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4-Fourth Semester > exam 4- gi/ hepatic > Flashcards

exam 4- gi/ hepatic Flashcards

1
Q

Gastric Analysis- how does it work

A

gastric secretions by inserting ng tube into stomach and taking contents out-

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2
Q

gastric analysis

npo how long
assess x2

A

npo for 8-12 hrs,

assess meds and baseline vitals

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3
Q

PTC (Percutaneous Transhepatic Cholangiography)-

how does it work

assess what

A

evaluates filling of hepatic/biliary ducts- contrast medium is injected- a

assess allergy to iodine

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4
Q

ERCP (Endoscopic Retrograde Cholangio-Pancreatography)-

vsiaulzes what

retrieves what

assess what

A

visaulzed gi structures to retrieve gallstones from common bile duct-

assess allergy to contrast medium

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5
Q

Liver Biopsy-

rules out what
no what med
assess what

A

rules out metastic cancer-

no anticoagulants a week before-

assess baseline vitals

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6
Q

Barium Enema-

what does it do
what w colon
what diet

A

identify structure abnomralites of colon and rectum-

colon needs to be free of fecal matter-

clear liquid

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7
Q

Barium Swallow (Upper GI series)-

diagnosis what
drink what

A

diagnose conditions of esophagus and stomach-

pt drink 16-20 oz of chalky liquid-

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8
Q

Barium Enema

npo how long

after test do what

A

go npo 8 hrs before,

after test make sure pt takes laxitves to remove it in bile

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9
Q

Esophagogastroduodenoscopy (EGD)-

visualzes what
what time

A

directly visualizes the mucous membranes of esophagus, stomach-

2 days after barium swallow-

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10
Q

Esophagogastroduodenoscopy (EGD)-

npo how long
may need what

A

npo 6-8 hrs-

may need sedative

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11
Q

Esophageal Manometry –

what problems
how does it work
npo how long
assess what

A

esophageal motility ptoblems-

cath is inserted into mouth

  • npo for 8-12 hrs,

assess meds

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12
Q

Occult Blood – tests for what

A

test for hidden blood in stool

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13
Q

Small Bowel Series (Lower GI series)-

diagnose what
what before
give what

A

dinaogse abnomralites of esophagus, sotmahc and small intestine-

npo before test-

give barium

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14
Q

Sigmoidoscopy and Colonoscopy

what does it look at
what diet
what prep

A

– visual examination of colon –

liquid diet-

bowel prep

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15
Q

Pyloric Stenosis-

affects what time
what does it do

A

Affects infants from first week through 8th week

Constriction of bottom part of stomach-

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16
Q

Pyloric Stenosis-S/S:

main sign
wt
I
c
s
what type of stools

A

projectile vomiting-no bile, maybe blood,

lose weight,

irritable,

crying,

starving,

few small stools

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17
Q

Pyloric Stenosis-Diagnosis
p e
s
what series

A

: physical exam

, sonogram,

upper GI series

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18
Q

Pyloric Stenosis-Interventions:

main intervention

A

surgical correction (pyloromyotomy: cutting the pyloric muscle)

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19
Q

Pyloric Stenosis- blood gases

what chloride
what k
met what

A

hypochloremic

hypokalemia

metabolic alkalosis

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20
Q

Pyloromyotomy- surgery to correct pyloric stenosis- discharge teaching

s/s of what
additional what
come back if what
look for what
how often

A

s/s of infection

Complications-additional

n/v-come back

Look for baby in pain

How often can they feed

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21
Q

Pediatric Gastroesophageal Reflux- patho

A

Backward flow of acidic GI contents into the esophagus ->irritation & inflammation ->erosion

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22
Q

Pediatric Gastroesophageal Reflux-Manifestations

p
what type of spit up
crying when
what changes

A

: painful,

spit up in excessive amount-regurguation,

crying when spitting up ,

nuerochanges,

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23
Q

Pediatric Gastroesophageal Reflux- Risk for

a
p
s

A

aspiration,

pneumonia

sepsis

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24
Q

Pediatric Gastroesophageal Reflux-Diagnostics:

what series
e
what of stomach

A

upper gi series,

endoscopy,

ph of stomach(stomach will be more acidic then esophagus)

