Pancreatitis is a painful inflammatory condition in which the pancreatic enzymes are prematurely activated resulting in autodigestion of the pancreas.
The most common cause of pancreatitis are biliary tract disease and alcoholism, but can also result from such things as abnormal organ structure, blunt trauma, penetrating peptic ulcers, and drugs such as sulfonamides and glucocorticoids. Pancreatitis may be acute or chronic, with symptoms mild to severe.
Nursing Care Plan for Pancreatitis
Here is a Sample of Nursing Care Plan for Pancreatitis.
Nursing Care Plan for Pancreatitis: Nursing Diagnosis
Nursing Care Plan for Pancreatitis | Nursing Diagnosis of Pancreatitis
Nursing Diagnosis of Pancreatitis: Pain, acute May be related to:
- Obstruction of pancreatic, biliary ducts
- Chemical contamination of peritoneal surfaces by pancreatic exudate/autodigestion of pancreas
- Extension of inflammation to the retroperitoneal nerve plexus
Possibly evidenced by
- Reports of pain
- Self-focusing, grimacing, distraction/guarding behaviors
- Autonomic responses, alteration in muscle tone
Desired Outcomes/Evaluation Criteria—Patient Will:
Pain Control (NOC)
- Report pain is relieved/controlled.
- Follow prescribed therapeutic regimen.
- Demonstrate use of methods that provide relief.
Nursing Care Plan for Pancreatitis: Nursing Intervention & Rationale
Nursing Care Plan for Pancreatitis: Nursing Intervention & Rationale
Nursing Interventions of Pancreatitis with Rationale
Pain Management (NIC)
Nursing Interventions of Pancreatitis with Rationale: Independent
- Investigate verbal reports of pain, noting specific location and intensity (0–10 scale). Note factors that aggravate and relieve pain. Rationale: Pain is often diffuse, severe, and unrelenting in acute or hemorrhagic pancreatitis. Severe pain is often the major symptom in patients with chronic pancreatitis. Isolated pain in the RUQ reflects involvement of the head of the pancreas. Pain in the left upper quadrant (LUQ) suggests involvement of the pancreatic tail. Localized pain may indicate development of pseudocysts or abscesses.
- Maintain bedrest during acute attack. Provide quiet, restful environment. Rationale: Decreases metabolic rate and GI stimulation/secretions, thereby reducing pancreatic activity.
- Promote position of comfort, e.g., on one side with knees flexed, sitting up and leaning forward. Rationale: Reduces abdominal pressure/tension, providing some measure of comfort and pain relief. Note: Supine position often increases pain.
- Provide alternative comfort measures (e.g., back rub), encourage relaxation techniques (e.g., guided imagery, visualization), quiet diversional activities (e.g., TV, radio). Rationale: Promotes relaxation and enables patient to refocus attention; may enhance coping.
- Keep environment free of food odors. Rationale: Sensory stimulation can activate pancreatic enzymes, increasing pain.
- Administer analgesics in timely manner (smaller, more frequent doses). Rationale: Severe/prolonged pain can aggravate shock and is more difficult to relieve, requiring larger doses of medication, which can mask underlying problems/complications and may contribute to respiratory depression.
- Maintain meticulous skin care, especially in presence of draining abdominal wall fistulas. Rationale: Pancreatic enzymes can digest the skin and tissues of the abdominal wall, creating a chemical burn.
- Withhold food and fluid as indicated. Rationale: Limits/reduces release of pancreatic enzymes and resultant pain.
- Maintain gastric suction when used. Rationale: Prevents accumulation of gastric secretions, which can stimulate pancreatic enzyme activity.
- Prepare for surgical intervention if indicated. Rationale: Surgical exploration may be required in presence of intractable pain/complications involving the biliary tract, such as pancreatic abscess or pseudocyst.
Nursing Care Plan for Pancreatitis
Nursing Interventions of Pancreatitis with Rationale: Collaborative
- Administer medication as indicated:
- Narcotic analgesics, e.g., meperidine (Demerol), fentanyl (Sublimaze), pentazocine (Talwin); Rationale: Meperidine is usually effective in relieving pain and may be preferred over morphine, which can have a side effect of biliary-pancreatic spasms. Paravertebral block has been used to achieve prolonged pain control. Note: Pain in patients whohave recurrent or chronic pancreatitis episodes may be difficult to manage because they may become dependent on the narcotics given for pain control.
- Sedatives, e.g., diazepam (Valium); antispasmodics, e.g., atropine; Rationale: Potentiates action of narcotic to promote rest and to reduce muscular/ductal spasm, thereby reducing metabolic needs, enzyme secretions.
- Antacids, e.g., Mylanta, Maalox, Amphojel, Riopan; Rationale: Neutralizes gastric acid to reduce production of pancreatic enzymes and to reduce incidence of upper GI bleeding.
- Cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid). Rationale: Decreasing secretion of HCl reduces stimulation of the pancreas and associated pain.
Nursing Care Plan for Pancreatitis: Overview; Nursing Care Plan for Pancreatitis: Nursing Priorities & Discharge Goals; Nursing Care Plan for Pancreatitis: Nursing Diagnosis; Nursing Care Plan for Pancreatitis: Nursing Intervention with Rationale. Nursing Care Plan for Pancreatitis.
