NRSG 421: GI || QUESTIONS ANSWERED
CORRECTLY TO PASS!!
What are the six categories for acute abdominal pain? correct answers - Inflammatory
(bacterial or chemical cause)
- Mechanical (ileus or obstruction)
- Neoplastic (tumour obstructing nerves or vessels)
- Vascular (clot or atherosclerosis
- Congenital
- Traumatic
Acute pancreatitis can be divided into three categories. What are these categories? correct
answers - Mild acute pancreatitis
- Moderately severe acute pancreatitis
- Severe acute pancreatitis
What is mild acute pancreatitis? correct answers Absence of organ failure and local or
systemic complications
What is moderately severe acute pancreatitis? correct answers Characterized by transient
organ failure (resolves within 48 hours) and/or local or systemic complications without
persistent organ failure
What is severe acute pancreatitis? correct answers Persistent organ failure that may involve
one or multiple organs
What are some causes of acute pancreatitis? correct answers - Gallstones*
- Alcohol
- Infection (mumps, coxsackie B)
- Pancreatic tumours
- Medications (azathioprine, thiazide, valproic acid)
- Trauma
- Idiopathic (tropical pancreatitis, CF)
What are the two main causes for chronic pancreatitis? correct answers - Alcoholism
- Idiopathic
What are some signs and symptoms of pancreatitis? correct answers - Acute onset of
persistent, severe epigastric abdominal pain (may be in upper right quadrant). Pain may vary
depending on cause. Pain partially relieved by sitting up or bending forwards
- Nausea and vomiting
- Dyspnea due to diaphragmatic inflammation, secondary to pancreatitis
- Foul smelling, foamy, grey coloured stools
- Back pain
What are some clinical findings that indicate pancreatitis? correct answers - Upper epigastric
abdominal pain on palpation
- Abdominal distention and hypoactive bowel sounds (ileus from inflammation)
- May have jaundice
, - Severe pancreatitis may have fever, tachypnea, hypoxemia and hypotension
- Cullen's sign
- Grey turner sign
What is Cullen's sign? correct answers Bruising around umbilicus
What is Grey Turner's sign? correct answers Bruising of the flanks
How is pancreatitis diagnosed? correct answers Diagnosis is made if 2 of the following 3
criteria are met:
- Abdominal pain strongly suggestive of pancreatitis
- Amylase and/or lipase levels at least three times higher than normal
- Characteristic findings of pancreatic inflammation on either transabdominal CT or
ultrasound
Why are NG suction and NPO status used as medical management for pancreatitis? correct
answers These interventions suppress/reduce pancreatic enzyme secretions. This decrease in
stimulation allows the pancreas to rest
Why might antibiotics be used to medically manage pancreatitis? correct answers Abx
therapy can aid in the early phase of infection due to inflammation and necrotic pancreatic
tissue being a good medium for bacteria growth.
What are some surgical interventions that can be done to treat pancreatitis? correct answers -
Surgical drainage of retained necrotic fluid
- If the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic
sphincterotomy is performed along with laparoscopic cholecystectomy in order to decrease
the risk of recurrence.
What medications can be used to manage acute pancreatitis? correct answers - Mophine:
relief of pain
- Nitroglycerin: relaxation of smooth muscle and relief of pain
- Antispasmodics: decrease vagal stimulation and pancreatic outflow
- Carbonic anhydrase inhibitor: reduces amount of pancreatic secretions and concentration of
bicarbonate
- Antacids: neutralize gastric pH
- H2 receptor antagonist: decreases HCl secretion which helps to reduce pancreatic activity
What medications are used to manage chronic pancreatitis? correct answers - Pancrelipase
- Insulin
- HCl
What patient teaching should be provided for pancrelipase? correct answers - Will be taking
for life
- Assess for pork allergy
- Take drug before, during, or immediately after meals
- Avoid crushing microspheres within capsules
- Do not switch to a different brand without consulting your doctor
CORRECTLY TO PASS!!
