A Reading on

PANCREATITIS

In Partial Fulfillment of the

Requirements in NCM 216 – RLE

NUTRITION & GASTRO-INTESTINAL, METABOLISM & ENDOCRINE ROTATION

Submitted to:

, RN, MN

Clinical Instructor

Submitted by:

St. N.

BSN 3A – GROUP 2

January 27, 2021

Title: Pancreatitis

Bibliography:

Belleza, M. (2021). Pancreatitis. Retrieved from:

https://nurseslabs.com/pancreatitis/#:~:text=Performing%20nursing
%20interventions%20for%20a%20patient%20with%20pancreatitis,via%20patient-
controlled%20analgesia%20or%20bolus.%20Improve%20breathing%20pattern.

Summary:

Pancreatitis refers to the inflammation of the pancreas which can be classified

into either acute or chronic. Trypsin, produced by the pancreas’ own proteolytic
enzymes, is the cause of acute pancreatitis – making the organ digest itself.
Pancreatitis occur when gallstones lodge in the ampulla of Vater upon entering the
common bile duct and impede the passage of pancreatic juice causing bile reflux. The
enzymes of the pancreas would be activated together with bile once entering the bile
duct and return to the pancreatic duct – leading to pancreatitis. Additionally, there are
also several other mechanisms that contributes to the condition: alcohol abuse,
bacterial or viral infection, duodenitis, and the use of corticosteroids, thiazide diuretics,
and oral contraceptives.

Once with pancreatitis, the individual will feel a severe abdominal pain brought
about by irritation and edema of the inflamed pancreas, broad-like abdomen,
ecchymosis, nausea, vomiting, and hypotension as a result from the infiltration of
significant volumes of protein-rich fluid into the tissues and the peritoneum. Moreover,
complications such as fluid and electrolytes disturbances, pancreatic necrosis, and
septic shock due to bacterial infection would also occur alongside pancreatitis. There
are several assessment and diagnostic findings to determine the presence of the
condition, some of which include: ultrasound of the abdomen to identify pancreatic
inflammation; and serum amylase, lipase, and bilirubin as these serve as baseline to
know if there are problems concerning the pancreas. To treat or prevent the
aforementioned complications and to relieve the underlying symptoms, analgesia such
as morphine, fentanyl, or hydromorphone may be administered to manage pain;
intensive care to reduce the chances of renal failure due to blood loss and low albumin
levels; respiratory care as there would be a possibility of an elevated diaphragm due to
the inflamed pancreas which would cause atelectasis; and biliary drainage to drain the
pancreas are recommended. Surgically, the condition can be corrected with Caudal
pancreaticojejunostomy, Pancreaticoduodenal resection, Pancreatic surgery, or Side-to-
side pancreaticojejunostomy which is deemed to be the most successful with the rates
of 60% to 90%.

For nursing management, the goals that are needed to be achieved by the
patient with pancreatitis include relief of pain and discomfort, and an improvement in
nutritional status, respiratory function, and fluid and electrolyte balance. To achieve
these would include the following possible interventions: administration of parenteral
opioids to manage pain, frequent changing of positions to improve breathing pattern,
providing a high-carbohydrate diet along with a low fat and proteins in between acute
attacks, and to maintain the patient’s skin integrity. To prevent the patient from having
the condition again, a strict adherence and a clear instruction of avoiding foods rich in
fat, heavy meals, and alcohol should be given; along with imparting knowledge about
the signs and symptoms of pancreatitis for the patient to be aware on when to return to
the hospital.

Reflection:

As with the summarization of the article, I could agree to the fact that it provided
a concise and a clear information about pancreatitis starting from the pathophysiology of
the condition, down to its nursing management. The words used could also be easily
understood by its readers in contrast to other articles which use convoluted
explanations or advanced terms. Furthermore, the article itself also provided a practice
quiz at the end of the page to test the readers’ understanding about the topic, which I
consider to as a brilliant and a helpful part to engrave the topic in the minds of the
readers. Moreover, the article is also very beneficial for me as a student nurse as it
includes possible nursing diagnoses together with its goals and interventions which will
definitely come in handy for case analyses and nursing care plans. It also includes what
to assess when a patient has a pancreatitis and a discharge guideline that would be
very beneficial for nursing practice.

Truth be told, I have never had a history of pancreatitis nor have any family
member with the said condition; hence, although it is not my first time to hear about the
disease, it is the first that I have read about its pathophysiology and the signs and
symptoms that would occur that would signal its presence in the body. When I read
about its causes where one of which is alcohol abuse, I am also not quite concerned as
none of my immediate family members are alcohol drinkers. I am perplexed, however,
to its number of cases in the United States gaining up to 5000 per year as mentioned in
the article. Though it is not really one of their main cause of mortality, I thought that it is
probably because of the lifestyle of most of the people in their country. Some of them
are really heavy drinkers, some are drug users, and others – both. It is a good thing that
our country forbids the use of illegal drugs as I am very much certain that the number of
its negative effects could outweigh the positive ones.

Regarding the article as a whole, I could not distinguish any negative impact as it
really serves as a good reference for a study and even has its author as a registered
nurse, herself. As such, I could say that the nursing implications of the article is clearly
evident: it could be useful for nursing education as it elucidated properly the
pathophysiology of the disease, to its causes, and even its clinical manifestations which
would enable the student nurses to think critically and understand what needs to be
done and put it into actions during their duties; for nursing practice, the article itself
already provided possible nursing diagnoses and with those given diagnoses come with
their corresponding interventions, the nurse can already think of additional ways to
further alleviate the problem faced by the patient who has pancreatitis; and lastly for
nursing research, student nurses would be able to use it as a credible source in creating
research topics pertaining to pancreatitis, as the article itself is filled with important
information that would answer the possible questions of people who would inquire about
the mentioned condition.