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25
Q

pediatric gastroesophagheal reflux solution- give what

A

give ppi 30-60 mins before feeding

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26
Q

Pediatric Gastroesophageal Reflux- Treatment -Modify feeding habits –

what feeds
waht volume
what before
frequent what

A

scheduled feeds,

smaller volume,

ppi before

Frequent burping

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27
Q

Pediatric Gastroesophageal Reflux- Treatment -
avoid what foods x2

A

Avoid fatty foods and citrus juice

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28
Q

Pediatric Gastroesophageal Reflux- Treatment - meds

p
a
h

A

Proton pump inhibitors,

antacids,

histamine antagonists

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29
Q

Surgery for adult and peds: Gerd

A

Surgery for adult and peds: laparoscopic Nissen

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30
Q

Gerd- what is it

A

backwards flowing of gastric contetns into esophagus

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31
Q

s/s-Gerd-

what/when
what pain
what throat
h

A

heartburn aftermeals, when bending over or when reclining,

chest pain,

sort throat

hoarsnes

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32
Q

Gerd-Complications x2

A
  • esophagal strictures and barrets esophagus
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33
Q

Gerd-

Esophageal strictures can lead to

Barrets esophagus can lead to

A

Esophageal strictures can lead to dysphagia due to scar tissue

Barrets esophagus can lead to esophageal cancer

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34
Q

Gerd-Diangosed w

b s
upper
what test

A

barium swallow,

upper endoscopy,

Bernstein test

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35
Q

Gerd-Manage acute/chronic pain-

what meals
stop what

A

small frequent meals,

stop smoking

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36
Q

Gerd-Tx- antacids-

neutralizes what

A

neutralizes stomach acid,

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37
Q

Gerd-Ppi- omeprazole and lansoprazole-

reduce what
can cause what
monitor what
report

A

reduce gastric secretions-

can cause osteopniea and osteoporosis-

monitor lft

,report black tarry stools

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38
Q

Gerd-H2 receptor agonist- famotidine and rantidine-

how does it work
no what
report what

A

reduce acidity of secretions-

no smoking or nsaids,

report any alterations like rash

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39
Q

gerd- tx- Metoclopromide

how does it work
dont do what x2

A

-stimulates upper gastric moltility and gastric emptying-

do not drive, and no alcohol

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40
Q

Hitaital hernia-
what is it
what is tx

A

when stomach protrudes into diaphragm into thoracic cavity

tx is gerd tx

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41
Q

Hitaital hernia- s/s-

r
h
what feeling
what pain
d
what bleeding

A

reflux,

heartburn,

feeling of fullness,

chest pain,

dysphagia,

occult bleeding

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42
Q

Hitaital hernia- diagnosis

b s
upper

A

barium swallow

upper endoscopy

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43
Q

Pediatric Biliary Atresia-Cause:

what happens
leads to what if not treated

A

extra bile duct fails to close

->cholestasis, cirrhosis, portal hypertension, end-stage liver disease and if not treated –

child will not survive

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44
Q

Pediatric Biliary Atresia-Symptoms:

how long after
increasingly
I
failure
what urine
what stools
no interest in what
prolonged what

A

2-3 weeks after birth,

increasingly jaundiced,

irriabtle,

failure to thrive,

dark tea colored urine,

white clay colored stools,

no interest in feeding,

prolonged bleeding times, itching, bruising

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45
Q

Pediatric Biliary Atresia-Diagnosis

what test
b
what levels
what scan
u

A

: liver function tests,

bilirubin,

ammonia levels,

cat scan,

ultrasound

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46
Q

Pediatric Biliary Atresia

need to have what
what is only curative

A

Need to have surgery! (Kasai procedure) –

many also need liver transplant in the future-only treatment

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47
Q

Pediatric Biliary Atresia

prep w what after kasai

and what else

A

Prep w/ antibiotics and antibiotics used for 1-2 years after kasai procedure

, and vitamin K

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48
Q

Peptic Ulcer Disease-Gastric Ulcers & Duodenal ulcers- what are they

A

break in gastrointestinal mucosa

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49
Q

Peptic Ulcer Disease-Gastric Ulcers & Duodenal ulcers-
Causes

s
use what
what infection

A

: Common w/ people that smoke,

use NSAIDS / ASA,

H. pylori infection

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50
Q

Peptic Ulcer Disease-Gastric Ulcers & Duodenal ulcers-S/S:

what pain/radiated where
pain occurs when
releived by what

A

gnawing, burning, aching pain in the epi-gastric area, radiates to back.

Pain occurs when the stomach is empty.

