Hepatobiliary
What nursing diagnoses might apply to a patient with peritonitis?
1. Acute infection 2. Deficient fluid volume (shock) 3. Increased capillary permeability (fluid is much freer to move back and forth which causes lower pressure) 4. Risk for systematic infection
What are some nursing interventions for peritonitis?
1. Administer antibiotics as ordered 2. Monitor vitals/temperature 3. Setting parameters for SBP < 90 4. Monitor electrolytes (WBC, CBC) 5. Address pain
What are some nursing interventions for portal hypertension?
1. Ascites - give albumin, diuretic as ordered, paracentesis, prep for paracentesis, banana bag b. Albumin - monitor levels, give albumin c. Respiratory - sleep on their side or elevate bed to help them breathe at night d. Monitor ammonia levels
What does peritonitis look like?
1. Large pot belly (ascites) 2. Tympanic abdomen 3. Pain/discomfort/rebound tenderness (early sign is board-like abdomen which needs to be treated to prevent it from turning worse) 4. Fever 5. High WBC count
What are some nursing interventions for esophageal varicies?
1. Patient teaching 2. Are they having trouble swallowing? 3. Risk for bleeding d. Monitoring - looking in the throat
What nursing diagnoses might apply to a patient with cirrhosis?
1. Risk for bleed (lack of vitamin K, esophageal varicies, elevated PT/PTT) 2. Malnutrition (CBC, B12, folate, iron) 3. Activity intolerance 4. Altered LOC 5. Altered fluid volume 6. Delayed wound healing (lack of albumin)
How fast is the onset of IV morphine?
2-3 minutes
What will a PT time look like for liver failure?
20 seconds
PTT
29-41 seconds
ALT
8-40
LDH
85-285
A client admitted with severe epigastric abdominal pain radiating to the back is vomiting and reports difficulty breathing. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? (Select all that apply) a. Administer pain-relieving medication b. Administer a low-fat diet c. Administer electrolytes d. Administer plasma e. Assist the client to a semi-Fowler position
A client admitted with severe epigastric abdominal pain radiating to the back is vomiting and reports difficulty breathing. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? (Select all that apply) a. Administer pain-relieving medication b. Administer a low-fat diet c. Administer electrolytes d. Administer plasma e. Assist the client to a semi-Fowler position
A client with liver cirrhosis complains that his skin always feels itchy and he "scratches himself raw" while he sleeps. The nurse should recognize that the itching is a result of which abnormality associated with cirrhosis? a. Folic acid and B vitamin deficiency from a prolonged diet insufficiency b. Protime (PT) result of 26 seconds and an INR of 2.5 c. A total bilirubin of 2.6 mg/dL d. Decreased vitamin K levels causing pinpoint bleeding under the skin
A client with liver cirrhosis complains that his skin always feels itchy and he "scratches himself raw" while he sleeps. The nurse should recognize that the itching is a result of which abnormality associated with cirrhosis? a. Folic acid and B vitamin deficiency from a prolonged diet insufficiency b. Protime (PT) result of 26 seconds and an INR of 2.5 c. A total bilirubin of 2.6 mg/dL d. Decreased vitamin K levels causing pinpoint bleeding under the skin
A client's health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the client's increased risk for what hematologic disorder? a. Thrombocytopenia b. Thrombosis formation c. Infectious response d. Anemia
A client's health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the client's increased risk for what hematologic disorder? a. Thrombocytopenia b. Thrombosis formation c. Infectious response d. Anemia
Why does portal hypertension cause esophageal varices?
A direct result of high blood pressure in the portal vein; causes blood to build up in nearby blood vessels, including those in your esophagus.
A patient is admitted with abrupt onset of jaundice, nausea and vomiting, hepatomegaly, and abnormal liver function tests. Blood tests are negative for viral causes of hepatitis. Which question by the nurse is most appropriate? a. "Have you been around anyone who is jaundiced?" b. "Do you use any prescriptions or over-the-counter drugs?" c. "Are you taking corticosteroids for any reason?" d. "Do you have a history of IV drug use?"
