1. Pancreatitis Acute pancreatitis

3. Definition Is an inflamation of the pancreas ranging from mild edema to extensive hemorrhage the structure and function of the pancreas return to normal after an acute attack

4. causes Causes=- 1-biliary disease like biliary stone 2-alcohol consumption 3-infection like mumps 4-anti cancer drugs 5-hyperlipidemia-truma and surgery 6-oral contra captives-corticosteroid 7-less common bacterial and viral

5. Clinical feature Sudden onset -sever epigastric pain -nausea –vomiting, hypovolumic shock -hemorrhage in pancreas -reduce bowel sound -dry mucous membrane

6. Investigation -S. amylase—RBS -S. Ca. k. Na. albumin -plan abdominal X ray -abdominal U\S -CT abdomen -chest X ray

7. Medical treatment -analgesic –pethidine 100mg IV -Rest gland by continuous gastric suction -IV fluid and correct electrolyte -treat shock and respiratory distress

8. Complications Complication=- -pleural effusion -haemorrhage with hypovolemic shock -chronic panceratitis -acute renal failure

9. N P=- ASSESSMENT=- -history of gallbladder disease and alcohol -assess GI distress including nausea vomiting –diarrhea and fat stool -assess characteristic of abdominal pain -assess nutrition and fluid status -assess respiratory status

10. ND=- 1-PAIN R\L to disease process -goal – controlling pain -N. intervention=- -assess pain level -administer analgesic as prescribed -assist patient to comfortable position -maintain NPO to decrease pancreatic enzyme secretion and rest gland -NGT for suction -reassess pain

11. ND=- 2-Fluid volume deficit R\L to vomiting-low intake-fever and fluids shifts -outcome=- maintain fluid balance -N-intervention=- -assess fluid status -I.V FLUID as prescribed -monitor intake and output -provide care for fever -anti emetic as prescribed -reassess fluid status

12. ND=- 3- IN effective breathing pattern R\L to sever pain and pulmonary complication -goal=- Improving respiratory function -N. action=- -assess respiratory rate-rhythm-effort and oxygen saturation -up right position -report sings of respiratory distress -instruct patient to cough and take deep breathing To improve respiratory function