Relieved by food

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51
Q

Peptic Ulcer Disease-Gastric Ulcers & Duodenal ulcers-Treatment:

waht w what
stop what
b c
a
m

A

2 antibiotics w PPI,

stop NSAIDS,

Bismuth compounds,

antacids,

misoprostol

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52
Q

duodenal ulcers

pain what w meal
occurs when
what stool

A

pain relieved by meal

occurs 2-3 hrs after meal

dark tarry stool

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53
Q

gastric ulcer

pain what w meal
occurs when
what occurs
risk for what

A

pain increased by meal

occurs30-1hr after meal

vomiting occurs

risk for gi bleed

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54
Q

Peptic Ulcer Disease->Complications-Hemorrhage
S/S?-

worry about what
h
what in stool
what skin

A

worry about shock-hypotension, tachycardia,

,hematemesis( coffee ground emesis w dark colored and fouls smelling)

, blood in stool,

pale and clammy,

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55
Q

Peptic Ulcer Disease->Complications-

Pyloric Obstruction-what is it

s/s- /, c what feeling

A

edema around sphincter

n/v,

cramping,

feeling full

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56
Q

Pyloric Obstruction-

tx

Peptic Ulcer Disease->Complications

A

Gastric decompression- ng tube, iv

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57
Q

Perforation-can be lethal- medical emergency
Risk for

b p
s s
h

Peptic Ulcer Disease->Complications

A

bacterial peritonitis,

septic shock

hypovolemia

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58
Q

Perforation-can be lethal- medical emergency-S/S?

what bp
what hr
what emesis
what bowel sounds
what abdomen
what pain

Peptic Ulcer Disease->Complications

A

drop in map,

increase hr,

mixture of coffee ground emesis and bright red,

absent bowel sounds,

distended abdomen

, sever upper abdominal pain

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59
Q

Perforation-can be lethal- medical emergency-For both and hemorrhage

want what
what for blood
get what
potentail what

Peptic Ulcer Disease->Complications

A

want large bore ivs,

type and cross match for blood,

get gi consult/ct of pelvis,

potential intubation, maybe ng

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60
Q

Perforation-can be lethal- medical emergency

how do you try and fix
if you cant - then what

Peptic Ulcer Disease->Complications

A

Get to or, try to fix with clipping,

if you cannot, need laparotomy

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61
Q

perforation -what is priority and why

A

priority is airway

-can choke on vomit

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62
Q

Gastrointestinal Bleeding-UGI bleeding ->

g
p
e v

A

gastritis, PUD, esophageal varices

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63
Q

Gastrointestinal Bleeding-At risk-

s
chronic what

A

smokers

chronic alchoholics

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64
Q

Gastrointestinal Bleeding-S/S:

h
what bs
what stools x2
what symptoms

A

Hematemesis- “coffee-ground”

, hyperactive BS,

melena(black tarry stools), hematochezia(frankly bloody stools),

Shock symptoms (tachycardia, hypotension, pallor, decreased urine output)

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65
Q

Gastrointestinal Bleeding- can lead to

what shock
a
what failure
b I
m I
c/d

A

hypovolemic shocks,

acidosis,

renal failure,

bowel infarction,

MI,

coma/ death

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66
Q

Gastrointestinal Bleeding: Interventions

what labs
what Diagnostic

A

Labs: CBC, Blood type & cross match, electrolytes, BUN, Liver function, coagulation profile

Diagnostic: Upper endoscopy

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67
Q

Gastrointestinal Bleeding: Interventions-If pt comes in and is vomiting blood-

what iv
put where
what blood
protect waht

A

large bore ivs,

get them laying down,

type and cross match blood,

protect airway (intubation/ng)

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68
Q

Gastrointestinal Bleeding: Interventions-Treatments

o
potential
replacing
what drip
what antidote

A

:oxygen,

potential antibiotics,

fluids/blood

put on ppi drip,

maybe antidote for their anticoag,

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69
Q

Gastrointestinal Bleeding:

Interventions- why a gastric lavage

needs what

A

Gastric Lavage: removes blood from GI system

needs or

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70
Q

Gastrointestinal Bleeding: Interventions- Watch for hypovolemic schock-

assess what
mintor what
insert what
2
replace

A

assess vs,

monitor change in skin,

insert indewelling catheter,

2 large bore iv,

replace fluids

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71
Q

Esophageal Cancer 2 types

A

Squamous Cell

Adenocarcinoma - Dysplastic columnar epithelium (associated with Barrett’s Esophagus)

