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Nursing of Adults I > Chapter 48: Liver, Biliary Tract, and Pancreas Problems (Part 2- Gallbadder, Pancreas) > Flashcards

Chapter 48: Liver, Biliary Tract, and Pancreas Problems (Part 2- Gallbadder, Pancreas) Flashcards

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1
Q

in a patient with pancreatitis, a clear-liquid diet may be given (and then progressed) once these two things are present

A

bowel sounds have returned
no pain

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2
Q

in gallbladder disorders, direct bilirubin is _____________ and is indicative of _____________ process in liver and biliary system

A

increased, obstructive

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3
Q

if stones are located in the common bile duct, surgeons explore the duct and place ________ in common bile duct to maintain patency; this allows bile to pass from liver to duodenum until edema from surgery diminishes

A

T-tube

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4
Q

minimally invasive method to remove gallbladder

A

laparoscopic cholecystectomy

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5
Q

this type of surgery can be done if tumor is limited to the head of the pancreas with no node involvement or metastasis (pancreatic cancer)

A

Whipple resection

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6
Q

gallstones are more common in (men, women) and with age

A

women

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7
Q

bulky fatty stool from lack of pancreatic lipase

A

steatorrhea

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8
Q

predominant sign of cholecystitis

A

severe, steady RUQ pain that radiates to mid upper back or to right scapula/shoulder and lasts 12-18 hours

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9
Q

if asymptomatic and low risk for complications, treatment for gallbladder disorders may be _____________

A

conservative

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10
Q

these two pancreatic cancer treatments are palliative

A

chemotherapy, radiation

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11
Q

diagnostic method of choice for gallbladder disorders: checks for gallstones and dilated duct, wall inflammation, presence of abnormal fluid, and whether the gallbladder is emptying or not

A

ultrasound

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12
Q

this lab may be increased from inflammation (pancreatitis)

A

white blood cell (WBC)

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13
Q

client that experiences frequent symptoms, has acute cholecystitis, or has very large gallstones typically has this treatment

A

gallbladder and stones surgically removed

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14
Q

health promotion for pancreatitis should address these five things

A

alcohol, smoking, stress, diet, infection symptoms

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15
Q

two most common causes of pancreatitis

A
  1. gallbladder disease
  2. chronic alcohol use
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16
Q

to help prevent gallbladder disorders, teach about changing __________________, educate on dangers of ________ dieting, and possibly implement ____________________

A

modifiable risk factors, yo-yo, cholesterol-lowering drugs

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17
Q

cholelithiasis or cholecystitis: may present with fever and chills

A

cholecystitis

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18
Q

this type of procedure can be done for pancreatic cancer; connects the pancreatic duct, common bile duct, and/or stomach to the jejunum

A

anastomoses

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19
Q

this complementary therapy decreases gallbladder symptoms and stimulates bile secretion

A

goldenseal

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20
Q

pancreatitis usually occurs in this age group

A

50-60

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21
Q

complication of Whipple resection

A

leaking of digestive juices from healing and breakdown (will have drain)

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22
Q

first sign of pancreatic cancer

A

jaundice

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23
Q

maintain ___________ of T-tube site because bile is irritating

A

cleanliness

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24
Q

in a T-tube patient, if stool color is pale, do this

A

clamp tube per order and monitor response

25
Q

if gallbladder is ___________ or ____________, may not be candidate for laparoscopic cholecystectomy and may require open surgical method

A

very large, infected

26
Q

manifestations include epigastric pain and/or RUQ pain, intolerance to fatty foods, nausea, flatulence, bloating, abdominal distention, diarrhea, chest pain

A

cholelithiasis

27
Q

what is Turner’s sign?

