CCRN Flashcards
Kehr’s Sign
Left shoulder pain due to diaphragmatic irritation common in ruptured spleen
Grey Turner’s
Ecchymosis of the flank, common in retroperitoneal bleed
Cullen’s Sign
Ecchymosis around the umbilicus, common in intraperitoneal bleed
Bowel sounds in the chest:
sign oof diaphragm rupture
Free air on abdominal xray
GI perf
Normal bladder pressure
0-5
Where do you place transducer for the bladder pressure
at the level of the symphysis pubis
How to maintain abdominal compartment syndrome
-HOB 20 or less or reverse tren.
-ngt to low intm suction
What is bowel infarction
reduced blood flow to the mesenteric vessels with prolonged ischemia– will see abdominal distention, abdominal pain and cramping, HYPOACTIVE OOR ABSENT BOWEL SOUNDS
3 common types of bowel obstruction
Paralytic Ileus, SBO and LBO
SBO
vomiting early, small distention, hypokalemia, high pitches bowel sounds
LBO
vomiting late, large distention, low pitched bowel sounds, recent change in bowel habits
Bowel Perf
leak of GI contents into the peritoneal cavity causing infection and inflammation
Acute liver failure
common cause is Tylenol OD, liver will be enlarged and felt on palpation
Late/ chronic liver failure
common cause is alcohol abuse, the liver will become non-palpable
Presentation of Liver Failure
-Jaundice: elevated bilirubin
-AMS: high ammonia
-Asterixis: high ammonia
-Ascites: low protein and albumin
-Hepatorenal syndrome
-Sepsis
Liver Failure Labs
-Pancytopenia (low WBC, RBC, platelets)
-Inc PT and OPTT
-Dec fibrinogen
- Inc AST, ALT
-Low glucose
Neomycin
helps to kill gut bacteria that is responsible for producing ammonia– can cause a Vitamin K deficiency
TIPPS Procedure
palliative procedure for liver failure– relieve pressure on esophageal varices or ascites
Blakemore Tube
used to tamponade the bleeding of esophageal varices– keep scissors at the side of the bed
Meds for Upper GI bleeds
give H2 blockers and PPIs
vasopressin
octreotide
sorbitol
betablockers
Acute pancreatitis S/S:
-abd pain in all quadrants
-N/V and rigid abdomen
-dec or absent bowel sounds
-inc WBC, amylase and lipase
-decreased calcium
-inc BS
Acute Pancreatitis Complication
-Left pleural effusion
-LLL atelectasis (from the lifting of the diaphragm)
-Bilateral crackles or rales
-ARDS… Death
Signs of Hemorrhagic Pancreatitis
ECCHYMOSIS Cullen’s (umbilicus) and Grey Turner’s (flank)