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72
Q

why is upper gi bleed worse

why is lower gi bleed more common

A

upper gi becuase of airway

lower gi because warfarin and aspirin

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73
Q

Esophageal Cancer-Causes:

what use
untreated what
what factors

A

tobacco & alcohol use,

long-term untreated GERD,

congenital factors

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74
Q

Esophageal Cancer-Manifestations

what stuck
d
what wt
c

A

: choke/food stuck,

dysphagia,

wt loss,

cough

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75
Q

Esophageal Cancer -Diagnosis

A

Barium swallow

Tissue biopsy via endoscopy

Esophagogastroduodenoscopy with biopsies of the esophagus and tumor

CXR, CT scan, MRI

CBC, albumin, ALT, alkaline phosphatase, AST, bilirubin

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76
Q

Esophageal Cancer-Goal

control
maintain

A

: Control dysphagia, maintain nutritional status

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77
Q

Esophageal Cancer-Nonsurgical management:

what therapy x2
c
r
p
e d
e t

A

nutrition and swallowing therapy,

chemotherapy,

radiation therapy,

photodynamic therapy,

esophageal dilation,

endoscopic therapies

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78
Q

Esophageal Cancer-Surgical management:

is it a cure
what happens

A

palliative, not a cure,

removal of part or all of the esophagus (esophagectomy)

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79
Q

Esophageal Cancer-Post-op interventions:

manage what
who place ng- no
scheduled what
waht line
may need what

A

airway management,

doctor/surgeron place ng in-no suction- (preventing vomit),

scheduled antiemetics,

central line,

may need tpn, g tube

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80
Q

Esophageal Cancer-Health Promotion:

what diet
cannot do what
meds are how
maintain what

A

mechanical soft diet,

cannot eat post surgery for a while,

meds need to be crushed or liquid,

maintain activity

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81
Q

Esophagectomy Interventions-Discharge Teaching-

no what x2
what feeding
how to give meds where
preventing what

A

no smoking, no alchohol,

g tube feeding,

how to give meds in g tube

, preventing dvt/pe,

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82
Q

h pylori

from what

how tx

what is in stool

A

from contaminated water

treated with 2 antibiotics

fat is in the stool

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83
Q

h pylori- s/s

what pain
lack of what
what wt

A

buring pain

lack of appetite

losing wt

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84
Q

Stomach (Gastric) Cancer- adenocarcinomas-Causes

what water
what infection
chronic what
what diet
partial what

A

: contaminated water-low socioeconomical status

h pylori infection

chronic gastritis

smoked /processedfoods diet

partial gastric resection

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85
Q

Stomach (Gastric) Cancer-Manifestations

f
what in stomach
general
what labs

A

: fatigue-,

dull stomach ache,

general discomfort,

will have low rbc/h/h

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86
Q

Stomach (Gastric) Cancer0 diagnostics

what labs
what is definitive diagnostic

A

: CBC (anemia), upper GI x-ray with barium swallow, CT scan

Upper endoscopy with visualization and biopsy (definitive diagnosis)

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87
Q

Stomach (Gastric) Cancer-Interventions:

do what only when prior to metastasis

r/c

A

Surgical resection (only when diagnosed prior to metastasis)

Radiation / Chemotherapy

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88
Q

Stomach (Gastric) Cancer
-Palliative care

what is palliative

A

Gastrostomy/jejunostomy feeding tube

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89
Q

Stomach (Gastric) Cancer-Surgical Interventions:

p
t
t what

A

Partial gastrectomy

Total gastrectomy

Total gastrectomy with esophagojejunostomy

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90
Q

Gastric Cancer Surgery-Total gastrectomy with anastomosis of esophagus to jejunum

what happens

A

Stomach is completely out

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91
Q

Gastric Cancer Surgery-Total gastrectomy with anastomosis of esophagus to jejunum

priority

n
a
what issues
c
what shift
a

A

Nutritional,

airway

absoption issues

constipation

electrolyes shift,

anemia

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92
Q

Complications of Gastric Surgery- dumping syndrome

what is it

A

massive fluid shift from vascular system to gi system,

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93
Q

dumping syndrome

when pt does what
causes what
usually when

A

when pt eats a large amount of fluid and food together-

causes pressure-

usually 30 mins of meal-

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94
Q

Complications of Gastric Surgery- dumping syndrome

s/s

/
what bowel sounds
d /p
what bp
what hr
s
impending

A

n/v,

hyperactive bowel sounds

dizziness, pale

,hypotension,

tahcyardia,

sweating,

impending doom

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95
Q

Complications of Gastric Surgery- dumping syndrome-Diet

what w liquids/solid
what type of meals

high in 3x

A
  • separate liquids and solids,

small frequent meals

high in b 12, carb and protein,

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96
Q

Complications of Gastric Surgery- dumping syndrome-Positioning

A
  • semi recombant after eating,
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97
Q
  • dumping syndrome