A patient is admitted with abrupt onset of jaundice, nausea and vomiting, hepatomegaly, and abnormal liver function tests. Blood tests are negative for viral causes of hepatitis. Which question by the nurse is most appropriate? a. "Have you been around anyone who is jaundiced?" b. "Do you use any prescriptions or over-the-counter drugs?" c. "Are you taking corticosteroids for any reason?" d. "Do you have a history of IV drug use?"
13. Which of the following is NOT a role of the liver? A. Removing hormones from the body B. Producing bile C. Absorbing water D. Producing albumin
A. Removing hormones from the body B. Producing bile C. Absorbing water D. Producing albumin
Patient has NG tube and feels distention and nausea. What is the priority intervention?
Check canister for suction (is it on)?
What type of diet will we have a patient with hepatic encephalopathy on?
Low protein
What are later signs of cirrhosis?
Remember the mneumonic: "The Liver is Scarred" Tremors of hands (asterixis: hand-flapping due to increased toxins in the blood) Hepatic foetor or "fetor hepaticus": very late in the disease and is a pungent, sweet, musty smell. This is from the buildup of toxins (mercaptans) in the blood. Why in the breath? The portal hypertension shunts these toxins where they pass through the lungs allowing the smell to be noticed. Eye and skin yellowing (jaundice) Loss of appetite (spleen pushing on stomach...feel full) Increased Bilirubin (skin and urine....jaundice) and ammonia Varices (esophagus and gastric...at risk for bleeding...watching for activities that can increase rupture: coughing, vomiting, drinking ETOH, constipation) Edema in legs (low albumin and congestion of hepatic veins) Reduced platelets and WBCs (bleeding and infection risk) Itchy skin (toxins the blood) Spider angiomas (chest) (increased estrogen in the blood) Splenomegaly (low platelets and WBCs), stool clay colored (no bilirubin in the stool...should be there not in the urine or blood) Confusion or coma (high toxin and ammonia level) Ascites (low albumin and venous congestion) Redness on the palms of the hands (increased estrogen in the blood) Renal failure (hepatorenal syndrome) Enlarged breast in men (decrease metabolism of estrogen so there is more in the blood) Deficient on vitamins (B12, A, C, D, E, K and iron) (no longer able to store and have bile to help absorb these fat soluble vitamins)
The left upper quadrant of the abdomen contains the: a. Spleen, ovary, ureter b. Spleen, stomach, body of pancreas c. Stomach, head of pancreas, left adrenal gland d. Liver, gallbladder, pylorus
The left upper quadrant of the abdomen contains the: a. Spleen, ovary, ureter b. Spleen, stomach, body of pancreas c. Stomach, head of pancreas, left adrenal gland d. Liver, gallbladder, pylorus
Why does cirrhosis cause gynecomastia in males?
The liver cells are failing to remove the hormone estrogen properly from the body, which causes estrogen levels to increase causing gynecomastia
The nurse is caring for a client with acute pancreatitis. Which of the following statements is true regarding the care of this patient? a. Acute pancreatitis is accompanied by a right pleural effusion b. Insertion of NG tube with intermittent suction is applied c. Acute pancreatitis frequently requires surgical drainage of a cyst d. Insulin administration is required when the patient is on TPN
The nurse is caring for a client with acute pancreatitis. Which of the following statements is true regarding the care of this patient? a. Acute pancreatitis is accompanied by a right pleural effusion b. Insertion of NG tube with intermittent suction is applied c. Acute pancreatitis frequently requires surgical drainage of a cyst d. Insulin administration is required when the patient is on TPN
The nurse monitors a client with cirrhosis for the development of encephalopathy. Which finding would alert the nurse to elevated NH4 values? a. Snoring while asleep b. New onset of dark, tea colored urine c. Difficulty with ambulation d. Vision changes
The nurse monitors a client with cirrhosis for the development of encephalopathy. Which finding would alert the nurse to elevated NH4 values? a. Snoring while asleep b. New onset of dark, tea colored urine c. Difficulty with ambulation d. Vision changes
The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply: A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis
The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply: A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis
What fat soluble vitamin issue do you see with liver failure?
