Pancreatitis is a disease in which the pancreas (the large gland behind the stomach and next to the small intestine) becomes inflamed. It is the painful inflammatory condition in which the enzymes of the pancreas are prematurely activated resulting in autodigestion of the pancreas. The 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.
- Acute pancreatitis is a sudden inflammation that lasts for a short time. It may range from mild discomfort to a severe, life-threatening illness.
- Chronic pancreatitis is long-lasting inflammation of the pancreas. It most often happens after an episode of acute pancreatitis.
Nursing Care Plans
Nursing care management of patients with pancreatitis includes relief of pain and discomfort caused by pancreatitis, improvement of nutritional status, improving respiratory function, and improvement of fluid and electrolyte status.
- Acute Pain
- Risk for Deficient Fluid Volume
- Imbalanced Nutrition: Less Than Body Requirements
- Risk for Infection
- Deficient Knowledge
- Acute Pain
- Risk for Imbalanced Fluid Volume
- Imbalanced Nutrition: Less Than Body Requirements
- Other Nursing Care Plans
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
- Report pain is relieved/controlled.
- Follow prescribed therapeutic regimen.
- Demonstrate use of methods that provide relief.
|Investigate verbal reports of pain, noting specific location and intensity (0–10 scale). Note factors that aggravate and relieve pain.||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.||Decreases metabolic rate and GI stimulation and secretions, thereby reducing pancreatic activity.|
|Promote position of comfort on one side with knees flexed, sitting up and leaning forward.||Reduces abdominal pressure and tension, providing some measure of comfort and pain relief. Note: Supine position often increases pain.|
|Provide alternative comfort measures (back rub), encourage relaxation techniques (guided imagery, visualization), quiet diversional activities (TV, radio).||Promotes relaxation and enables patient to refocus attention; may enhance coping.|
|Keep environment free of food odors.||Sensory stimulation can activate pancreatic enzymes, increasing pain.|
|Administer analgesics in timely manner (smaller, more frequent doses).||Severe and prolonged pain can aggravate shock and is more difficult to relieve, requiring larger doses of medication, which can mask underlying problems and complications and may contribute to respiratory depression.|
|Maintain meticulous skin care, especially in presence of draining abdominal wall fistulas.||Pancreatic enzymes can digest the skin and tissues of the abdominal wall, creating a chemical burn.|
|Administer medication as indicated:|
||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.|
||Potentiates action of narcotic to promote rest and to reduce muscular and ductal spasm, thereby reducing metabolic needs, enzyme secretions.|
||Neutralizes gastric acid to reduce production of pancreatic enzymes and to reduce incidence of upper GI bleeding.|
||Decreasing secretion of HCl reduces stimulation of the pancreas and associated pain.|
|Withhold food and fluid as indicated.||Limits and reduces release of pancreatic enzymes and resultant pain.|
|Maintain gastric suction when used.||Prevents accumulation of gastric secretions, which can stimulate pancreatic enzyme activity.|
|Prepare for surgical intervention if indicated.||Surgical exploration may be required in presence of intractable pain and complications involving the biliary tract, such as pancreatic abscess or pseudocyst.|
Recommended nursing diagnosis and nursing care plan books and resources.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans