b. Although serum lipase levels and urinary amylase 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._x000d_Serum calcium levels are decreased and serum glucose is increased.

2 / 5

2. When assessing a patient with acute pancreatitis, the nurse would expect to find___

1. hyperactive bowel sounds.

2. hypertension and tachycardia.

3. a temperature greater than 102° F (38.9° C).

4. severe left upper quadrant (LUQ) or mid-epigastric pain.

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, the patient is hypotensive and may manifest symptoms of shock, and there is only a low-grade fever.

3 / 5

3. What treatment measure is used in managing the patient with acute pancreatitis?

1. Surgery to remove the inflamed pancreas

2. Pancreatic enzyme supplements administered with meals

3. Nasogastric (NG) suction to prevent gastric contents from entering the duodenum

4. Endoscopic pancreatic sphincterotomy using endoscopic retrograde cholangiopancreatography (ERCP)

c. Pancreatic rest and suppression of secretions are promoted by preventing any gastric contents from entering the duodenum, which would stimulate pancreatic activity._x000d__x000d_Surgery is not indicated for acute pancreatitis but may be used to drain abscesses or cysts. Pancreatic enzyme supplements are necessary in chronic pancreatitis if a deficiency in secretion occurs, but not for acute pancreatitis. An endoscopic retrograde cholangiopancreatography (ERCP) pancreatic sphincterotomy may be done when pancreatitis is related to gallstones.

4 / 5

4. With pancreatic carcinoma, insulin deficiency is suspected when the patient evidences___

1. an abnormal glucose tolerance.

2. glucosuria.

3. hyperglycemia.

4. all of the above.

5 / 5

5. Which complication of acute pancreatitis requires prompt surgical drainage to prevent sepsis?

1. Tetany

2. Pseudocyst

3. Pleural effusion

4. Pancreatic abscess

d. A pancreatic abscess, usually from an infected pseudocyst, is a collection of pus that must be drained to prevent infection of adjacent organs and sepsis. Tetany from hypocalcemia 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._x000d_

Pleural effusion is treated by treating the cause (pancreatitis) and monitoring for respiratory distress and oxygen saturation.

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