Vitamin K, epistaxis
What information accurately describes the role of the liver in the functioning of the gastrointestinal (GI) system? (Select all that apply) a. Absorbed products of digestion are delivered to the liver from the small intestines b. Absorption of nutrients occurs in the liver c. The liver is responsible for filtering the produces absorbed by the small intestines d. Necessary breakdown of absorbed products occur in the liver
What information accurately describes the role of the liver in the functioning of the gastrointestinal (GI) system? (Select all that apply) a. Absorbed products of digestion are delivered to the liver from the small intestines b. Absorption of nutrients occurs in the liver c. The liver is responsible for filtering the produces absorbed by the small intestines d. Necessary breakdown of absorbed products occur in the liver
What would post procedure nursing care include for a client undergoing a liver biopsy? a. Placing the client in left lying sim to promote bile drainage b. Confirmation of the return of a gag reflex c. Measure the circumference of the abdomen d. Applying pressure to the puncture site and monitor for bleeding
What would post procedure nursing care include for a client undergoing a liver biopsy? a. Placing the client in left lying sim to promote bile drainage b. Confirmation of the return of a gag reflex c. Measure the circumference of the abdomen d. Applying pressure to the puncture site and monitor for bleeding
When caring for a client recently diagnoses with fecal-oral transmittable hepatitis, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function? a. Jaundice b. Pruritus of the arms and legs c. Fatigue during ambulation d. Irritability and drowsiness
When caring for a client recently diagnoses with fecal-oral transmittable hepatitis, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function? a. Jaundice b. Pruritus of the arms and legs c. Fatigue during ambulation d. Irritability and drowsiness
When caring for the patient with end stage liver disease which of the following assessment findings require an intervention? a. Jaundiced skin and total bilirubin of 3.6 mg/dl b. Nausea and anorexia c. Distended abdomen with respiratory rate of 26 d. White blood cell count 17,830 /mm3
When caring for the patient with end stage liver disease which of the following assessment findings require an intervention? a. Jaundiced skin and total bilirubin of 3.6 mg/dl b. Nausea and anorexia c. Distended abdomen with respiratory rate of 26 d. White blood cell count 17,830 /mm3
When performing a physical assessment of a patient with severe sepsis as a result of peritonitis, what abnormal assessment would the nurse expect to find? a. A WBC of 8,100 despite the presence of chills b. A blood pressure of 100/72 with a capillary refill of <3 seconds c. Leukocytosis in a patient with absent bowel sounds d. Renal output that fluctuates according to intravenous intake
When performing a physical assessment of a patient with severe sepsis as a result of peritonitis, what abnormal assessment would the nurse expect to find? a. A WBC of 8,100 despite the presence of chills b. A blood pressure of 100/72 with a capillary refill of <3 seconds c. Leukocytosis in a patient with absent bowel sounds d. Renal output that fluctuates according to intravenous intake
Which of the following techniques is considered the best way to determine whether a nasogastric tube is positioned in the stomach? a. Instilling air and auscultating over the epigastric area for the presence of the tube b. Irrigating with normal saline and observing for return of solution c. Placing the tube's free end in water and observing for air bubbles d. Aspirating with a syringe and observing for gastric contents
Which of the following techniques is considered the best way to determine whether a nasogastric tube is positioned in the stomach? a. Instilling air and auscultating over the epigastric area for the presence of the tube b. Irrigating with normal saline and observing for return of solution c. Placing the tube's free end in water and observing for air bubbles d. Aspirating with a syringe and observing for gastric contents
Which statement is correct when caring for a patient receiving total parenteral nutrition with lipids (TPN)? (Select all that Apply) a. TPN tubing is replaced every 24 hours b. Patient may receive TPN via PICC line c. TPN is considered fluid intake and is documented each shift d. The patient will need to be on Reglan or equivalent while on TPN e. Lipids are to be hung above the filter when piggy backing with TPN
Which statement is correct when caring for a patient receiving total parenteral nutrition with lipids (TPN)? (Select all that Apply) a. TPN tubing is replaced every 24 hours b. Patient may receive TPN via PICC line c. TPN is considered fluid intake and is documented each shift d. The patient will need to be on Reglan or equivalent while on TPN e. Lipids are to be hung above the filter when piggy backing with TPN
What are signs of portal hypertension?
esophageal varicies and ascites
What is something we can delegate to CNA with a liver patient?
oral care 2-3 times per day
In a patient receiving gastric surgery, what are signs the anastomosis is leaking?
pain, fever, decreased LOC
What are the main signs of peritonitis?
pain, tympanic upon percussion, distention
How do you know patient is having difficulty absorbing fats?
patient is receiving lipids in their TPN
What is cirrhosis?
