Acute pancreatitis is an inflammatory condition of the exocrine pancreas caused by premature activation of digestive enzymes within the gland, leading to autodigestion of pancreatic tissue and surrounding structures. It ranges from mild self-limiting interstitial edematous pancreatitis (80–85% of cases) to severe necrotizing pancreatitis with multi-organ failure (15–20%, mortality 15–35%). Missing early deterioration — particularly the shift from interstitial to necrotizing disease — results in septic complications, ARDS, and preventable death. Top 3 Nursing Priorities: 1. Aggressive IV fluid resuscitation in the first 24–48 hours (lactated Ringer's 250–500 mL/hr) — inadequate early hydration is the single most modifiable factor that drives progression to necrotizing pancreatitis. 2. Pain management with titrated opioids + positioning (fetal position, side-lying) — adequate pain control enables deep breathing, reducing atelectasis and aspiration risk. 3. Monitor for systemic complications using the Ranson criteria and BISAP score — early identification of severe disease drives ICU transfer before cardiorespiratory failure develops. Common NCLEX Trap: Students delay nutrition until pain fully resolves and amylase/lipase normalize. Evidence supports early enteral nutrition (within 24–72 hours) via nasojejunal tube in severe pancreatitis...