1. Which of the following is considered a “hallmark” symptom of pancreatitis?
A. Vomiting – not necessarily indicative of anything specific
B. Mid-epigastric pain that radiates to the back – typical symptom of pancreatitis
C. Gradual onset of pain – pain is usually sudden and severe
D. Alcohol consumption – this is a risk factor, not a symptom
2. A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To what diagnosis does the nurse attribute these findings?
A. Malnutrition
B. Osteomyelitis
C. Alcohol abuse
D. Diabetes mellitus
Rationale: The patient with alcohol abuse could develop pancreatitis as a complication, which would increase the serum amylase (normal 30-122 U/L) and serum lipase (normal 31-186 U/L) levels as shown.
A. Parenteral fluids – used to restore blood volume and prevent hypotension and shock in acute pancreatitis
B. Corticosteroids – used to treat autoimmune chronic pancreatitis, not acute
C. Nasogastric suctioning – helps with pain from acute pancreatitis and prevents paralytic ileus in patients who are nauseous and/or vomiting
D. H2 receptor antagonists – decreases gastric acid production and therefore decreases stimulation of pancreas in acute pancreatitis
E. Narcotics or Demerol – narcotics help with pain associated with acute pancreatitis and Demerol is used when the sphincter of Oddi is involved
F. Surgical resection of the pancreas – used as a treatment option for chronic pancreatitis, not acute
4. Which lab test result would indicate that Mr. Walker has acute pancreatitis?
A. Elevated bilirubin levels
B. Elevated serum lipase and amylase levels
C. Low white blood cell count
D. Elevated blood alcohol level
Rationale: The pancreas will continue to release the enzymes lipase and amylase even when the outflow of these enzymes becomes blocked. This will result in an elevated serum lipase and amylase level in the blood.
5. Why is the body more susceptible to secondary infections during cases of pancreatitis?
A. The production of anti-inflammatory cytokines and specific cytokine inhibitors
B. The formation of pseudocysts
C. The release of cortisol in response to stress
D. The activation of leukocytes in response to pro-inflammatory cytokine production
Rationale: As a result of the systemic inflammatory response during acute pancreatitis, anti-inflammatory cytokines and specific cytokine inhibitors are produced, increasing the body’s risk for infection.