· A degenerative disorder of the liver where the lobes become covered in fibrous (scar) tissue. · · Blood flow through the liver is reduced which destroys it
What is pancreatitis primarily caused by (patho)?
· Acute or chronic inflammation of the Pancreas due to damage to the biliary tract by alcohol, trauma, disease or certain drugs · Enzymes cannot flow from pancreas due to edema or occlusion, duct ruptures releasing digestive enzymes · Cysts may form as a result · Presents with severe abdominal pain · Can be life threatening
How do we treat ascites?
· Body reabsorption · Paracentesis: Yellow, clear, fluid. Measure amount, may do tests for malignancy on fluid.
How do we treat peritonitis?
· DX: X-ray of ab X-ray of abdomen to visualize "free air"as the result of perforation · CBC to determine extent of infection · Aggressive antibiotics, surgical correction of perforation · NG,IV fluids · Meticulous asepsis for wound care · Prevent shock from loss of fluids into the peritoneal space · 40% mortality rate
What do we do for pancreatitis?
· Draw blood for Amylase, Lipase levels · Assess an abdominal CT · Ultrasound of pancreas · Elevated WBC is present · Amylase elevates sooner in the bloodstream but Lipase is more specific to DX of Pancreatitis
How do we treat cirrohosis?
· Eliminate underlying cause (alcohol, drugs) · Decrease buildup of body fluids (diuretics) · Antiemetic: Diphenhydramine · Vitamin supplements: K & C · Folic acid (banana bag) containing: o MVI o Thiamine o Folic acid · Paracentesis for comfort · Lactulose (to ↓ NH4)
What activities should we avoid in a patient with esophageal varicies?
· Excessive coughing · Alcohol consumption · Straining during a bowel movement · Vomiting
What will a nurse expect to see in a patient with liver cirrhosis?
· Jaundice · Ascites · Hx of alcohol abuse · Spider veins, bruises easily · Complaints of GERD, upset stomach, nausea, indigestion · Clay-colored stool · Elevated ALT and AST · Increased bilirubin · Elevated PT/PTT · Skinny body with a fat belly · RUQ Pain · Decreased albumin · Changes in mentation due to ammonia buildup · Esophageal varicies rupture: Bloody emesis, black tarry stool, itchy skin, dark urine
How do we treat esophageal varices?
· Treatment of rupture: Sengstaken-Blakemore tube insertion · Inserted by a Gastroenterologist or MD · Patient will have an endotracheal tube prior to insertion, then off to ICU
What are the major risk factors for pancreatitis?
● Alcohol abuse ● Obesity ● Gallbladder disease (cholelithiasis, choledocholithiasis) ● Gastric / duodenal surgery ● Abdominal trauma ● Infection (such as hepatitis B) ● Medications ○ Corticosteroids ○ Sulfonamides ○ NSAIDs
INR
0.9-1.2
What our some goals for nursing management of peritonitis?
1. Maintain stable vitals 2. Treat infection 3. Maintain fluid and electrolyte balance
What would we delegate to a CNA for a patient on TPN?
glucometer readings
What is our expected outcome after giving a banana bag?
improved labs (increased folate)
What is peritonitis?
inflammation of the peritoneal cavity
What are two signs of liver problems?
petichiae, purpura
Pancreatitis can be associated with ________ and _________.
tetany, hypocalcemia
What are esophageal varices?
the result of liver disease that causes veins above it to distend due to the backup of blood that can no longer be filtered properly
What is anastomosis?
where the vein and artery are connected
What are complications that can develop from late-stage cirrhosis?
· Ascites · Splenomegaly (enlarged spleen) · Esophageal varicies
What are some serious signs of progressing cirrhosis?