when is it concern
risk of what

Complications of Gastric Surgery

A

concern for 6-12 months after surgery

risk of fluid volume defeicit,

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98
Q

Malabsorption Syndromes: Celiac Disease-S/S

ab
d
chronic

A

ab cramping,

diahhrea,

chronic anemia,

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99
Q

Malabsorption Syndromes: Celiac Disease-Diagnosis

what panel
what draw
what w what

A

celiac panel-

venous draw ,

endoscopy w colonoscopy and bioposy,

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100
Q

Malabsorption Syndromes: Celiac Disease-Labs

c
b
what vit d
what calcium

A

cbc,

bmp,

low vit d, low calcium,

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101
Q

classical celiac

atypical celiac

A

Classical- gluten intolerance

Atypical- gi symtpms are mild

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102
Q

silent celiac

latent celiac

A

Silent- no symtpms

Latent- has genes, but doenst expiernce symtpms

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103
Q

Malabsorption Syndromes: Celiac Disease-Tx-

no what
maybe what

A

no gluten,

maybe vitamin and mineral suplementals

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104
Q

Malabsorption Syndromes: Celiac Disease

what allergy

what sensitivity

A

Wheat allergy- IgE antibodies increase when exposed to gluten

Gluten sensitivity:

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105
Q

Malabsorption Syndromes: Celiac Disease

no what foods

only use what if really sure

A

No wheat, rye, barley! Oats can be contaminated, so avoid unless absolutely sure.

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106
Q

Colon Polyps

what are they

can become what

what s/s

A

small growths attached to intestine

can become malignant

usually asytmomatic

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107
Q

Colon Polyps

diagnosed with
when are these done

A

Diagnosis: barium enema & sigmoid or colonoscopy, biopsy

First one at 45- then 10 years after unless polyps or underlying conditions

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108
Q

Colon Polyps-Interventions

A

: polypectomy or total colectomy for certain types (high malignancy potential)

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109
Q

Colorectal Cancer (CRC) (large bowel)-> most are adenocarnionmas

how does it happen

A

progressive, starts as polyps and leads to malgignancy

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110
Q

Colorectal Cancer (CRC) (large bowel)

why is this such a bad thing

A

Easily metastasizes to nearby organs (especially the liver) and through the vascular or lymphatic system

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111
Q

Colorectal Cancer (CRC) (large bowel)->Tumor can lead to complications such as

b
b o
p

A

bleeding,

bowel obstruction

perforation

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112
Q

Colorectal Cancer (CRC)-Risk factors:

g p
what factors
I

A

genetic predisposition,

personal & dietary factors,

Inflammatory Bowel Disease (IBD)

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113
Q

Colorectal Cancer (CRC)-Manifestations

b
what stools
what pain
what wt

A

bloating

, bloody stools,

rectal /abdominal pain or pressure ,

wt loss

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114
Q

Colorectal Cancer (CRC)- Diagnosis:

A

H & H, fecal occult blood, CT scan, sigmoidoscopy or colonoscopy, Carcinoembryonic antigen (CEA), CT/MRI/US, Biopsy

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115
Q

Colorectal Cancer (CRC)-Nonsurgical interventions:
Based on the staging of the disease

r
a c
L p

A

Radiation

Adjuvant chemotherapy

Laser photocoagulation – uses heat to destroy small tumors

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116
Q

Colorectal Cancer (CRC)-Surgical Interventions:

what w Early stage small tumors:

A

transanal approach (rare)

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117
Q

Colorectal Cancer (CRC)-Surgical Interventions:

Colon resection (removal of what and what

A

removal of tumor and regional lymph nodes)

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118
Q

Colorectal Cancer (CRC)-Surgical Interventions:

Colectomy -removal of what

A

(colon removal with colostomy)

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119
Q

Colorectal Cancer (CRC)-Surgical Interventions:-

Abdominoperineal (AP) resection -removal of what x3

A

removal of sigmoid colon, rectum, and anus)

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120
Q

Colorectal Cancer (CRC)-Surgical Interventions-May need Colostomy placed- management & care

keep what
provide what
asess s
asess o

A

–keep it clear of irritants

provide stoma care,

assess skin

, asses ouput

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121
Q

Differnce between colostomy and ileltomsy

A

colostomy- creates an incision in the colon-large intestine

ileostomy-creates an incision in ileum-small intestine

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122
Q

tpn administration

must have what
monitor what
change how often

A

must have a CVAD

Monitor electrolyte and protein levels

change tubing every 24 hrs

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123
Q

administration of blood

hand
open
all
spike/and
prime w
prepare/invert
spike
close
prime/ attach
regulate
monitor for

