ATI Med Surg: Pancreatitis Exam

1. A client has been admitted to the hospital with a diagnosis of acute pancreatitis and the nurse is assessing the client's pain. What type of pain is consistent with this diagnosis? a. Burning and aching, located in the left lower quadrant and radiating to the hip b. Severe and unrelenting, located in the epigastric area and radiating to the back c. Burning and aching, located in the epigastric are and radiating to the umbilicus d. Severe and unrelenting, located in the left lower quadrant and radiating to the groin - Ans: b The pain associated with acute pancreatitis is often severe and unrelenting, is located in the epigastric region, and radiates to the back. The other options are incorrect. 2. The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. a. Administer antacids as prescribed b. Encourage coughing and deep breathing c. Administer anticholinergics as prescribed d. Give small, frequent high-calorie feedings e. Maintain the client in a supine and flat position f. Give meperidine (Demerol) as prescribed for pain. - Ans: a, b, c, f The client with acute pancreatitis normally is placed on NPO status to rest the pancreas and suppress gastrointestinal secretions. Because abdominal pain is a prominent symptom pancreatitis, pain medication such as meperidine is prescribed. Some clients experience lessened pain by assuming positions that flex the trunk, with the knees drawn up to the chest. A side-lying position with the head elevated 45 degrees decreases tension on the abdomen and may help ease the pain. The client is susceptible to respiratory infections because the retroperitoneal fluid raises the diaphragm, which causes the client to take shallow, guarded abdominal breaths. Therefore measures such as turning, coughing, and deep breathing are instituted. Antacids and anticholinergics may be prescribed to suppress gastrointestinal secretions. 3. Nursing management of the patient with acute pancreatitis includes (select all that apply) a. checking for signs of hypocalcemia. b. providing a diet low in carbohydrates. c. giving insulin based on a sliding scale. d. observing stools for signs of steatorrhea. e. monitoring for infection, particularly respiratory tract infection. - Ans: a, e 4. Which complication of acute pancreatitis requires prompt surgical drainage to prevent sepsis? a. Tetany b. Pseudocyst c. Plerual effusion d. Pancreatic abscess - Ans: d A pancreatic abscess is a collection of pus that must be drained to prevent infection of adjacent organs and sepsis. Tetany from hupocalcemia is treated with IV calcium gluconate (10%). Although pseudocysts usually resolve spontaneously, they may be treated with surgical, percutaneous catheter, or endoscopic drainage to prevent perforation. Pleural effusion is treated by treating the cause (pancreatitits) and monitoring for respiratory distress and oxygen saturation. 5. When assessing a patient with acute pancreatitis, the nurse would expect to find: a. hyperactive bowel sounds. b. hypertension and tachycardia. c. a temperature greater than 102 F (38.9 C). d. Severe midepigastric or left upper quadrant (LUQ) pain. - Ans: d the predominant symptom of acute pancreatitis is severe, deep abdominal pain that is usually located in the left upper quadrant (LUQ) but may be in the midepigastrium. Bowel sounds are decreased or absent, temperature is elevated only slightly, and the patient has hypovolemia and may manifest symptoms of shock. 6. Combined with clinical manifestations, what is the laboratory finding that is most commonly used to diagnose acute pancreatitis? a. Increased serum calcium b. Increased serum amylase c. Increased urinary amylase d. Decreased serum glucose - Ans: b Although serum lipase levels and urinary amylasy levels are increased, an increased serum amylase level is the criterion most commonly used to diagnose acute pancreatitis in the first 24 to 72 hours. Serum calcium levels are decreased. 7. What treatment measure is used in the management of the patient with acute pancreatitis? a. Surgery to remove the inflamed pancreas b. Pancreatic enzyme supplements administered with meals