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NURS 405A Exam 3 Study Guide Solutions

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NURS 405A Exam 3 Study Guide Solutions Anatomy of the pancreas - ANSWER-It is both an exocrine (acinar cells) and endocrine (islets of langerhans) organ acinar cells - ANSWER-Secrete digestive enzymes including amylase, protease and lipase intot he pancreatic duct Islet cells - ANSWER-secrete ...

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  • October 30, 2024
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NURS 405A Exam 3 Study Guide Solutions


Anatomy of the pancreas - ANSWER✔✔-It is both an exocrine (acinar cells) and endocrine (islets of

langerhans) organ


acinar cells - ANSWER✔✔-Secrete digestive enzymes including amylase, protease and lipase intot he

pancreatic duct


Islet cells - ANSWER✔✔-secrete insulin, glucagon, somatostatin, pancreatic polypeptide into

bloodstream


Function of insulin - ANSWER✔✔-beta cells of the islets of langerhans move glucose from the blood into

other body tissues where it is used for energy


Function of glucagon - ANSWER✔✔-alpha cells cause liver to convert glycogen to glucose


What does the gallbladder do? - ANSWER✔✔-Stores and releases bile (made in the liver) to digest fats


Acute pancreatitis - ANSWER✔✔-acute inflammation of the pancrease that can range from mild to

severe, severe can be life threatening


pancreatic enzymes spill into surrounding tssues and organs causing autodigestion and pain



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pancreas typically recovers from an acute episode


Most common causes of acute pancreatitis (U.S.) - ANSWER✔✔-Gallbadder disease (gallstones) due to

high fat diet (more common in women than men)


Chronic alcohol use (more common in men)


idopathic


hypertriglyceridemia


less common causes of acute pancreatitis - ANSWER✔✔-drug reactions (thiazide diuretics, DM meds)


pancreatic cancer


trauma


gallstones are... - ANSWER✔✔-hardened deposits of undissolved cholesterol, salts or bilirubin


Clinical manifestation of acute pancreatitis - ANSWER✔✔-abdominal pain (cause your pancreas is

digesting itself) (mid-epigastric and LUQ radiating to back, worse with eating, worse when recumbent

(lying flat))


N/V


Vital signs (resemble sepsis): dec BP, inc HR, low grad fever



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Labs: inc amylase, inc lipase (Lipase more specific to pancreas) (amylase can elevate with mumps,

cerebral trauma, renal transplant)


Hyperglycemia and hypocalcemia (combining of calcium and fatty acids during fat necrosis)


S/S of hypocalcemia - ANSWER✔✔-Early sign of hypocalcemia is numbness/tingling around lips and

fingers


muscle twitching and tetany can also occur


postive chovstek and trousseau signs


Nursing assessment for acute pancreatitis - ANSWER✔✔-abdomen is painful, guarded, distended


bowel sounds decreased or absent


crackles in bases of lungs


Grey Turner's (flank: bruise like sign on skin) and Cullen's signs (preumbilical red line)


Acute pancreatitis primarily affects what systm? - ANSWER✔✔-cardiovascular and pulmonary systems


Patient's with Grey Turner's and Cullen's signs - ANSWER✔✔-less than 1% of patients have these signs

and they are associated with a high rate of mortality


Acute Pancreatitis complications - ANSWER✔✔-Inflammation and free digestive enzymes can affec

nearby organs, vessels and lungs:

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hemorrhage


shock


necrosis


peritonitis


pancreatic pseudocyst


pancreatic abscess, acute renal failure


ARDS, Hypocalcemia


DIC


pancreatic pseudocyst from acute pancreatitis - ANSWER✔✔-a localized collection of pancreatic juices

confirned to a retoperitoneal area by a fibrous membrane


pancreatic abscess from acute pancreatitis - ANSWER✔✔-a collection of pus and necrotic tissue


ARF from acute pancreatitis - ANSWER✔✔-caused by hypoxemia, release of pancreatic amylase from

injured pancreas with impairment or renal microcirculation, decrease in renal perfusion pressure due to

abdominal compartment syndrome, intraabdominal hypertension or hypovolemia


ARDs from acute pancreatitis - ANSWER✔✔-due to systemic inflammation, potentially the most serious

manifestation of AP w/ mortality rate in the range of 30-40%

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