A

hand hygiene,

open y tubing,

all clamps in off,

spike ns bag and put on iv pole,

prime with ns,

prepare blood-invert2-3 times,

spike blood,

close ns,

prime with blood, attach to vad,

regulate blood flow,

montor for reaction

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124
Q

NG insertion

determine
2/e/p/c
perform/prepare
assess/stand
what position
apply
place
measure
prepare
apply
__tube
hand pt
gently
have pt/flex
encourage
check
temporarily
check placement-
connect
fasten
provide

A

determine order

identify/ explain/ provide privacy / cultural needs

perform hand hygiene and. prepare supplies

asses nares and stand on side of bed

high fowlers positions

apply pulse ox/ capnogrophy

place bath towel over pt

measure length of tube

prepare tape

apply clean gloves

lubricate tubing

hand pt cup of water/determain hand signal

gently insert tube in nostril

have pt take a deep breath and flex head toward chest

encourage small sips of water

check for position of tubing

temporarily anchor tube

check placement- X-ray,ph and air bolus

connect to suction

fasten end of gown

provide oral/nasal care

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125
Q

central venous management

use what
change
repsond

A

use sterile technique

change dressings

respond to any adverse events

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126
Q

Gastrititis- what is it

A

inflammation of stomach lining

127
Q

what is acute gastritis

what is sever form of that

A

Acute- dispruption of mucosal barrier by irrirant like nsaids-

severe form of acute is erosive gastritis-

128
Q

acute gastritis s/s

a
what releived by what
what pain
/

A

Anorexia,

disocomfort relieved by belching,

severe ab pain,

n/v

129
Q

Chronic gastritis- s/s

A

vague discomfort after eating

130
Q

Gastrititis- Diangnostc

testing for what
what analysis
/

A
  • testing for h pylori,

gastric analysis

, h/h,

131
Q

Gastrititis- Meds

p
h
s

A
  • ppi,

h2 receptors,

sucralfate,

132
Q

Gastrititis- Meds-if hpylori-

A

2 antibiotics w bismuth

133
Q

gastritis tx-

how long npo
slow
replacing what
g l

A

6-12 hrs of npo,

slow introduction of food,

replacing electrolytes,

gastric lavage

134
Q

IBS- what is it

A

spastic bowels

135
Q

ibs s/s

what pain- releived by what
altered what
what abdominal

A

ab pain relieved by defecation,

altered defecation habits,

abdominal bloating,

136
Q

IBS- spastic bowels-Diagnosis- focused on what

A

focused on ruling out other things, like testing for blood in stools, looking at colonoscopy and such

137
Q

IBS treatment-

what laxatives
anti c
anti d
anti d

A

Bulk forming laxative-

Anticholinergic-

Anti-diarrhea-

Antidepressants-

138
Q

IBS education- dietary habits-

additional what
avoid what

A

additional fiber ,

avoid trigger foods like dairy, caffine and soda

139
Q

Peritonoitis-what is it

A

inflammation of peritoneum-

contamination from bacteria from some sort

140
Q

s/s- peritonitis

what pain
what abdomen
p I
f

A

severe abdominal pain,

distedend abdomen,

paraytic ileus (bowel doesn’t go forward)

, fever

141
Q

Peritonoitis-Needs prompt treatment to prevent septic shock- how identify

what wbc
p
b c

A

elevated wbc,

paracetnesis,

blood cultures

142
Q

peritonitis tx

A

broad spectrum antibiotic like imipenem or meropenem, then get specific antibiotic

143
Q

peritonitis tx plan

2 what
what for bp
what kills bacteria
what helps against stomach
what for decomp

A

2 ivs

vasopressors

antibiotics

antiemetics

ng decomp

144
Q

Intestinal decompression- peritonitis

does what
what is inserted
what is maintained
until when
what is withheld

A

relieves abdominal distention-

ng tube is inserted

suction is maintained

until bowel sounds are present And passing flatus

fluids and foods are withheld

145
Q

If cause of peritonitis is
perforation,
gangrous bowel,
or inflamed appendix-

need what

A

need laparotomy to remove damaged tissue

146
Q

peritonitis

Also can get what
does what
return form surgery w what

A

perintoneal lavage-

washes out cavity w warm istonic fluid to remove contaminetnts

Return from surgery w jp drain

147
Q

paralytic ileus

what is it

why can it happen

A

when the bowels stop moving

can be from anesthesia, or opioid useage

148
Q

assess what before giving foods

b s
b b
b m

paralytic ileus

A

bowel sounds

butt burps (farts)

