1. The client/caregiver has a basic under- standing of anatomy and physiology of the pancreas.
   1. It is located behind the stomach in a horizontal position, with the head attached to the small intestine and the tail reaching to the spleen.
   2. The pancreas excretes a digestive juice that is emptied into the small intestine.
   3. The pancreas also produces two hormones: insulin and glucagon.
2. The client/caregiver can define pancreatitis.
   1. It is an inflammation of the pancreas that may be acute or chronic.
   2. Damage to the pancreas is caused by premature activation of enzymes.
   3. Chronic pancreatitis is progressive destruction of pancreatic tissue replaced by fibrotic tissue.
3. The client/caregiver can list factors that increase risk of pancreatitis.
   1. Alcohol abuse (accounts for most chronic pancreatitis)
   2. Gallbladder disease
   3. Drug toxicity
   4. A higher risk in African Americans
   5. A higher risk in men than women
   6. Cystic fibrosis
4. The client/caregiver can recognize signs and symptoms of acute pancreatitis.
   1. Pain
      1. Pain usually has a sudden, severe onset after ingestion of a heavy meal or alcohol.
      2. Pain is located in left upper quadrant of abdomen or mid to upper abdomen and may radiate to the back.
   2. Nausea or vomiting
   3. Abdominal rigidity and tenderness
   4. Fever and/or chills
   5. Sweating and clammy skin
   6. Low blood pressure
   7. Fast heart rate
   8. Respiratory distress
   9. Mild jaundice
   10. Weight loss
5. The client/caregiver can recognize symptoms of chronic pancreatitis.
   1. Dull, aching chronic epigastric pain
   2. Jaundice
   3. Impaired glucose tolerance
   4. Frothy, foul-smelling stools
   5. Weight loss
   6. Nausea and vomiting
   7. Symptoms of diabetes mellitus
6. The client/caregiver can list measures to prevent or manage pancreatitis.
   1. Avoid alcohol and tobacco products.
   2. Limit the fat in your diet.
   3. Use a high-carbohydrate diet. Stress complex carbohydrates found in grains, vegetables, and legumes.
   4. Take fat-soluble vitamin supplements (vitamins A, D, and E) and calcium as ordered.
   5. Avoid stimulants such as nicotine and caffeine (coffee, tea, and colas) to decrease pancreatic secretions.
   6. Eat small, frequent meals to minimize the secretion of pancreatic enzymes.
   7. Take analgesics for pain control as ordered. Be aware of the potential for drug abuse with uncontrolled pain.
   8. Take medications as ordered.
   9. Use lotions or creams to decrease itchy dry skin.
   10. Report any symptoms of severe epigastric pain, nausea and vomiting, foul-smelling, clay-colored stools, weight loss, and dark urine.
   11. Surgical intervention may be necessary.
7. The client/caregiver is aware of signs and symptoms of possible complications.
   1. Respiratory distress
   2. Jaundice
   3. Abscess
   4. Circulatory or renal failure
   5. Hemorrhage/shock
   6. Diabetes
   7. Peptic ulcer
   8. Infection
   9. Drug addiction
   10. Depression

Resources

National Pancreas Foundation
www.pancreasfoundation.org/

Pain-control clinic
Dietician
Mental health counseling
Support groups

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com