Pancreatitis: acute pancreatitis and chronic pancreatitis nursing NCLEX review lecture on symptoms, treatment, pathophysiology, diet, and nursing interventions. Pancreatitis is inflammation of the pancreas that can lead to the digestion of the pancreas by its own enzymes and/or irreversible structural damage to the organ.

There are two types of pancreatitis: acute pancreatitis and chronic pancreatitis. In acute pancreatitis, there is sudden inflammation of the pancreas due to something that has triggered the digestive enzymes to become activated inside the organ (high amylase and lipase levels will be found in the blood) and the pancreas starts to digest itself and swell. Two common causes of acute pancreatitis include: gallstones obstruction and heavy consumption of alcohol. Typically, acute pancreatitis is reversible if the patient is treated promptly.

Chronic pancreatitis is chronic inflammation of the pancreas (can be caused by repeated episodes of acute pancreatitis but most common cause is years of alcohol abuse) that has led to irreversible damage to the structure of pancreas. There will be loss of the function of the endocrine and exocrine cells (acinar and islet of langerhans cells), damaged to the pancreatic duct etc.

Symptoms of pancreatitis include: sudden, very painful mid-epigastric or left upper quadrant which can be felt in the back as well, fever, increased heart rate, decreased blood pressure, Cullen’s sign, Grey-Turner’s sign, hyperglycemia, dark-urine, jaundice, steatorrhea (oily/fatty stools).

What is Cullen and Grey-Turner’s Sign? Cullen’s Sign is a bluish discoloration around the belly button, whereas Grey-Turner’s Sign is bluish discoloration found on the flanks of the abdomen. They are due to retroperitoneal bleeding. Watch the video for an easy way to remember how to tell them apart.

Nursing interventions for pancreatitis include: maintain NPO status, inserting/monitor NG tube, controlling pain, administering pancreatic enzymes and stomach acid reducers per MD order, assessing urine, hydration status, diet education etc.

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