagnosed acute pancreatitis and notes a recent elevation in temperature, a respiratory rate of 28 breaths/min, and a few crackles in the bases of the lungs. Which actions by the nurse would best address the patient's current situation? (Select all that apply) a. Obtain O2 saturation level b. Obtain STAT ABGs c. Elevate the bed to semi-Fowler's position d. Perform percussion and postural drainage e. Instruct patient on incentive spirometry use

a. Obtain O2 saturation level c. Elevate the bed to semi-Fowler's position e. Instruct patient on incentive spirometry use

Which statement made by the patient reflects an understanding of the nurse's instruction regarding the proper use of oral pancreatic enzymes? a. Pancreatic enzymes will help with food digestion b. I will take the enzymes regularly even if I skip a meal c. I should take the enzymes after meals, but not snacks d. I can open up the capsule and sprinkle the drug on food

a. Pancreatic enzymes will help with food digestion

Which instructions regarding home management should the nurse include when preparing a patient with chronic pancreatitis for discharge? (Select all that apply) a. Take insulin as prescribed b. Self-monitor blood glucose levels c. Consume caffeine in small amounts only d. Take B and C complex vitamin supplements e. Stop smoking cigarettes and tobacco products

a. Take insulin as prescribed b. Self-monitor blood glucose levels e. Stop smoking cigarettes and tobacco products

The nurse is assessing a patient for pain related to pancreatitis. Which statements about pain would the nurse anticipate from the patient? (Select all that apply) a. The pain comes on suddenly b. The pain gets worse when I eat c. The pain is severe, deep, and piercing d. The pain gets better with passing gas e. The pain is centered on my belly button

a. The pain comes on suddenly b. The pain gets worse when I eat c. The pain is severe, deep, and piercing

Following teaching, the nurse is evaluating the patient's understanding of the need for both an endoscopic retrograde cholangiopancreatography (ERCP), plus endoscopic sphincterotomy, and a laparoscopic cholecystectomy. Which statement by the patient indicates the need for further teaching? a. All three procedures take care of the current problem and prevent if from happening again b. A laparoscopic cholecystectomy visualizes the colon, and the ERCP removes the gallstones c. An ERCP can visualize the biliary tract, and the endoscopic sphincterotomy cuts muscle layers d. The procedures work together to remove the gallstones and gallbladder and fix the sphincter of Oddi. The goal is to alleviate pain

b. A laparoscopic cholecystectomy visualizes the colon, and the ERCP removes the gallstones

The nurse is reviewing the current prescriptions for a patient with pancreatitis. Following a recent assessment, the patient was found to have decreased bowel sounds and abdominal distention. Which current medication order would the nurse question for this patient? a. Dopamine b. Dicyclomine c. Omeprazole d. Pancrelipase

b. Dicyclomine

A patient presents to the primary care provider one week after hospital discharge for an episode of acute pancreatitis. The patient reports a fever that has lasted for the last few days and stools have had a "really foul smell" and "appear greasy." A finger stick of blood glucose indicates a glucose level of 220 mg/dL. Which does the nurse suspect may be occurring? a. Atelectasis with pneumonia b. Further pancreatic destruction c. Pancreatic pseudocyst formation d. New onset type 1 diabetes

b. Further pancreatic destruction

The nurse is awaiting orders for a patient being admitted from the emergency room for conservative therapy for pancreatitis. The nurse would include which goals in the plan of care for the newly admitted patient? (Select all that apply) a. Skin integrity will remain intact b. Patient will remain free of infection c. Patient will verbalize understanding of NPO status d. Fluid and electrolyte levels are within normal limits e. Patient will rate pain at less than 2 in a 24-hour period f. Patient will limit alcohol consumption to one beer per week

b. Patient will remain free of infection c. Patient will verbalize understanding of NPO status d. Fluid and electrolyte levels are within normal limits e. Patient will rate pain at less than 2 in a 24-hour period

A patient admitted for evaluation of pancreatitis is scheduled for a chest x-ray. Which explanation provided by the nurse to the patient explains the need for a chest x-ray? a. We need to assess for cardiac complications related to pancreatitis b. We need to assess for pulmonary complications relate to pancreatitis c. We will use the chest x-ray to assess the pancreas and look for abscesses and pseudocysts d. The chest x-ray is performed to determine pulmonary changes in every admitted to the hospital

b. We need to assess for pulmonary complications relate to pancreatitis

The nurse is caring for a patient being treated for acute pancreatitis and notes that the patient's arms are jerking and that they are experiencing muscular twitching. The patient is also complaining of numbness and tingling in the fingers. Which should be the nurse's initial action? a. Administer sublingual nitroglycerin b. Obtain STAT ECG c. Assess for Chvostek's sign or Trousseau's sign d. Initiate IV fluids of LR at 150 mL/hour

c. Assess for Chvostek's sign or Trousseau's sign

Which statement best describes the pathophysiology f acute pancreatitis? a. Repeated episodes of acute pancreatitis lead to organ dysfunction b. Chronic alcohol consumption and abuse cause autodigestion of the pancreas c. Inflammation activates enzymes, resulting in autodigestion within the pancreas d. Gallstones become lodged in the common bile duct, causing clay-colored stools

c. Inflammation activates enzymes, resulting in autodigestion within the pancreas

A patient being treated for pancreatitis says to the nurse, "I thought nitroglycerin was only given for chest pain." Which explanation provided by the nurse best addresses this statement? a. Nitroglycerin can relieve the pain you are experiencing from oversecretion of gastric acids b. Nitroglycerin helps to minimize fluid and electrolyte loss in patients with chronic pancreatitis c. Some antispasmodic medications can cause chest pain, so we give nitroglycerin to relax smooth muscle d. This medication is prescribed by your primary health care provider for all patients admitted with pancreatitis

c. Some antispasmodic medications can cause chest pain, so we give nitroglycerin to relax smooth muscle

The caregiver of a patient with suspected pancreatitis asks the nurse why both serum amylase and serum lipase tests are being done if they are both enzymes related to the pancreas. Which explanation by the nurse accurately explains why both are being done? a. The serum amylase and lipase are decreased in acute pancreatitis b. These tests are always done at the same time to determine severity c. Serum amylase diagnoses pancreatitis; lipase determines if it is acute or chronic d. The serum amylase can be high due to other causes, so we also run the serum lipase

d. The serum amylase can be high due to other causes, so we also run the serum lipase