A nurse in a medical-surgical unit is caring for a client. Exhibits For each finding, click to specify if the finding is consistent with pancreatitis or peritonitis. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Rationale: Bloody stools: Bloody stools are not a typical finding in either acute pancreatitis or peritonitis. They are more commonly associated with lower GI pathologies such as diverticulosis, hemorrhoids, or inflammatory bowel disease. Their absence here does not support either condition. Hyperbilirubinemia: Hyperbilirubinemia (total bilirubin 3.7 mg/dL) may occur with pancreatitis, especially if there is biliary obstruction due to inflammation or gallstones. Obstructed bile flow leads to accumulation of bilirubin, causing jaundice as seen in this client’s yellow sclera and palate. Elevated WBC count: Leukocytosis (WBC 18,000/mm³) is a systemic inflammatory response commonly seen in both acute pancreatitis and peritonitis. In pancreatitis, this reflects the inflammatory process of autodigestion of the pancreas. In peritonitis, it reflects infection and inflammation of the peritoneal cavity. Abdominal pain: Severe abdominal and epigastric pain radiating to the back is classic for acute pancreatitis. Peritonitis can also cause diffuse abdominal pain with guarding and rigidity, particularly when the peritoneum becomes inflamed. The pain in peritonitis often worsens with movement, while pancreatitis pain may worsen with eating or lying flat.