Level 4 INPA #2 UPDATED ACTUAL
Questions and CORRECT Answers
pancreatitis patho - CORRECT ANSWER - -Scar tissue or gallstones can occlude the
pancreatic duct.
- If the digestive enzymes (amylase, lipase, etc) can't get out and they become activated inside
the pancreas instead of the small intestine then they auto-digest the pancreas
Pancreatitis (chronic) - CORRECT ANSWER - - develops from repeated attacks of
pancreatitis which causes scarring and calcification of the pancreatic cells that lead to the
permanent and progressive destruction of the pancreas
digestive enzymes of pancreas and what they do - CORRECT ANSWER - - trypsin:
digests protein
- Amylase: digest carbs
- lipase: digest fats
Pancreatitis causes - CORRECT ANSWER - alcoholism
Gallbladder disease
viral infection
duodenal or peptic ulcers
pancreatic cancer
drugs like glucocorticoids
metabolic disorders: hyperparathyroidism, dyslipidemia
post surgical trauma from ERCP
The etiologic factors cause injury to the pancreatic cells or activation of the pancreatic enzymes
in the pancreas rather than intestine (where they are supposed to be activated)
,acute pancreatitis s/s - CORRECT ANSWER - -Severe mid to upper abdomen pain (worse
after eating
-May radiate to sides & upper back
- nausea, vomiting, flatulence
- frothy & foul smelling stool which is a sign of steatorrhea (inc fat in the stool)
- shallow breathing
- Interstitial hemorrhage
- edema
- low grade fever
- leukocytosis
- jaundice
- hypotension
- tachycardia
In which positions are the s/s relieved - CORRECT ANSWER - client sits up & leans
forward or curls into a fetal position
pancreatitis assessment - CORRECT ANSWER - - bowel sounds are diminished or absent
- abdominal distention
- abdomen tender to palpitation
Pancreatitis risk factors - CORRECT ANSWER - - alcohol
- male
- hereditary predisposition
pancreatitis complications - CORRECT ANSWER - Hypovolemic shock caused by the
release of large amounts of protein - rich fluid into tissues & peritoneal cavity or b/c of
vomiting/bleeding
,pseudocysts: cavity around the pancreas pockets necrotic tissue and other debris that accumulate,
if cyst perforates exudate inflames the surrounding tissues causing peritonitis
pancreatic abscess resulting from extensive necrosis of pancreatic cells. The abscess can become
infected leading to sepsis or pneumonia
Hypocalcemia: Combining of calcium and fatty acids during fat necrosis. Lipase that's released
from pancreas breaks down fats into fatty acids which binds to calcium in blood stream and
levels drop
pancreatitis diagnostics - CORRECT ANSWER - -Abd CT and US of pancreas
-Lab analysis of amount of pancreatic enzymes in serum
- Blood work: Increased serum amylase and lipase
-Pancreatic insulin production may be diminished and some patients develop diabetes mellitus
- various endoscopic tests: ercp
- stool sample
- electrolyte imbalance - low potassium, calcium
Pancreatitis Nursing Interventions - CORRECT ANSWER - NPO
improving breathing patterns
improving skin integrity
monitor intake & output
monitor/maintain fluid electrolyte balance, infection, shock & hyperglycemia
, monitor blood sugar
positioning/comfort measures
Diet: small, frequent meals that should be high in carbs & protein & low in fat
Pancreatitis Medical Management - CORRECT ANSWER - NSG w suction (relieves n/v,
distention) & provide oral care
General fluid therapy for hydration and albumin to pull fluid trapped in the peritoneum back into
the circulation
Pain management - opioids
H2 receptor antagonists (famotidine) or protein pump inhibitors - to suppress gastric acid & dec
pancreatic activity
Iv antibiotics - to prevent localized abscesses or treat systemic sepsis
Pancreatitis patient teaching - CORRECT ANSWER - - withholding digestive stimulants:
alchohol, caffeine, pepper
- clear, low fat diet to start
- cessation of alcohol intake
- how to administer insulin
- support groups
Preload/Afterload - CORRECT ANSWER - Preload volume of blood in ventricles at end
of diastole. Afterload is the The force or resistance against which the heart pumps.