- Anemia, inability to absorb Vit K or clotting factors - Hepatic encephalopathy: NH4 intoxication - Discomfort in the epigastric region - Pruritus, jaundice, weight loss, tremors - Elevated liver enzymes, prolonged coag studies
Total bilirubin
0.1-1.2
PT
7-10 seconds
AST
8-35
After abdominal surgery, why does the client have an NG tube in place for several days postoperatively? a. Provide enteral feedings in the immediate postoperative period b. Prevent excessive pressure on suture lines c. Prevent the development of ascites d. Enable administration of antacids to promote healing of fistulas
After abdominal surgery, why does the client have an NG tube in place for several days postoperatively? a. Provide enteral feedings in the immediate postoperative period b. Prevent excessive pressure on suture lines c. Prevent the development of ascites d. Enable administration of antacids to promote healing of fistulas
What is hepatic encephalopathy?
Ammonia intoxication
Why does pancreatitis cause a low serum calcium level?
Calcium is smooth and coating like milk, if we find calcium in our body where it is usually not, it is a sign of something that was once there and is not there anymore. Body had to repair it. Calcium came in to cure stuff. Think calcium soapsuds. Serum calcium becomes low because the body pulls it from the bloodstream to help heal the area near the pancreas.
What will a patient's labs look like with cirrhosis?
Elevated: · Bilirubin · AST(SGOT) · ALT (SGPT) · LDH · Prolonged PT- INR, PTT · Elevated ammonia (NH4) · Needle Biopsy + for cell changes
What blood products would be ordered for a liver failure patient with hematological issues?
FFP, cryo, PRBC Provides them with clotting factors and blood
What is peritonitis caused by?
Fecal matter seeps in after a rupture. May be caused by ruptured appendix, abscess, strangulated hernia, foreign body.
Where can we administer TPN?
Given through CENTRAL line
Why does portal hypertension cause ascites?
High pressure in the blood vessels pushes fluid out of the vessels and into the peritoneal cavity
What is portal hypertension?
Increased pressure in the portal venous system caused by backup of blood that can no longer be filtered properly through the liver
Why do patients with hepatitis have pale-colored stools and dark-colored urine?
Pale stools resul from reduced bile from the liver. Dark urine results from excess bilirubin excreted by the kidneys.
What is our expected outcome after doing paracentesis?
Patient's abdominal girth has decreased from x measurement to x measurement, patient's daily weight went down 6 lbs. after procedure, etc.
Why does a patient with cirrhosis have bleeding gums, bruising, etc.?
Patients with cirrhosis lack vitamin K which causes elevated PT/PTT.
How does peritonitis lead to sepsis and shock?
Peritoneal area is large, and there is a lot of volume that leaves the vascular bed to help heal the area which leads to hypovolemia and shock. Sepsis can occur because the bacteremia circulates in the blood and the body's defenses (WBCs) overreact leading to lack of oxygen getting to organs, low perfusion, low pressure in the vascular bed.
What are the signs and symptoms of pancreatitis?
Sudden, steady, intense epigastric pain centered to the umbilicus and radiating to the back; pain lessens by laying down
The client develops chronic pancreatitis. What would be the appropriate home diet for the client with chronic pancreatitis? a. A low protein, high fiber diet distributed over four to five moderate sized meals a day b. A low fat, bland diet distributed over five to six small meals a day c. A high calcium, low fat distributed over three meals and evening snack daily d. A diabetic exchange diet distributed over three meals and two snack daily
The client develops chronic pancreatitis. What would be the appropriate home diet for the client with chronic pancreatitis? a. A low protein, high fiber diet distributed over four to five moderate sized meals a day b. A low fat, bland diet distributed over five to six small meals a day c. A high calcium, low fat distributed over three meals and evening snack daily d. A diabetic exchange diet distributed over three meals and two snack daily
What does TPN stand for?
Total Parenteral Nutrition
What is the purpose of TPN?