Bowel movements

149
Q

what is opioid alternative for when in pain and bowel is paralytic ileus

make sure what organ works

also give what for pain

paralytic ileus

A

ketorolac

make sure kidneys work

also can give Tylenol

150
Q

what drug promotes motility in bowel

also do what as well

paralytic ileus

A

metoclopramide

also move the patient around

151
Q

Gastroenteritis

what is it
caused by what

A
  • inflammation of the stomach

Caused by contaminated water or food- “food poisoning”

152
Q

Gastroenteritis-s/s -

a
/
what pain
d
b

A

anorexia,

n/v,

ab pain,

, diahhrea,

Borborygmi, excessively loud and hyperactive bowel sounds

153
Q

Gastroenteritis-Complications

what imbalances
vomiting leads to what

A
  • electrolyte imabalanaces-

vomiting leads to metabolic alkolosis

154
Q

Gastroenteritis-Tx

A

is doesn’t really need tx, maybe needs antibiotics, or antidiahhreals, and replacing fluids lost,

155
Q

Gastroenteritis-If botusilsm is suspected-

A

gastric lavage

156
Q

Gastroenteritis-If ecoli is suspected

A

plasmapheresis

157
Q

Gastroenteritis-what if renal failure

158
Q

Diverticular disease-Risk factors-

what diet
decreased what

A

low fiber diet

decreased activity levels

159
Q

Diverticular disease-what are these

Diverticulosis
Diverticulitis

A

Diverticulosis- presence of diverticula- often asymtpmatic- can lead to hemorrhage and divertultiis

Diverticulitis- inflammation around diverticular sac- undigested food and bacteria collect in diverticula and allow bacteria to settle

