1. Pancreaticoduodenectomy “Whipple” By: Taylor Sand

2. The Whipple Procedure Removal of the head of the pancreas, the gallbladder, portions of the duodenum, small portions of the stomach, and the lymph nodes near the head of the pancreas Surgeon reconnects the remaining pancreas and digestive organs. Commonly performed surgery to remove tumors in the pancreas

3. Before and After

4. Complications Delayed gastric emptying; stomach takes too long to empty its contents Supplemental feedings by a feeding tube Abdominal infection; leakage where the pancreas has been connected to the intestine Only 10% of patients have major complications

5. Nursing Care Drains NG tube Folly Catheter I’s & O’s Pneumatic boots Antibiotics Pain Management Patient Teaching www.weavinggrace.com

6. Fun Facts Named after Allen Oldfather Whipple Head of the pancreas where approximately 75% of pancreatic cancer tumors occur Most common operation to treat pancreatic cancer Surgery requires between 4 and 6 hours to complete depending on circumstances

7. Pancreatic Cancer Accounts for only about 2.4% of new cancer diagnoses each year Fourth most frequent cause of cancer death in both men and women Responds poorly to treatment Spreads rapidly www.imdb.com www.fanpop.com

8. NLCEX Questions 1. The physician has scheduled a Whipple procedure for a client with pancreatic cancer. The nurse recognizes that the client’s cancer is located in: a. The tail of the pancreas b. The head of the pancreas c. The body of the pancreas d. The entire pancreas

9. NCLEX Questions 2. The doctor has ordered Percocet (oxycodone) for a client following abdominal surgery. The primary objective of nursing care for the client receiving an opiate analgesic is to: a. Prevent addiction b. Alleviate pain c. Facilitate mobility d. Prevent nausea

10. NCLEX Questions 3. A patient's family does not know the patient's end- of-life care preferences, but assumes that they know what is best for the patient under the circumstances. This assumption reflects: a. Justice b. Paternalism c. Pragmatism d. Veracity

11. NCLEX Questions 4. A medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the patient becoming angry with the physicians and nursing staff. The best approach to diffuse the emotionally charged discussion is to: a. Allow patient and family members time to be alone b. Arrange time for the patient to speak to another patient with cancer c. Direct the discussion and validation of emotion, without reassurance d. Request a consult from a social worker on the oncology unit

12. References Mayo Clinic - Mayo Clinic. (n.d.). Retrieved October 9, 2014. www.mayoclinic.com www.mayoclinic.com Whipple Procedure: Effects, Success Rate, and More. (n.d.). Retrieved October 9, 2014. www.webmd.comwww.webmd.com Bhosale, P., Fleming, J., Balachadran, A., Charnsagavej, C., & Tamm, E. (2012, May 24, 2012). Complications of a Whipple surgery: Imaging analysis. Springer Science & Business Media, 273-284. http://dx.doi.org/10. 1007/s00261-012-9912-4