Used in place of NG tube feed
While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as: A. Metallic Hepatico B. Fetor Hepaticus C. Hepaticoacidosis D. Asterixis
While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as: A. Metallic Hepatico B. Fetor Hepaticus C. Hepaticoacidosis D. Asterixis
What is asterixis?
flapping motion of the hands caused by buildup of toxins in the blood (specifically ammonia)
________ reside in the liver and help remove bacteria, debris, and old red blood cells. A. Hepatocytes B. Langerhan cells C. Enterocytes D. Kupffer cells
________ reside in the liver and help remove bacteria, debris, and old red blood cells. A. Hepatocytes B. Langerhan cells C. Enterocytes D. Kupffer cells
What are early signs of cirrhosis?
abdominal pain, liver enlargement
What is the pathophysiology of the GI system?
absorbs nutrients into the bood
What is ascites?
accumulation of fluid in the peritoneal cavity
Why do patients with cirrhosis have mental disorientation?
ammonia buildup
What are NSAIDs?
antipyretic
What are some medications we use to treat hepatitis?
antiviral, immunoglobulin
A hospitalized client with an active GI bleed is receiving albumin. What is our priority intervention?
assess lung sounds throughout infusion
What type of diet would we give to pancreatitis patient after removing NG tube?
bland diet (ex. toast with jam, oatmeal, applejuice, etc.)
What does lipase do?
breaks down fats
What do we do if patient has 3/10 post-op pain?
discharge them home
What are some ways we manage cirrhosis?
· Monitor for blood in sputum, urine, feces · Push diet high in protein, carbs, and adequate vitamins · Supportive education on eliminating alcohol from diet · I&O, ADLs, note edema, mental status changes · Monitor lab trends
What are common causes of cirrhosis?
· Obesity · Heavy alcohol consumption · Medications (Tylenol) · Genetic · Blockage of the bile duct · Hepatitis C
What type of presentation will we see in a patient with pancreatitis?
· Pain in LUQ or epigastric area (their pancrease is literally digesting itself)(aggravated by fatty foods or alcohol consumption) · Pain that radiates to the back · Pain lessens when flexing the truck (or fetal position) · Hx of drinking or smoking · Elevated amylase and lipase · Abdominal tenderness, distention, rigidity, and guarding · Dyspnea, orthopnea, and possible crackles in lungs · Low grade fever, nausea,vomiting, possible jaundice if common bile duct involved (NPO and NG tube if patient's pancreatic enzymes are acutely elevated and they're nauseated) · Weight loss, tachycardia, why? · Hypoactive bowel sounds · Cullen sign (bluish periumbilical discoloration) · Hypotension · Leukocytosis
How do we treat someone with pancreatitis?
· Pain meds: Demerol or morphine · NPO, IV fluids, NG tube insertion (rest GI/hepatobiliary tract) · Fluid bolus - Need to maintain a MAP during times of hypovolemia, heta starch, hespan, and albumin may be given to pull off excess fluid once the vascular bed is stable and we know they can get the fluid off promptly, then we can give Lasix · Antacids, H2 antagonists (Tagamet) · Pancreatic enzymes (what do they do? aids in digestion process) · Antibiotics · TPN via central line · Insulin if beta cells are injured
What are the signs and symptoms of peritonitis?
· Severe abdominal pain · Tender and tympanic on percussion · Tachycardia · Fever · Life threatening
What are some nursing implications of peritonitis?
· Support patient with life-threatening illness · Assess for support system · Chaplain, social worker
What will we monitor if patient develops splenomegaly?
· Thrombocytopenia · Increased PT-INR · Leukopenia The spleen stores platelets and WBCs. An enlarged spleen can develop due to portal hypertension, which causes the platelets and WBCs to become stuck inside the spleen due to the increased pressure in the hepatic vein (hence lowering the count and the body's access to these important cells for survival).
What is pancreatitis?
● Inflammation of the pancreas leading to pancreatic ductal flow obstruction ● Lack of pancreatic function leads to hypocalcemia, steatorrhea, and sometimes hyperglycemia if the beta cells are affected ● Inflammatory response induces fluid gifts that lead to hypovolemia, decreased perfusion of major organs, ascites, and pleural effusions ● Inflamed pancreas can leak fluid into the peritoneal cavity leading to peritonitis and septic shock
What type of diet is a client with pancreatitis on?
● NPO initially to allow pancreas to recover ● Low fat, low protein diet with bland foods ● TPN if oral intake isn't tolerated ● Abstain from alcohol and caffeine
What will someone's labs look like if they have pancreatitis?
● Serum amylase and lipase (definitive lab) levels are elevated ● Bilirubin level test is elevated