A

bruising on the side

28
Q

seven risk factors for pancreatitis

A
  1. alcohol consumption
  2. biliary obstruction
  3. peptic ulcers
  4. trauma
  5. hypertriglyceridemia
  6. extreme hyperlipidemia
  7. some medications
29
Q

if patient goes home with T-tube, teach about these two things

A

cannot have tub bath
manifestations of infection

30
Q

ethnic group in which gallbladder disorders are more common

A

Native American

31
Q

cholelithiasis gallstones are made up of these two things

A

cholesterol
calcium bilirubinate

32
Q

gallstones result from a combination of factors, including these three

A

biliary stasis
abnormal composition and reabsorption
inflammation of gallbladder

33
Q

to diagnose pancreatic cancer, a(n) ____________ or ____________ is done followed by _________________________

A

CT scan, needle aspiration, tumor marker staging

34
Q

in pancreatitis, this electrolyte may be decreased

A

calcium

35
Q

T-tube drainage is expected to be this color

A

bloody green brown

36
Q

cholelithiasis pain occurs in these two areas (include any places pain radiates to and when pain may occur)

A

epigastric pain or RUQ pain
chest pain that may radiate to mid/upper back and right scapula (usually 1 hour after eating and can last 4-5 hours)

37
Q

when flow of bile out of gallbladder is obstructed, gallbladder becomes ______________, and ________________ response is initiated

A

distended, inflammatory

38
Q

this lab may be increased from possible pancreatic necrosis (pancreatitis)

A

C-reactive protein (CRP)

39
Q

most gallbladder disorders result in _______________ bile flow from the liver to the gallbladder to the duodenum

A

obstructed

40
Q

T-tube post-op patients should be placed in ____________ position to allow for drainage

A

Fowler’s

41
Q

cholelithiasis or cholecystitis: does not present with fever or chills

A

cholelithiasis

42
Q

during an acute gallbladder attack, patient should be kept _________ and may need a(n) _____________ to relieve nausea and vomiting

A

NPO, NG tube

43
Q

gallstones may follow __________ surgery due to weight loss or from certain drugs such as ________________ and __________

A

bariatric, oral hypertensives, ceftriaxone (Rocephin)

44
Q

most common cause of cholelithiasis inflammation

A

gallstone lodged in cystic duct

45
Q

monitor T-tube drainage and record every _________

A

8 hours

46
Q

what is Cullen’s sign?

A

bruising on the abdomen

47
Q

in pancreatitis, these two lab work tests, when elevated, indicate an obstructed bile duct

A

bilirubin, alkaline phosphatase

48
Q

pain presentation of pancreatitis: _______, ________, _________ gastric pain that
1. is worse when __________ or when __________
2. may radiate to left or right side of _______
3. may feel better in _________ position or _______________ with knees _______

A

sudden, severe, steady, lying supine, walking, back, sitting, leaning forward, bent

49
Q

best imaging test for pancreatitis and related complications such as pseudocysts and abscesses

A

CT scan

50
Q

two lab work tests that are expected to be elevated with pancreatitis

A

serum amylase (also urinary amylase)
serum lipase

51
Q

most common cause of obstructed bile flow

A

gallstones

52
Q

when caring for a patient with a T-tube, monitor stool ________

A

color

53
Q

five risk factors for gallstones

A

obesity
diabetes
high estrogen states
hyperlipidemia
Crohn’s disease

54
Q

it is not uncommon for T-tube drainage to be ______ in first day, then it decreases to _______ by day 3

A

0.5-1 L, 200 mL

55
Q

patient with pancreatitis needs to be kept ________ to prevent normal secretions from stimulating pancreas to release pancreatic enzymes

A

NPO

56
Q

when food is allowed, a pancreatitis patient should have a diet high in ____________ and low in _____________

A

carbohydrates, fats

57
Q

jaundice may occur if gallstone becomes __________, causing hepatocyte damage from __________ into liver

A

lodged, bile reflux

58
Q

if bile flow is obstructed, __________________ and ___________ may need to be administered (gallbladder problems)

A

fat soluble vitamins, bile salts

Nursing of Adults I (21 decks)

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