Pancreatitis Practice Questions with Answers and NCLEX® Review

Introduction to Pancreatitis

Pancreatitis is inflammation of the pancreas that can worsen when food or drink is consumed. It can occur at any age, but it commonly occurs in adults between the ages of thirty and fifty-five. Common causes of pancreatitis include; gallstones, alcohol abuse, or certain medications. 

There are two types of pancreatitis: acute and chronic.

Acute pancreatitis occurs suddenly and can lead to organ failure if not treated quickly. It’s often caused by gallstones or heavy alcohol consumption. Still, it can also occur after surgery on the gallbladder or pancreas, as a side effect of medications like nonsteroidal anti-inflammatory drugs (NSAIDs), or as a result of abdominal trauma.

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Chronic pancreatitis develops slowly over time and can be caused by diabetes, alcoholism, cystic fibrosis, inflammatory bowel disease, and autoimmune disorders (like lupus erythematosus).

Pathophysiology of Pancreatitis

The pancreas is a long, narrow gland located near the stomach that produces enzymes that help digest food, as well as hormones that help regulate blood sugar levels. The pancreas also contains ducts that release bicarbonate and digestive juices into the small intestine to help break down food.

Pancreatitis occurs when digestive enzymes become activated while still in the pancreas, irritating the cells of your pancreas and causing inflammation. This activates neutrophils (white blood cells) to send harmful proteins to the pancreas. The inflammation and enzymes can begin to digest the pancreas (autodigestion).

Signs and Symptoms of Pancreatitis

• Epigastric pain
• Left upper quadrant (LUQ) pain (radiating to the back)
• Bruising
• Turner’s & Cullen’s sign
• Jaundice 
• Hypotension

Pancreatitis Causes

• Alcohol abuse
• Gallstones & gallbladder disease
• Cystic fibrosis
• Certain medications 
• Diabetes
• Abdominal surgery
• Smoking
• Certain medications

Nursing Interventions for Pancreatitis

Assist in NPO feeding.

Perform insertion of a nasogastric tube (NGT) for suction.

Administer prescribed IV pain meds, like Hydromorphone, as needed (no morphine).

• Morphine is not used because it can exacerbate the disease with increased pancreatic neutrophil infiltration resulting in further necrosis.

Monitor vital signs, including fluid intake and output, diet, pain levels, and glucose levels (hyperglycemia = insulin).

Pancreatitis Conclusion

Alcohol misuse, certain drugs, or conditions like gallstones can all lead to a painful condition in the pancreas called pancreatitis. There are two types of pancreatitis; acute and chronic.

Prompt treatment is required in acute pancreatitis, as organ failure can occur. It is frequently brought on by gallstones or binge drinking, but it can also be brought on by abdominal trauma, nonsteroidal anti-inflammatory drug (NSAID) side effects, surgery on the pancreas or gallbladder, or gallstones.

Chronic pancreatitis is a slow-moving condition caused by autoimmune diseases, cystic fibrosis, inflammatory bowel disease, diabetes, and alcoholism (like lupus erythematosus).

Sources

https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/pancreatitis 

https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes 

https://my.clevelandclinic.org/health/diseases/8103-pancreatitis