MSII Biliary

Regular level lipase

114-286 units is normal level

Amylase returns to normal within

2-3 days

Orders included of suspected pancreatitis

CT, oral and iv contrast, serum CBC, camp, amylase and lipase

Amylase does what

Changes starch to sugar

A client with calculi in the gallbladder is said to have

Cholelithiasis

Which is a clinical manifestation of cholelithiasis

Clay-colored stools Explanation:The client with gallstones has clay-colored stools and excruciating upper right quadrant pain that radiates to the back or right shoulder. The excretion of bile pigments by the kidneys makes urine very dark. The feces, no longer colored with bile pigments, are grayish (like putty) or clay colored. The client develops a fever and may have a palpable abdominal mass

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk

Maintain a high-carbohydrate, low-fat diet.

Whipped procedure aka

Pancreatoduodenectomy

abdominal pain and vomiting. Bp 150-95, hr 89, T 99, resp 22

Pt presenting with pancreatitis would admit with this

which condition is the major cause of morbidity and mortality in clients with acute pancreatitis

Recurrent attacks of severe upper abdominal and back pain accompanied by vomiting

Pancreatic risk factors include

Smoking, chems, high fat/meat

A patient is admitted to the hospital with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for

Ultrasonography

Lipase is lazy and takes (returns to normal in)

Up to 2 weeks

The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelitiasis can interfere with the absorption of

Vitamin A

Reevaluate pt pain within what timeframe

Within 1 hour/per facility policy

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note

yellow sclerae

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find

Elevated urine amylase levels

the digestion of carbohydrates is aided by

amylase

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client

assisting the client to turn, cough, and deep breathe every 2 hours

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client

Administering morphine I.V. as ordered

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder

Edema and inflammation

What medicine would be held for 48 hours following admin iv contract

Metformin

A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function

30 mg/dL

Diagnostic Procedures for pancreatitis

X-ray, mri, ct, us

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN

Measure blood glucose concentration every 4 to 6 hours

Lab results for pancreatitis pt

WBC 16500, amylase 350, lipase 560, glucose 130

Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tra

Hot roast beef sandwich with gravy

A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system

Maintain the client in a semi-Fowler's position

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client

Relieving abdominal pain

A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is boardlike and no bowel sounds are detected. What is the major concern for this patient

The patient has developed peritonitis

The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status

To avoid inflammation of the pancreas

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels

Frequent vomiting, leading to loss of fluid volume

A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the

Gallbladder

Because clients with pancreatitis cannot tolerate high-glucose concentrations, total parental nutrition (TPN) should be used cautiously with them. Which of the following interventions has shown great promise in the prognosis of clients with severe acute pancreatitis

Providing intensive insulin therapy

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason

To reduce gastric and pancreatic secretions

Which is a gerontological consideration associated with the pancreas

>55yo higher risk complications and death

Diagnosis findings for pancreatitis includes

>amylase & lipase, >WBC, hypocalcmia, hyperglycemia, elevated bilirubin in some, X-ray, mri, ct, us

Options for pancreas cancer

Chemo, radiation surgery

A nurse is teaching a client about the cause of acute pancreatitis. The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis

Duct obstruction enzymes back up autodigestion and inflamm by own enzymes

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes

Dysfunction of the pancreatic islet cells

Amylase is an enzyme derived from which of the following organs

Pancreas, salivary glands, liver

A nursing instructor is lecturing to a class about chronic pancreatitis. Which of the following does the instructor list as major causes

Alcohol consumption and smoking

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority

Acute pain related to biliary spasms

When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretion

Frequent changes of positions