Pancreatitis Diagnosis for New Nurse Practitioners

Рет қаралды 6,987

Күн бұрын

Epigastric pain as a chief complaint happens ALL the time in primary care. And we all order labs to help rule out pancreatitis, but most clinicians feel uncomfortable with diagnosing pancreatitis in primary care. Even though it’s not that common, it’s certainly a red flag diagnosis to watch out for.
In this video I cover:
✅ The main causes of pancreatitis
✅ What labs to order and what to look out for
✅ The criteria for diagnosing pancreatitis
✅ The next steps to take when you suspect it
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Пікірлер: 25

@ibrahmarshad7309 3 жыл бұрын

I love you for this! don’t ever stop making these videos please!!!

@RealWorldNP 3 жыл бұрын

So glad it's helpful!

@blessedlh3860 3 жыл бұрын

Thank you for your quick and thorough presentation. I am enjoying learning on your channel. Please keep the videos coming.

@RealWorldNP 3 жыл бұрын

Thank you! Will do!

@cherylann2271 3 жыл бұрын

Thank you, this was helpful, starting advance patho this summer. I had pancreatitis once and it was the worst pain I’ve ever experienced. I spent 5 days in the hospital.

@RealWorldNP 3 жыл бұрын

Glad you are better!

@marieguerline4343 3 жыл бұрын

Thanks for your presentations, very knowledgeable.

@RealWorldNP 3 жыл бұрын

Glad you like them! Thanks for watching!

@jeremiahvelasquez563 3 жыл бұрын

Awesome, thank you!

@RealWorldNP 3 жыл бұрын

You're welcome!

@ddtravers1 3 жыл бұрын

super helpful, thank you!

@RealWorldNP 3 жыл бұрын

Glad it was helpful!

@jenniferwoodring1410 3 жыл бұрын

Very helpful review thanks

@RealWorldNP 3 жыл бұрын

Glad it was helpful!

@karenburhenn1686 3 жыл бұрын

Hi, Thanks for this great presentation. I did not catch your thoughts on imaging? CT vs US?

@RealWorldNP 3 жыл бұрын

Totally! You're welcome! Contrast ab CT is typically the imaging of choice for patients with a concern of pancreatitis, it's difficult to see the pancreas on ultrasound. MRI is also an option but I see CT more often in terms of accessibility/insurance.

@slehman80able 3 жыл бұрын

Hey Liz, you are wonderful; oh how I wish rapid transport of knowledge from your brain to mine was possible :) I know you said that you have never actually witnessed pancreatitis in person. To premise this, I should mention that I am a new grad NP (still in the credentialing process, so not seeing patients yet.) However, while working in as a RN in the ED, I have seen many presentations of acute pancreatitis, these patients are in severe pain. With that in mind, while watching this all I could think was "would we keep a patient who presents with these symptoms to do a work up or send the directed to the ED?" In conclusion of your video it made more sense, because moderate cases can be treated on a outpatient bases. All that said, it got my wheels turning, and made me wonder, would you (or anyone else reading this) do a workup in the office on someone who presents with this type of severe abdominal pain or send them to the ED? I know its never black and white and variables such as turn around times on diagnostics would have to be considered. Just curious of your thoughts. Thanks for ALL YOU DO!!

@RealWorldNP 3 жыл бұрын

You're so welcome! Such great questions. It's really case by case as you said, it depends on the severity of the pain, the vital sign stability, and your differentials. If your differentials included something that was imminently dangerous or needed diagnostic clarity ASAP with imaging, most of the time they need to get sent to the ED. So sometimes even mild to moderate cases are pancreatitis are concerning when you see them-- before you get lab results-- and so if you make that decision to order a stat CT, most of the time that's done in the ER. It's tricky clinical judgment decisions though! And I use that guidemarker if I'm trying to order one or more labs/tests stat, they need attention in the ER setting, especially if there are red flag diagnoses at play.

@dr.julietfarrell8849 2 жыл бұрын

Excellent!

@brendaca7234 7 ай бұрын

Another cause is complications from an ERCP. That’s what caused mine.

@RealWorldNP 7 ай бұрын

Correct! ERCP can cause acute pancreatitis.

@Lunal0v 2 жыл бұрын

What about chronic pancreatitis ? I’ve been told their lipase and amylase may be elevated with chronic pancreatitis. Will a CT w/contrast rule out an obstructed bilary stone ? Thanks

@RealWorldNP 2 жыл бұрын

A CT with contrast generally assists in determining severity disease process in chronic pancreatitis and diagnosis of biliary colic. Biliary stones independent of pancreatitis though, an ultrasound is generally appropriate and less invasive. Amylase and lipase may be slightly elevated in Chronic pancreatitis but usually higher in acute pancreatitis.

@cindyhotchkiss8607 11 ай бұрын

What was the imaging that should be used

@RealWorldNP 11 ай бұрын

Thanks for your question. The imaging you chose depends on the other differential diagnosis . Options include ; Abdominal ultrasound, CT of abdomen, or MRCP.