Medical Surgical Nursing

 Ultrasound and CT scans.

 Hematocritand hemoglobin levels to monitor for bleeding.

 Peritoneal fluid may contain increased levels of pancreatic enzymes.

 The stools are often bulky, pale, and foul-smelling. Fat content of stools varies

between 50% and 90% in pancreatic disease; normally, the fat content is 20%.

Medical Management

 Management of the patient with acute pancreatitis is directed toward relieving

symptoms and preventing or treating complications. All oral intake is withheld

to inhibit pancreatic stimulation and secretion of pancreatic enzymes.

 Parenteral nutrition is usually an important part of therapy, Nasogastric

suction may be used to relieve nausea and vomiting, to decrease painful

abdominal distention and paralytic ileus, and to remove hydrochloric acid so

that it does not enter the duodenum and stimulate the pancreas.

 Histamine-2 (H2) antagonists to decrease pancreatic activity by inhibiting HCl

secretion.

Pain Management

 Adequate pain medication is essential during the course of acute pancreatitis

to provide sufficient pain relief and minimize restlessness, which may

stimulate pancreatic secretion further. Morphine and morphine derivatives are

often avoided because it has been thought that they cause spasm of the

sphincter of Oddi; meperidine (Demerol) is often prescribed because it is less

likely to cause spasm of the sphincter

Intensive care

 Correction of fluid and blood loss and low albumin levels is necessary to

maintain fluid volume and prevent renal failure. The patient is usually acutely

ill and is monitored in the intensive care unit, where hemodynamic monitoring

and arterial blood gas monitoring are initiated. Antibiotic agents may be

prescribed if infection is present; insulin may be required if significant

hyperglycemia occurs.

Respiratory Care

 Aggressive respiratory care is indicated because of the high risk for elevation

of the diaphragm, pulmonary infiltrates and effusion, and atelectasis.

Hypoxemia occurs in a significant number of patients with acute pancreatitis