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Med Surg > Endocrine GI Gu > Flashcards

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
Q

Treatment for chronic pancreatitis

A

Pancrealipase

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26
Q

Reasons for pancreatic cancer

A

Unknown reason smoking most likely

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27
Q

Tumors of pancreatic cancer

A

Very painful asymptomatic until outside of pancreas

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28
Q

Diagnostics for pancreatic cancer

A

A19-9 tumor marker
Don’t tell patient

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29
Q

Surgery for pancreatic cancer

A

Whipple procedure removes it

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30
Q

Cholelithiasis

A

Gallbladder inflammation

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31
Q

What causes gallstones

A

Fatty high carb meals

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32
Q

Treatment of cholelithiasis

A

Cholecystectomy
Control pain
Remove gallbladder
Outpatient procedure

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33
Q

What happens if a patient starts vomiting after the cholecystectomy

A

Return to the hospital
Clip must have fallen out before healing properly

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34
Q

Diabetic insipidus

A

Passing too much water could lead to fluid volume deficit it is caused by damage to the pituitary gland

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35
Q

What could cause damage the pituitary to gland to cause diabetes insipidus

A

Head injury
Brain tumor
Brain surgery
CNS Infection

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36
Q

Signs and symptoms of diabetes insipidus

A

Dehydration
Decreased blood pressure
Decreased electrolytes
Diluted urine specific gravity(1. 005) Hypernatremia
Headache

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37
Q

Medicstion for diabetes insipidus

A

Desmopressin
Vasopressin
DVVP

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38
Q

What nursing interventions should you do for diabetes insipidus

A

●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

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39
Q

SIADH definition

A

Retain too much water - fluid volume overload

40
Q

What are the signs and symptoms of siadh

A

Low urine output
Hyponatremia
SEIZURES
Increase heart rate
Increase respiratory
Increase BP - hypertension

41
Q

Diagnostics for siadh

A

Serum sodium
Serum osmolality
Specific gravity of urine > 1.025

42
Q

Treatment of siadh

A

●Hypertonic normal saline
●Diuretics
○Furosemide
●Demeclocycline

43
Q

Nursing interventions for SIADH

A

Fluid restriction
Seizure precaution
Oral hygiene
Assistance with ambulation

44
Q

Hypothyroidism. (Hashimoto’s disease)

A

High TSH
Low T3
Low T4

45
Q

Sign symptoms of hypothyroidism

A

Gradual change
Gain weight
Cold intolerance
Sluggish fatigue
Nail Hair Skin changes

46
Q

Medication for hypothyroidism

A

●Levothyroxine
○Is a lifelong medication
●Periodic labs required

47
Q

Myxedema coma

A

Doesn’t know they have a thyroid issue
Can’t wake up
Comatose state

48
Q

What triggers myxedema coma

A

Infection
Drugs
Exposure to cold
Trauma
Illness

49
Q

Signs and symptoms of myxedema coma

A

Subnormal temperature
Hypotension
Hypoventilation
Comatose

50
Q

Treatment of myxedema coma

A

Levothyroxine can be increased every 4 to 6 weeks

51
Q

Diagnostics for myxedema coma

A

Low TSH
Low T4

52
Q

Nursing interventions for myxedema coma

A

●Teach low caloric diet
●Proper use of medication
●Self-monitoring
○Bowel movement
○Weight management

53
Q

Hyperthyroidism

A

Caused by Graves disease overworked thyroid
TSH Low
T3 High
T4 High

54
Q

Signs and symptoms of hyperthyroidism

A

Heat intolerance
Weight loss
Muscle wasting
Exophthalmos

55
Q

Medications for hyperthyroidism

A

●Anti thyroid medications
○Propylthiouracil
▪︎Most common
●Beta blockers
○Propranolol
○Atenolol

