5 Pancreatitis Nursing Care Plans


A guide to nursing diagnosis for pancreatitis, including the different types of nursing care plans, symptoms, causes, and treatments. Get a better understanding of this condition and how to provide the best care for patients.

What is Pancreatitis?

Pancreatitis is a disease in which the pancreas (the large gland behind the stomach and next to the small intestine) becomes inflamed. It is a 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.

Here are five (5) nursing care plans (NCP) and nursing diagnoses for patients with pancreatitis:

  1. Acute Pain
  2. Risk for Deficient Fluid Volume
  3. Imbalanced Nutrition: Less Than Body Requirements
  4. Risk for Infection
  5. Deficient Knowledge

Acute Pain

Pancreatitis is associated with acute pain due to multiple factors. The obstruction of the pancreatic and biliary tract can cause a buildup of pressure, leading to pain. In addition, inflammation can extend to the retroperitoneal nerve plexus, which can cause severe pain. Autodigestion of the pancreas also releases digestive enzymes that can damage surrounding tissues and cause pain.

Nursing Diagnosis

  • Acute Pain

May be related to

  • Obstruction of pancreatic, and biliary ducts
  • Chemical contamination of peritoneal surfaces by pancreatic exudate/autodigestion of the 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
  • Observed evidence of pain
  • Guarding behavior
  • Protective gestures
  • Positioning to avoid pain
  • Sleep disturbances (eyes lackluster, beaten look, fixed or scattered movement
  • Expressive behavior (restlessness, moaning, crying, vigilance, irritability, sighing)
  • Distraction behavior (pacing, seeking out other people)
  • Change in muscle tone
  • Diaphoresis

Desired Outcomes

  • The client will report relief/control of pain.
  • The client will follow the prescribed therapeutic regimen.
  • The client will verbalize nonpharmacologic methods that provide relief.
  • The client will demonstrate the use of relaxation skills and diversional activities, as indicated, for the individual situation

Nursing Assessment and Rationales

1. 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 the involvement of the head of the pancreas. Pain in the left upper quadrant (LUQ) suggests the involvement of the pancreatic tail. Localized pain may indicate the development of pseudocysts or abscesses.

Nursing Interventions and Rationales

1. Maintain bedrest during an acute attack. Provide a quiet, restful environment.
Decreases metabolic rate and GI stimulation and secretions, thereby reducing pancreatic activity.

2. Promote a 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.

3. Provide alternative comfort measures (back rub), encourage relaxation techniques (guided imagery, visualization), and quiet diversional activities (TV, radio).
Promotes relaxation and enables the patient to refocus attention; may enhance coping.

4. Keep the environment free of food odors.
Sensory stimulation can activate pancreatic enzymes, increasing pain.

5. Administer analgesics in a 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.

6. 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.

7. Withhold food and fluid as indicated.
Limits and reduces the release of pancreatic enzymes and resultant pain.

8. Maintain gastric suction when used.
Prevents accumulation of gastric secretions, which can stimulate pancreatic enzyme activity.

9. Administer medication as indicated:

  • 9.1. Narcotic analgesics: meperidine (Demerol), fentanyl (Sublimaze), pentazocine (Talwin)
    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 who have recurrent or chronic pancreatitis episodes may be difficult to manage because they may become dependent on the narcotics given for pain control.
  • 9.2. Sedatives: diazepam (Valium); antispasmodics: atropine
    Potentiates action of narcotics to promote rest and to reduce muscular and ductal spasms, thereby reducing metabolic needs, and enzyme secretions.
  • 9.3. Antacids: Mylanta, Maalox, Amphojel, Riopan
    Neutralizes gastric acid to reduce the production of pancreatic enzymes and to reduce the incidence of upper GI bleeding.
  • 9.4. Cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid)
    Decreasing the secretion of HCl reduces stimulation of the pancreas and associated pain.

10. Prepare for surgical intervention if indicated.
Surgical exploration may be required in presence of intractable pain and complications involving the biliary tract, such as a pancreatic abscess or pseudocyst.

11. Accept the client’s description of pain
Pain is a subjective experience and cannot be felt by others.

12. Provide comfort measures.
To promote nonpharmacological pain management.

13. Encourage adequate rest periods.
To prevent fatigue

14. Administer analgesics as indicated to maximum dosage, as needed.
To maintain an acceptable level of pain.

15. Evaluate and document the client’s response to analgesia and assist in transitioning or changing the drug regimen based on individual needs.
Increasing or decreasing dosage, stepped program (switching from injection to oral route, increased time span as the pain lessens) helps in self-management of pain.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its 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 showing 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.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is 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.

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.

See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:


Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers.

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