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NRSG 421: GI Exam Questions With
Verified Answers.
What are the six categories for acute abdominal pain? - answer✔- Inflammatory (bacterial or
chemical cause)
- Mechanical (ileus or obstruction)
- Neoplastic (tumour obstructing nerves or vessels)
- Vascular (clot or atherosclerosis
- Congenital
- Traumatic
Acute pancreatitis can be divided into three categories. What are these categories? - answer✔-
Mild acute pancreatitis
- Moderately severe acute pancreatitis
- Severe acute pancreatitis
What is mild acute pancreatitis? - answer✔Absence of organ failure and local or systemic
complications
What is moderately severe acute pancreatitis? - answer✔Characterized by transient organ failure
(resolves within 48 hours) and/or local or systemic complications without persistent organ failure
What is severe acute pancreatitis? - answer✔Persistent organ failure that may involve one or
multiple organs
What are some causes of acute pancreatitis? - answer✔- Gallstones*
- Alcohol
- Infection (mumps, coxsackie B)
- Pancreatic tumours
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- Medications (azathioprine, thiazide, valproic acid)
- Trauma
- Idiopathic (tropical pancreatitis, CF)
What are the two main causes for chronic pancreatitis? - answer✔- Alcoholism
- Idiopathic
What are some signs and symptoms of pancreatitis? - answer✔- Acute onset of persistent, severe
epigastric abdominal pain (may be in upper right quadrant). Pain may vary depending on cause.
Pain partially relieved by sitting up or bending forwards
- Nausea and vomiting
- Dyspnea due to diaphragmatic inflammation, secondary to pancreatitis
- Foul smelling, foamy, grey coloured stools
- Back pain
What are some clinical findings that indicate pancreatitis? - answer✔- Upper epigastric
abdominal pain on palpation
- Abdominal distention and hypoactive bowel sounds (ileus from inflammation)
- May have jaundice
- Severe pancreatitis may have fever, tachypnea, hypoxemia and hypotension
- Cullen's sign
- Grey turner sign
What is Cullen's sign? - answer✔Bruising around umbilicus
What is Grey Turner's sign? - answer✔Bruising of the flanks
How is pancreatitis diagnosed? - answer✔Diagnosis is made if 2 of the following 3 criteria are
met:
- Abdominal pain strongly suggestive of pancreatitis
- Amylase and/or lipase levels at least three times higher than normal
- Characteristic findings of pancreatic inflammation on either transabdominal CT or ultrasound
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Why are NG suction and NPO status used as medical management for pancreatitis? -
answer✔These interventions suppress/reduce pancreatic enzyme secretions. This decrease in
stimulation allows the pancreas to rest
Why might antibiotics be used to medically manage pancreatitis? - answer✔Abx therapy can aid
in the early phase of infection due to inflammation and necrotic pancreatic tissue being a good
medium for bacteria growth.
What are some surgical interventions that can be done to treat pancreatitis? - answer✔- Surgical
drainage of retained necrotic fluid
- If the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic sphincterotomy
is performed along with laparoscopic cholecystectomy in order to decrease the risk of recurrence.
What medications can be used to manage acute pancreatitis? - answer✔- Mophine: relief of pain
- Nitroglycerin: relaxation of smooth muscle and relief of pain
- Antispasmodics: decrease vagal stimulation and pancreatic outflow
- Carbonic anhydrase inhibitor: reduces amount of pancreatic secretions and concentration of
bicarbonate
- Antacids: neutralize gastric pH
- H2 receptor antagonist: decreases HCl secretion which helps to reduce pancreatic activity
What medications are used to manage chronic pancreatitis? - answer✔- Pancrelipase
- Insulin
- HCl
What patient teaching should be provided for pancrelipase? - answer✔- Will be taking for life
- Assess for pork allergy
- Take drug before, during, or immediately after meals
- Avoid crushing microspheres within capsules
- Do not switch to a different brand without consulting your doctor
Describe sepsis as a complication of pancreatitis - answer✔Abscess may form within the
pancreas as a result of necrosis. There is subsequent risk of infection and perforation into the
blood an adjacent organs