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Endocrine GI Gu Flashcards

1
Q

What are the big signs of hepatitis

A

Weight loss
Fatigue
Cough
Low-grade fever
Loss of appetite

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2
Q

Chronic hepatitis

A

Abnormal liver functions for 6 Plus months alt/ast

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3
Q

What are the diagnostics for hepatitis

A

AST/alt
blood test elevated when liver is in distress

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4
Q

Collaborative care for hepatitis

A

Rest
Well balanced diet
Vitamin supplements
Avoid alcohol

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5
Q

Treatment for hepatitis

A

●It’s hard on the body plan for rest days / afternoons
●Eat more protein
○Liver is best

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6
Q

Medication for hepatitis for A&B

A

Pegylated interferon
That is an immunosuppressant

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7
Q

Hepatitis C medication

A

Pegylated interferon with Ribavirin
If patient acquires a fever tell them to come back to the hospital

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8
Q

What is the chronic progressive disease of the liver
Degeneration and destruction

A

Cirrhosis

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9
Q

End stage liver damage
A/E

A

●Hypovolemic risk
○Increase heart rate
○Increase respiratory
○Increased vomiting - alkalosis
● Ascites toxic fluid

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10
Q

Is there a cure for cirrhosis

A

No

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11
Q

Treatment for ascites

A

Paracentesis to abdomen to remove fluid

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12
Q

Early signs and symptoms of cirrhosis

A

Abdominal pain
Change in bowel habits
Anorexia
Dyspepsia

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13
Q

Later signs and symptoms of cirrhosis

A

Jaundice
Edema
Ascites
Skin lesion
Heme disorders
Endocrine disturbances
Peripheral neuropathies

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14
Q

What is the fourth most common cancer in the world and is it deadly

A

Liver cancer
Yes
Consider palliative care

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15
Q

When does liver cancer usually metastasize

A

Fourth stage

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16
Q

How many liver lobes are there

A

Five

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17
Q

Signs and symptoms of liver cancer

A

Weight loss / anorexia
Peripheral edema
Ascites
Portal hypertension
Dull abdominal pain in RUQ
Increased abdominal girth
Jaundice
Extreme weakness

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18
Q

Diagnostics for liver cancer

A

Biopsy

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19
Q

Acute pancreatitis

A

Immensely painful
Left upper quadrant
Non-movable pain
Fetal position

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20
Q

Signs and symptoms of acute pancreatitis

A

●Gray-turner sign
○Bruising around pancreas
●Cullen sign
○Bruising around belly button
●Inflamed pancreas hypovolemia

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21
Q

Diagnostics for acute pancreatitis

A

●Serum amylase and lipase
○First choice
●Serum glucose
●Serum calcium
○Hypocalcemia

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22
Q

Collaborative care for acute pancreatitis

A

●Pain relief
○Opioids and narcotics
○IV and PCA
●Treat symptoms
●Fluids
●Removal of cause
●Surgical therapy
○Reduction of pancreas secretions

