A nurse is assessing a client post-liver transplant for signs of rejection. Which finding is most concerning?

Choice A reason: Oral analgesics are less effective in acute pancreatitis due to severe pain and potential gastric dysmotility from inflammation. IV opioids provide faster, more reliable pain relief, as oral absorption may be impaired, making this a less appropriate choice for acute pain management.

Choice B reason: A high-fiber diet is contraindicated in acute pancreatitis, as it stimulates digestion, increasing pancreatic enzyme secretion and worsening inflammation and pain. Patients are typically kept NPO (nothing by mouth) to rest the pancreas, making this an inappropriate intervention for pain control.

Choice C reason: IV opioid analgesics, such as morphine or fentanyl, are the preferred treatment for severe pain in acute pancreatitis. They provide rapid, effective analgesia by acting on central pain receptors, reducing discomfort without stimulating pancreatic activity, making this the priority intervention for pain management.

Choice D reason: Applying a warm compress to the abdomen is contraindicated, as heat may increase inflammation and blood flow to the pancreas, worsening pain and tissue damage. Pain management in pancreatitis relies on pharmacological interventions, making this an incorrect and potentially harmful action.

Choice A reason: Excessive alcohol consumption is a leading cause of pancreatic disease, particularly chronic pancreatitis. Alcohol induces oxidative stress and toxic metabolites, damaging pancreatic acinar cells, leading to inflammation, fibrosis, and impaired enzyme secretion, making it a well-established risk factor for pancreatic pathology.

Choice B reason: Excessive vitamin C intake is not associated with pancreatic disease. High doses may cause gastrointestinal upset or kidney stones but do not directly damage the pancreas or contribute to conditions like pancreatitis, making this an unlikely and irrelevant risk factor for pancreatic issues.

Choice C reason: A very low-fat diet is not a common cause of pancreatic disease. While low-fat diets may be recommended for pancreatitis management, they do not contribute to its development. Pancreatic damage is more linked to alcohol or gallstones, not dietary fat restriction.

Choice D reason: A high protein diet is not a primary risk factor for pancreatic disease. Excessive protein may stress the kidneys or liver in certain conditions, but it does not directly cause pancreatitis or other pancreatic disorders, unlike alcohol, which has a direct toxic effect on the pancreas.