Adult Health Study Guide Exam 4 Flashcards
-Appendicitis: signs/sx, pre and post-surgical nursing care for pt with appendicitis, complications
Signs/sx-
Pre and post- surgical-
complications-
-Peritonitis: s/sx, nursing interventions, labs associated
S/Sx:
Nursing interventions:
Labs:
difference between crohn’s disease and ulcerative colitis
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What is the nursing care/treatment for each, s/sx of each
Crohn’s s/sx
Ulcerative Colitis- s/sx
-Celiac disease: s/sx, cause, therapy (dietary tx)
gluten free- abdominal pain, inflammation of the small intestine
Diverticulosis vs diverticulitis: s/sx of each, how are the two different, causes? Nursing interventions for each and diet tx
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Obesity/malnutrition
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-What are anthropometric measurements?
height weight- nutritional status
-What are common s/sx of malnutrition and associated labs with malnutrition?
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What is the difference between kwashiorkor and marasmus?
Kwashiorkor-
Marasmus-
Enteric vs. parenteral nutrition: what are indications for each, routes of delivery, nursing care and complications for each?
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What is obesity and complications of obesity? Nursing implications/care- surgical interventions?
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-Bariatric surgery- indications, pre-post-op care. What is dumping syndrome? Dietary management?
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What is cholecystitis? What are common causes, s/sx, nursing care? Post-op cholycystectomy care?
acute cholecystitis- inflammation of gallbladder- usually get gallstones,
Chronic cholecystitis- repeated episodes of cystic duct obstruction result in chronic inflammation, pancreatitis, jaundice, icterus, obstructive jaundice,
Clinical manifestations- Upper abd pain, possibly radiating to right shoulder or triggered by high-fat meal
Flatulence, dyspepsia, eructation, anorexia, nausea and vomiting
Rebound tenderness
Fever
Steatorrhea (fatty stools) and jaundice (associated with chronic cholycystitis)
Risk Factors-The four F’s (female, forty, fat and fertile) Rapid wt. loss or prolonged fasting Long-term TPN use Family hx Gastric bypass Cystic fibrosis Glucose intolerance
diagnosis-No one specific lab test; look at LFT’s (GGT/LDH), alkaline phosphatase, WBC’s, bilirubin
Abdominal ultrasound: right upper quadrant: see edema and fluid around gallbladder
Cholangiogram to visualize gall bladder and bile ducts
ERCP endoscopic retrograde cholangopancreatography- visualizes bile ducts, pancreas and gall bladder
What is pancreatitis? What are common causes, s/sx, nursing care? Complications? Labs associated?
Can be mild to possibly life-threatening inflammatory process of the pancreas: can be acute or chronic
Inflammation/autodigestion
Necrotizing hemorrhagic pancreatitis/necrosis of blood vessels
Pancreatic pseudocyst
Malabsorption of fats
Diabetes mellitus
Clinical manifestations-Severe abdominal pain, nausea and vomiting
Cullen’s sign/Turner’s sign (periumbilical and flank ecchymosis).
Bowel sounds diminished/ileus
Abdominal tenderness, rigidity, guarding
Pancreatic ascites/pleural effusions
Significant changes in vital signs/shock
Lab assessment
- Amylase(stays elevated 48-72 hrs)
- Lipase (stays elevated for several days longer)
-Serum ALT (three fold rise or greater….biliary pancreatitis) WBC -Glucose -Bilirubin -Hypocalcemia table 59-4
-Monitor for signs of shock
What is cirrhosis: causes, s/sx, most common complications? Labs associated? Treatments for associated problems (ex. Portal htn, hepatic encephalopathy, ascites, bleeding varices, hepatopulmonary syndrome).
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How are the various viral hepatitis contracted: A,B,C,D,E? What are preventative measures?
A- spread fecal-oral route
B-unprotected sex, sharing needles, blood transfusions,
C- similar to B however it is the leading indication for liver transplantation in US!
D- transmitted by parenteral routes
E- resembles Hep A- fecal oral route
-General causes of liver disease?
cirrhosis, bilirary diseases, autoimmune liver disease, liver cancer, Hep B and C, alcoholic liver disease, NAFLD, fulminant acute liver failure
When is a liver transplant indicated? Post-op care…signs of rejection?
Donors- usually trauma victims-
immunosuppressant therapy- life long
-What is NAFLD? What are some causes and treatments?
Fatty inflitration of liver tissue that can lead to cirrhosis- most common cause of liver disease in the world- associated with diabetes type 2, obesity, and metabolic syndrome- may be asymptomatic- will see elevated liver enzymes (ALT and AST)-
Treatment- weight loss- glucose control, and lowering lipids
General GI stuff to know: how to insert an NGT or feeding tube? Caring for a pt. undergoing EGD and paracentesis
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