Questions and CORRECT Answers
pancreatitis patho - CORRECT ANSWER - -Scar tissue or gallstones can occlude the
pancreatic duct.
- If the digestive enzymes (amylase, lipase, etc) can't get out and they become activated inside
the pancreas instead of the small intestine then they auto-digest the pancreas
Pancreatitis (chronic) - CORRECT ANSWER - - develops from repeated attacks of
pancreatitis which causes scarring and calcification of the pancreatic cells that lead to the
permanent and progressive destruction of the pancreas
digestive enzymes of pancreas and what they do - CORRECT ANSWER - - trypsin:
digests protein
- Amylase: digest carbs
- lipase: digest fats
Pancreatitis causes - CORRECT ANSWER - alcoholism
Gallbladder disease
viral infection
duodenal or peptic ulcers
pancreatic cancer
drugs like glucocorticoids
metabolic disorders: hyperparathyroidism, dyslipidemia
post surgical trauma from ERCP
The etiologic factors cause injury to the pancreatic cells or activation of the pancreatic enzymes
in the pancreas rather than intestine (where they are supposed to be activated)
,acute pancreatitis s/s - CORRECT ANSWER - -Severe mid to upper abdomen pain (worse
after eating
-May radiate to sides & upper back
- nausea, vomiting, flatulence
- frothy & foul smelling stool which is a sign of steatorrhea (inc fat in the stool)
- shallow breathing
- Interstitial hemorrhage
- edema
- low grade fever
- leukocytosis
- jaundice
- hypotension
- tachycardia
In which positions are the s/s relieved - CORRECT ANSWER - client sits up & leans
forward or curls into a fetal position
pancreatitis assessment - CORRECT ANSWER - - bowel sounds are diminished or absent
- abdominal distention
- abdomen tender to palpitation
Pancreatitis risk factors - CORRECT ANSWER - - alcohol
- male
- hereditary predisposition
pancreatitis complications - CORRECT ANSWER - Hypovolemic shock caused by the
release of large amounts of protein - rich fluid into tissues & peritoneal cavity or b/c of
vomiting/bleeding
,pseudocysts: cavity around the pancreas pockets necrotic tissue and other debris that accumulate,
if cyst perforates exudate inflames the surrounding tissues causing peritonitis
pancreatic abscess resulting from extensive necrosis of pancreatic cells. The abscess can become
infected leading to sepsis or pneumonia
Hypocalcemia: Combining of calcium and fatty acids during fat necrosis. Lipase that's released
from pancreas breaks down fats into fatty acids which binds to calcium in blood stream and
levels drop
pancreatitis diagnostics - CORRECT ANSWER - -Abd CT and US of pancreas
-Lab analysis of amount of pancreatic enzymes in serum
- Blood work: Increased serum amylase and lipase
-Pancreatic insulin production may be diminished and some patients develop diabetes mellitus
- various endoscopic tests: ercp
- stool sample
- electrolyte imbalance - low potassium, calcium
Pancreatitis Nursing Interventions - CORRECT ANSWER - NPO
improving breathing patterns
improving skin integrity
monitor intake & output
monitor/maintain fluid electrolyte balance, infection, shock & hyperglycemia
, monitor blood sugar
positioning/comfort measures
Diet: small, frequent meals that should be high in carbs & protein & low in fat
Pancreatitis Medical Management - CORRECT ANSWER - NSG w suction (relieves n/v,
distention) & provide oral care
General fluid therapy for hydration and albumin to pull fluid trapped in the peritoneum back into
the circulation
Pain management - opioids
H2 receptor antagonists (famotidine) or protein pump inhibitors - to suppress gastric acid & dec
pancreatic activity
Iv antibiotics - to prevent localized abscesses or treat systemic sepsis
Pancreatitis patient teaching - CORRECT ANSWER - - withholding digestive stimulants:
alchohol, caffeine, pepper
- clear, low fat diet to start
- cessation of alcohol intake
- how to administer insulin
- support groups
Preload/Afterload - CORRECT ANSWER - Preload volume of blood in ventricles at end
of diastole. Afterload is the The force or resistance against which the heart pumps.
