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Acute hemorrhagic pancreatitis is characterized by inflammation of the pancreas. In the later part, vessels ruptured pancreatitis-pathophysiologyresulting to tissue ischemia. Eventually, it will lead to tissue necrosis. The main problem in acute hemorrhagic pancreatitis is autodigestion of the pancreas. The cause of inflammation mechanism in pancreatitis is unknown. Although it is considered as the milder form of pancreatitis, the patient could die because of hypovolemic shock, fluid and electrolyte disturbances, and sepsis.

Causes

  1. Alcohol abuse – 90 percent of all cases
  2. Biliary tract disease – second leading cause
  3. Bacterial and viral infection – e.g. it is a complication of mumps virus
  4. Blunt abdominal trauma
  5. Peptic ulcer disease

Clinical Manifestations

  1. Midepigastrium pain that is more severe after meals and alcohol ingestion that can’t be relieved by antacids
  2. Rigid or boardlike abdomen – indicates peritonitis
  3. Hypotension
  4. Cyanosis and cold clammy skin
  5. Acute renal failure is common
  6. Respiratory distress
  7. Hypocalcemia
  8. Hyperglycemia
  9. Disseminated intravascular coagulation

Diagnostic Studies

  1. Serum lipase and amylase – used in diagnosing
  2. Abdominal and chest x-ray
  3. Complete blood count

Medical Management

  1. Pain management – analgesia
  2. Intensive care
  3. Respiratory care
  4. Biliary Drainage

Nursing Interventions

  1. Report unrelieved or increasing pain.
  2. Teach nonpharmacologic interventions for relieving pain (e.g. relaxation, diversion, etc.)
  3. Maintain patient on bed rest.
  4. Provide high-carbohydrate, low-protein, low-fat diet as ordered.
  5. Counsel patient to avoid excessive use of coffee and spicy foods.
  6. Assist patient to turn and change positions every 2 hours.
  7. Monitor serum glucose levels and administer insulin as prescribed.
  8. Assess fluid and electrolyte status.
  9. Instruct patient to eliminate alcohol and refer to support groups as indicated.
  10. Measure intake and output accurately.

Acute Hemorrhagic Pancreatitis Pathophysiology

References:

  • NANDA Nursing Diagnosis 12th Edition by Doenges, et. al.
  • Brunner and Suddarth’s Textbook of Medical-Surgical Nursing 12th Edition
  • http://www.pathologyatlas.ro/acute-pancreatitis.php

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Iris is the recipient of Florence Nightingale Award in her class. She has genuine passion and interest in Endocrinology, Renal Nursing, and Nursing Research. Decided that the Nursing profession called her, she is serving the nursing community through writing or blogging for health-related educational websites and assisting students with their undergraduate thesis.