What are the six categories for acute abdominal pain? correct answers - Inflammatory
(bacterial or chemical cause)
- Mechanical (ileus or obstruction)
- Neoplastic (tumour obstructing nerves or vessels)
- Vascular (clot or atherosclerosis
- Congenital
- Traumatic
Acute pancreatitis can be divided into three categories. What are these categories? correct
answers - Mild acute pancreatitis
- Moderately severe acute pancreatitis
- Severe acute pancreatitis
What is mild acute pancreatitis? correct answers Absence of organ failure and local or
systemic complications
What is moderately severe acute pancreatitis? correct answers Characterized by transient
organ failure (resolves within 48 hours) and/or local or systemic complications without
persistent organ failure
What is severe acute pancreatitis? correct answers Persistent organ failure that may involve
one or multiple organs
What are some causes of acute pancreatitis? correct answers - Gallstones*
- Alcohol
- Infection (mumps, coxsackie B)
- Pancreatic tumours
- Medications (azathioprine, thiazide, valproic acid)
- Trauma
- Idiopathic (tropical pancreatitis, CF)
What are the two main causes for chronic pancreatitis? correct answers - Alcoholism
- Idiopathic
What are some signs and symptoms of pancreatitis? correct answers - Acute onset of
persistent, severe epigastric abdominal pain (may be in upper right quadrant). Pain may vary
depending on cause. Pain partially relieved by sitting up or bending forwards
- Nausea and vomiting
- Dyspnea due to diaphragmatic inflammation, secondary to pancreatitis
- Foul smelling, foamy, grey coloured stools
- Back pain
What are some clinical findings that indicate pancreatitis? correct answers - Upper epigastric
abdominal pain on palpation
- Abdominal distention and hypoactive bowel sounds (ileus from inflammation)
- May have jaundice
, - Severe pancreatitis may have fever, tachypnea, hypoxemia and hypotension
- Cullen's sign
- Grey turner sign
What is Cullen's sign? correct answers Bruising around umbilicus
What is Grey Turner's sign? correct answers Bruising of the flanks
How is pancreatitis diagnosed? correct answers Diagnosis is made if 2 of the following 3
criteria are met:
- Abdominal pain strongly suggestive of pancreatitis
- Amylase and/or lipase levels at least three times higher than normal
- Characteristic findings of pancreatic inflammation on either transabdominal CT or
ultrasound
Why are NG suction and NPO status used as medical management for pancreatitis? correct
answers These interventions suppress/reduce pancreatic enzyme secretions. This decrease in
stimulation allows the pancreas to rest
Why might antibiotics be used to medically manage pancreatitis? correct answers Abx
therapy can aid in the early phase of infection due to inflammation and necrotic pancreatic
tissue being a good medium for bacteria growth.
What are some surgical interventions that can be done to treat pancreatitis? correct answers -
Surgical drainage of retained necrotic fluid
- If the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic
sphincterotomy is performed along with laparoscopic cholecystectomy in order to decrease
the risk of recurrence.
What medications can be used to manage acute pancreatitis? correct answers - Mophine:
relief of pain
- Nitroglycerin: relaxation of smooth muscle and relief of pain
- Antispasmodics: decrease vagal stimulation and pancreatic outflow
- Carbonic anhydrase inhibitor: reduces amount of pancreatic secretions and concentration of
bicarbonate
- Antacids: neutralize gastric pH
- H2 receptor antagonist: decreases HCl secretion which helps to reduce pancreatic activity
What medications are used to manage chronic pancreatitis? correct answers - Pancrelipase
- Insulin
- HCl
What patient teaching should be provided for pancrelipase? correct answers - Will be taking
for life
- Assess for pork allergy
- Take drug before, during, or immediately after meals
- Avoid crushing microspheres within capsules
- Do not switch to a different brand without consulting your doctor