56
Q

Graves disease definition

A

Escalated hyperthyroidism

57
Q

Surgery for Graves disease

A

Thyroidectomy A partial or full surgery

58
Q

Pre-op for Graves disease

A

●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
Q

After surgery for Graves disease

A

●Trachea collapse after surgery
○Trach cart follows patient

60
Q

Diet for Graves disease

A

●Six full meals 3,000 calories
○Avoid stimulants
○Chocolate
○Smoking
○Alcohol

61
Q

Thyroid storm shock symptoms

A

Tachycardia
HYPERTHERMIC
Delirious

62
Q

Treatment for thyroid storm

A

PTU propylthiouracil
Fluids
Antipyretics
Cooling blankets
Quiet room

63
Q

Cushing syndrome disease definition

A

Too much ACTH
Corticosteroid

64
Q

Sign symptoms of Cushing syndrome

A

Moon face
Microfacture in bones
Osteoporosis
Buffalo hump

65
Q

Treatment/ Medication for Cushing syndrome

A

■24-hour urine collection.
●Corticosteroid suppress.
○KETOCONAZOLE
▪︎If not working pituitary gland removal - unlikely
▪︎Adrenalectomy

66
Q

What to monitor for Cushing syndrome

A

Hyperglycemia
Hypertension
Hypokalemia

67
Q

Nursing interventions for Cushing syndrome

A

Reverse isolation precautions protect patient from us patient will be on a lot of corticosteroids delayed healing is expected

68
Q

What to teach a patient with Cushing syndrome

A

Medical alert bracelet
Avoids extreme cold and heat
High protein diet

69
Q

Addison’s disease

A

Adrenal 90% gone
Bronze skin
Shock management

70
Q

Treatment for Addison’s disease

A

Corticosteroids
Fluids
Insulin
Treat symptoms
Antipyretic

71
Q

Home teachings for Addison’s disease

A

Glucorticosteroids is lifelong
Nausea vomiting
Diarrhea
Abdominal cramping
Sub Q = better to avoid complications

72
Q

Dka treatment

A

●First hydrate
○Isotonic normal saline
●Second insulin
○Regular insulin (short acting) ●Monitor electrolytes

73
Q

GFR

A

First for kidney issues
Under 15 equals dialysis

74
Q

Risk factors for kidney problems

A

History of chronic UTI
Age and race
Issue/affected part
Med history
Diuretics
Hypertension medicine
Diabetic medicine

75
Q

Sign symptoms of kidney issues

A

Skin color
Bruising
Rash
Yellowing
—-We’ll see on back
Edema
—-Get accurate weight
—- get accurate blood pressure

76
Q

CVA tenderness

A

Check for kidney stones
Check for infection
Check for blockage
Pain upon percussion

77
Q

Diagnostics for kidney problems

A

●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
Q

AKI

A

Sudden onset
Baseline
Hyponatremia
Hyperkalemia
Thorough history

79
Q

Questions to ask for acute kidney injury

A

Urinary incontinence
Excessive / recent use of ibuprofen Urinary changes
Trauma***

80
Q

Treatment of acute kidney injury

A

Isotonic fluids

81
Q

CKD

A

Decades to get there
Hypertension
Diabetes
PAD

82
Q

Treatment for CKD

A

Dialysis
Peritoneal dialysis

83
Q

Nursing assessment for CKD

A

Assess arms/hand
Cold pale
Check pulse
Check CMS

84
Q

Kidney transplant

A

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
Q

What do you need to monitor after a kidney transplant

A

●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
Q

Treatment for kidney transplant

A

Immunosuppressant drugs ○corticosteroids

87
Q

What to teach after kidney transplant

A

Watch temperature
Avoid crowds
Lipoma
How to palpate neck and axillary

88
Q

Chronic rejection to kidney transplant

A

Month 2 years
Can work with it

89
Q

Acute kidney rejection

A

Body attack kidney
Can go back on the list

90
Q

BPH

A

●In large prostate
●Men only
○History of chronic UTIs
○Burning pain upon urination

91
Q

Treatment for BPH

A

Flomax treats bladder spasms

92
Q

What happens if medication does not treat BPH

A

●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
Q

Gout

A

Uric acid build up
Type of arthritis
Pain typically in big toe

94
Q

What is the treatment for gout

A

Allopurinol = D.O.C.

95
Q

Treatment for siadh

A

Hypertonic normal saline
Furosemide
Demyocycline

Med Surg (3 decks)

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