# Situation: A 44-year-old man has chronic pancreatitis from long-term alcohol use and stopped drinking 3 months ago. He has diabetes caused by the pancreatitis and uses insulin glargine and insulin lispro. He also takes pancrelipase capsules. Months later he is admitted with a flare of severe epigastric pain that radiates to his back. Which position is MOST likely to ease his pain?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630500  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 44-year-old man has chronic pancreatitis from long-term alcohol use and stopped drinking 3 months ago. He has diabetes caused by the pancreatitis and uses insulin glargine and insulin lispro. He also takes pancrelipase capsules.

Months later he is admitted with a flare of severe epigastric pain that radiates to his back. Which position is MOST likely to ease his pain?

## 보기

1. Semi-Fowler's with the legs extended
2. Sitting up in bed and leaning forward **✔ 정답**
3. Lying prone with a pillow under the abdomen
4. Lying flat on his back with legs straight

**정답: 2**

## 해설

Pancreatic pain is worse lying flat and is often relieved by sitting up and leaning forward or by lying on the side with the knees drawn up, which reduces stretch on the inflamed retroperitoneal pancreas. Analgesics are given on schedule alongside positioning.

## 심화 해설

The position that eases pancreatic pain
The pancreas lies in the retroperitoneum, behind the stomach and against the spine. When it is inflamed, pain is typically severe, epigastric, and radiates to the back. Lying flat on the back stretches the abdomen and presses the inflamed gland against the posterior abdominal wall, worsening the pain. Sitting up and leaning forward, or lying on the side with the knees drawn up toward the chest (a fetal position), reduces this stretch and pressure. Clients with pancreatitis often find relief by sitting up and leaning forward or side-lying with the knees flexed.

How positioning fits into pain care
Positioning is a comfort measure that complements, not replaces, analgesia. During a flare, analgesics are given on schedule as ordered rather than waiting for severe pain, and the nurse reassesses pain regularly. Other measures include resting the gut as ordered, managing nausea, maintaining fluids, and avoiding alcohol. A client leaning forward over a bedside table with pillows for support can maintain the position comfortably.

| Position | Effect on pancreatic pain |
| --- | --- |
| Sitting up and leaning forward | Reduces stretch on the inflamed pancreas; relieves pain |
| Side-lying with knees flexed | Also relieves pain |
| Semi-Fowler's, legs extended | Helps breathing but less pain relief |
| Prone with pillow under abdomen | Presses on the inflamed area |
| Flat on the back, legs straight | Stretches the abdomen; worsens pain |

Why the other positions are wrong
Semi-Fowler's with the legs extended is useful for breathing and is often used after abdominal surgery, but it does not flex the trunk enough to relieve retroperitoneal pain. Lying prone with a pillow under the abdomen puts direct pressure on the inflamed epigastric area. Lying flat on the back with the legs straight stretches the abdominal wall and is the position that typically worsens pancreatic pain. Watch out! Semi-Fowler's is often the default answer in positioning questions, but pancreatitis has its own characteristic comfort position.

Exam takeaway
Recognize the pattern: epigastric pain radiating to the back, worse lying flat and after meals or alcohol, relieved by leaning forward. Key point! For pancreatitis pain, choose sitting up and leaning forward or the knee-chest side-lying position, alongside scheduled analgesia.

## 임상 시나리오

Positioning in PancreatitisComfort for epigastric pain radiating to the back
The inflamed pancreas lies in the retroperitoneum; lying flat stretches the abdomen and worsens pain.

Sitting up and leaning forward, or lying on the side with the knees drawn up, reduces stretch and eases pain.

Give analgesics on schedule as ordered and reassess pain regularly.

CautionLying flat or prone increases pressure on the inflamed pancreas and worsens pain.

## 핵심 개념

- **Retroperitoneum** — The space behind the peritoneum containing the pancreas, kidneys, and great vessels.
- **Chronic pancreatitis** — Long-term inflammation of the pancreas with recurrent pain and loss of exocrine and endocrine function.
- **Fetal position** — Side-lying with knees drawn up toward the chest, used to relieve abdominal pain.

## 같은 주제 문제

- [Situation: A 58-year-old man with alcohol-associated cirrhosis is admitted with tense asci…](https://mymerci.kr/pages/nclex_q.php?qn_id=630291)
- [Situation: A 58-year-old man with alcohol-associated cirrhosis is admitted with tense asci…](https://mymerci.kr/pages/nclex_q.php?qn_id=630292)
- [Situation: A 58-year-old man with alcohol-associated cirrhosis is admitted with tense asci…](https://mymerci.kr/pages/nclex_q.php?qn_id=630293)
- [Situation: A 58-year-old man with alcohol-associated cirrhosis is admitted with tense asci…](https://mymerci.kr/pages/nclex_q.php?qn_id=630294)
- [Situation: A 58-year-old man with alcohol-associated cirrhosis is admitted with tense asci…](https://mymerci.kr/pages/nclex_q.php?qn_id=630295)
- [Situation: A 46-year-old woman with obesity is admitted with acute cholangitis caused by a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630296)
- [Situation: A 46-year-old woman with obesity is admitted with acute cholangitis caused by a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630297)
- [Situation: A 46-year-old woman with obesity is admitted with acute cholangitis caused by a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630298)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._