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23
Q

Nursing actions for acute pancreatitis

A

Strict NPO status

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24
Q

Chronic pancreatitis

A

Pancreatic insufficiency

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25
Treatment for chronic pancreatitis
Pancrealipase
26
Reasons for pancreatic cancer
Unknown reason smoking most likely
27
Tumors of pancreatic cancer
Very painful asymptomatic until outside of pancreas
28
Diagnostics for pancreatic cancer
A19-9 tumor marker Don't tell patient
29
Surgery for pancreatic cancer
Whipple procedure removes it
30
Cholelithiasis
Gallbladder inflammation
31
What causes gallstones
Fatty high carb meals
32
Treatment of cholelithiasis
Cholecystectomy Control pain Remove gallbladder Outpatient procedure
33
What happens if a patient starts vomiting after the cholecystectomy
Return to the hospital Clip must have fallen out before healing properly
34
Diabetic insipidus
Passing too much water could lead to fluid volume deficit it is caused by damage to the pituitary gland
35
What could cause damage the pituitary to gland to cause diabetes insipidus
Head injury Brain tumor Brain surgery CNS Infection
36
Signs and symptoms of diabetes insipidus
Dehydration Decreased blood pressure Decreased electrolytes Diluted urine specific gravity(1. 005) Hypernatremia Headache
37
Medicstion for diabetes insipidus
Desmopressin Vasopressin DVVP
38
What nursing interventions should you do for diabetes insipidus
●Days after treatment - water deprivation test ○Take away fluids see if they are able to maintain alone ○If patient becomes violent give water back ●Assess i&o ●Daily weights
39
SIADH definition
Retain too much water - fluid volume overload
40
What are the signs and symptoms of siadh
Low urine output Hyponatremia SEIZURES Increase heart rate Increase respiratory Increase BP - hypertension
41
Diagnostics for siadh
Serum sodium Serum osmolality Specific gravity of urine > 1.025
42
Treatment of siadh
●Hypertonic normal saline ●Diuretics ○Furosemide ●Demeclocycline
43
Nursing interventions for SIADH
Fluid restriction Seizure precaution Oral hygiene Assistance with ambulation
44
Hypothyroidism. (Hashimoto's disease)
High TSH Low T3 Low T4
45
Sign symptoms of hypothyroidism
Gradual change Gain weight Cold intolerance Sluggish fatigue Nail Hair Skin changes
46
Medication for hypothyroidism
●Levothyroxine ○Is a lifelong medication ●Periodic labs required
47
Myxedema coma
Doesn't know they have a thyroid issue Can't wake up Comatose state
48
What triggers myxedema coma
Infection Drugs Exposure to cold Trauma Illness
49
Signs and symptoms of myxedema coma
Subnormal temperature Hypotension Hypoventilation Comatose
50
Treatment of myxedema coma
Levothyroxine can be increased every 4 to 6 weeks
51
Diagnostics for myxedema coma
Low TSH Low T4
52
Nursing interventions for myxedema coma
●Teach low caloric diet ●Proper use of medication ●Self-monitoring ○Bowel movement ○Weight management
53
Hyperthyroidism
Caused by Graves disease overworked thyroid TSH Low T3 High T4 High
54
Signs and symptoms of hyperthyroidism
Heat intolerance Weight loss Muscle wasting Exophthalmos
55
Medications for hyperthyroidism
●Anti thyroid medications ○Propylthiouracil ▪︎Most common ●Beta blockers ○Propranolol ○Atenolol
56
Graves disease definition
Escalated hyperthyroidism
57
Surgery for Graves disease
Thyroidectomy A partial or full surgery
58
Pre-op for Graves disease
●Cough / deep breathing ●Support head ○Don't look up ○Do not hyperextend neck ○Don't turn head or stretch ▪︎Put a C-collar on until healed ●Expected finding ○Difficulty talking will return eventually
59
After surgery for Graves disease
●Trachea collapse after surgery ○Trach cart follows patient
60
Diet for Graves disease
●Six full meals 3,000 calories ○Avoid stimulants ○Chocolate ○Smoking ○Alcohol
61
Thyroid storm shock symptoms
Tachycardia HYPERTHERMIC Delirious
62
Treatment for thyroid storm
PTU propylthiouracil Fluids Antipyretics Cooling blankets Quiet room
63
Cushing syndrome disease definition
Too much ACTH Corticosteroid
64
Sign symptoms of Cushing syndrome
Moon face Microfacture in bones Osteoporosis Buffalo hump
65
Treatment/ Medication for Cushing syndrome
■24-hour urine collection. ●Corticosteroid suppress. ○KETOCONAZOLE ▪︎If not working pituitary gland removal - unlikely ▪︎Adrenalectomy
66
What to monitor for Cushing syndrome
Hyperglycemia Hypertension Hypokalemia
67
Nursing interventions for Cushing syndrome
Reverse isolation precautions protect patient from us patient will be on a lot of corticosteroids delayed healing is expected
68
What to teach a patient with Cushing syndrome
Medical alert bracelet Avoids extreme cold and heat High protein diet
69
Addison's disease
Adrenal 90% gone Bronze skin Shock management
70
Treatment for Addison's disease
Corticosteroids Fluids Insulin Treat symptoms Antipyretic
71
Home teachings for Addison's disease
Glucorticosteroids is lifelong Nausea vomiting Diarrhea Abdominal cramping Sub Q = better to avoid complications
72
Dka treatment
●First hydrate ○Isotonic normal saline ●Second insulin ○Regular insulin (short acting) ●Monitor electrolytes
73
GFR
First for kidney issues Under 15 equals dialysis
74
Risk factors for kidney problems
History of chronic UTI Age and race Issue/affected part Med history Diuretics Hypertension medicine Diabetic medicine
75
Sign symptoms of kidney issues
Skin color Bruising Rash Yellowing ----We'll see on back Edema ----Get accurate weight ---- get accurate blood pressure
76
CVA tenderness
Check for kidney stones Check for infection Check for blockage Pain upon percussion
77
Diagnostics for kidney problems
●1st Urinalysis ○First void of the AM ●2nd Creatinine ○24 hr specimen ▪︎Send home w/pt ▪︎Teach - cool spot not 1st void ●3rd urine culture ○ check bacterial count ▪︎ urethra ▪︎ Kidney If blood culture is normal and patient is not getting better possible sepsis. Bladder scan KUB x-ray IVP
78
AKI
Sudden onset Baseline Hyponatremia Hyperkalemia Thorough history
79
Questions to ask for acute kidney injury
Urinary incontinence Excessive / recent use of ibuprofen Urinary changes Trauma***
80
Treatment of acute kidney injury
Isotonic fluids
81
CKD
Decades to get there Hypertension Diabetes PAD
82
Treatment for CKD
Dialysis Peritoneal dialysis
83
Nursing assessment for CKD
Assess arms/hand Cold pale Check pulse Check CMS
84
Kidney transplant
Unless narcotic or diseased leave patients old one in and structure new one in bod Urine output new one works immediately 24 to 48 hours
85
What do you need to monitor after a kidney transplant
●Electrolytes ●Fluid bolus challenge ○What goes in has to come out ○Give fluids and see how much comes out ▪︎If more comes out than what comes in means it worked well
86
Treatment for kidney transplant
Immunosuppressant drugs ○corticosteroids
87
What to teach after kidney transplant
Watch temperature Avoid crowds Lipoma How to palpate neck and axillary
88
Chronic rejection to kidney transplant
Month 2 years Can work with it
89
Acute kidney rejection
Body attack kidney Can go back on the list
90
BPH
●In large prostate ●Men only ○History of chronic UTIs ○Burning pain upon urination
91
Treatment for BPH
Flomax treats bladder spasms
92
What happens if medication does not treat BPH
●TURP ●Surgery if Med is not working. ○Culture prostate impending flow ○Triple Lumen catheter ▪︎Blood in catheter- clots ▪︎Increase irrigation ◇Avoid clots ◇A few days slow irrigation
93
Gout
Uric acid build up Type of arthritis Pain typically in big toe
94
What is the treatment for gout
Allopurinol = D.O.C.
95
Treatment for siadh
Hypertonic normal saline Furosemide Demyocycline

Med Surg (3 decks)

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