160
Q

Diverticular disease-s/s-

what pain
c
/
f
what abdomen

A

left sided pain,

constipation,

n/v,

fever,

distended abdomen

161
Q

Diverticular disease-Complications

b o
f f
h

A
  • bowel obstruction,

fistula formation

hemorrhage

162
Q

Diverticular disease-Diangoseed w

c
c

A

colonoscopy,

ct scan

163
Q

Diverticular disease-Meds

what med
s s
avoid what

A
  • broad spectrum antibiotics- metronidazole and ciproflaxin,

stool softeners

avoid laxatives

164
Q

Diverticular disease-Nutrition

increase what
avoid what

A
  • increase fiber,

avoid seedy foods

165
Q

Hernia- what is it

A
  • abdominal wall protrudes out of abdominal cavity
166
Q

Hernia-Inguinal herie-

in who
what is it
what looks like

A

males-

impropure closure of testes-

lump and swelling on groin

167
Q

Hernia- Umbilical hernia-

when
what pain

A

pregnancy/obesity-

sharp pain on coughing or straining

168
Q

Hernia- Incisional hernia

where is it

A
  • on surgical incision- bulge at incisional site
169
Q

Hernia- s/s

A
  • sac covered by skin
170
Q

Hernia-Tx-

modify what
anti
s s
last tx is

A

modify activity,

anti inflammatory meds,

stool softeners

last tx is surgery

171
Q

Intestinal obstruction- what is it

A

failure of intestinal contents to move through bowel lumen

172
Q

Small bowel obstruction- from what

a
h
t

A

adhesions,

hernias

tumors

173
Q

Small bowel obstruction-

what pain
v
what bowel sounds

A

Cramping pain

vomiting(may contain bile

, hyperactive bowel sounds

174
Q

Small bowel obstruction-Complications

what volume
organ
p
p v

A

hypovolemia

organ dysfunction,

perforation

pulmonary ventillation

175
Q

Large bowel obstruction-

c
i
f i

A

cancer

inflammation,

fecal impaction

176
Q

Large bowel obstruction-

c
what pain

A

constipation

severe ab pain

177
Q

Large bowel obstruction-
complications- colon dilation can lead to

g
p
p

A

gangrene,

perforation,

peritonitis

178
Q

Large bowel obstruction- dx

r s
a x

A

radiologic studies,

abdominal xray

179
Q

Partial small bowel obstructions can be treated w

what using what
n
what meds x2

A

gastrointestional decompression using ng tube,

npo,

pain meds / antibiotcs

180
Q

Complete mechanical obstruction tx

w what
what do prior

A

with surgical intervention-

prior to you give ng tube

181
Q

Preoperative Nursing Care bowel surgery

marking where
what placement
perform what

A

Marking of stoma site

NG tube placement and management

Perform bowel prep as ordered

182
Q

Postoperative Nursing Care- bowel surgery

monitor what
asess what
watching for what

A

Monitor bowel sounds

Assess surgical site dressing and drainage-CHECK bleeding

watching for peritonitis

183
Q

cholesethiasis

what is it

made from what

what low kind of diet

A

stone in gall bladder

made form fat

low fat diet

184
Q

when pt takes lots of antibiotics=

risk for what

treat w what

if that doesn’t work->

A

risk for c diff

treat w metronidazole

if that doesn’t work- give a stool replacement

185
Q

Liver functions

m
s
d
p
s

A

Metabolism

Synthesizes

Detoxifies

Produces

Storage

186
Q

Liver Function Tests

a
a
a
g
serum what

A

alt

ast

alp

ggt

serum bilirubin

187
Q

what other lab values for liver

what factors
what markers
waht electrolytes-(na/k/ca)

A

Clotting factors,

inflammatory markers,

low (na/k/ca)

188
Q

Abdominal ultrasound –non invasive-why used

A

used to look at abdominal organs

189
Q

Cholangiography

uses what to see what
assess

A

used x ray to view bile ducts in gallbladder

assess coags

190
Q

Endoscopic Retrograde Cholangiopancreatography (ERCP)-invasive

what does
discontinue what

A

uses x rays and endoscopy to see bile ducts and pancreatic duct

discontinue blood thinners

191
Q

Magnetic Resonance Cholangiopancreatography (MRCP) -invasive

visualizes what
uses what

A

visualizes biliary and pancreatic ducts

uses contract dye

192
Q

Liver biopsy

does what
performed how
what after

A

takes out small sample of liver for examination

performed under anesthesia

rest after

193
Q

Hepatocellular Failure:

impaired p
disrupted g
reduced b
impaired s

A

impaired protein metabolism

disrupted glucose metabolism

reduced bile production

impaired steroid hormone metabolism

194
Q

Jaundice (icterus):

accumulated what

due to what

A

accumulated bilirubin

due to disrupted metabolism and excretion

195
Q

Anp=

A

where is glucose stored/metaobolzied,

196
Q

foods to avoid in heptoceullular cancer

high in x2
p
a

A

food high in fat, sugar

processed

alchohol

197
Q

Hepatitis

what is it
leads to what
leads to what s/s

A

Widespread inflammation of liver cells

leads to congestion w inflammatory cells

ruq pain

198
Q

what hepatitis is transmitted fecal-oral

199
Q

what hepatitis is transmitted in blood and body fluids

200
Q

Complications of hepatitis

c h
c
d

A

: chronic hepatitis,

cirrhosis

death

201
Q

Diagnosing Hepatitis-manifestations

what symptoms
what pain

A

flu like symtpms

ruq pain

202
Q

diagnosing hepatitis

lab
presence of what

A

liver function tests

Presence of antigens and antibodies

203
Q

Liver biopsy

need to know what

A

– need to know if they take anticoags, know s/s of bleeding

204
Q

Hepatitis -Pre icteric phase- before jaundice

what symptoms
m
lack pf what
what pain
f
c

A

Flu-like symptoms- body aches,

mailaise,

lack of appetite,

mild RUQ pain,

fever,

chills,

205
Q

hepatitis- Icteric Phase-jaundice-5-10 days after symtpoms-

j
p
what stools
what urine

A

Jaundice-present in sclera skin and mucous membranes ,

pruritus,

clay-colored stools,

dark brown urine

206
Q

hepatitis- Post icteric / convalescent phase

what labs
less
what decreased

A

Bilirubin labs return to normal,

less fatigued

, pain decreased

207
Q

Medications for Hepatitis- prevention-what 2 vaccines

A

Hepatitis A (2 doses 6 months apart)

Hepatitis B (3 doses; first vaccine after birth)

208
Q

Medications for Hepatitis A-Post exposure prophylaxis

give what
when

A

Immune globulin (Ig)

within 2 weeks of exposure

209
Q

Medications for Hepatitis

what if severe

A

severe ->antiretroviral drugs (enecavir)

210
Q

what is hep c treated w
what can that cause

A

hep C tx w/ Interferon alpha

Can develop flu-like symptoms & depression

211
Q

Medications for Hepatitis-Complementary Therapies

m t
l r
g
st

A

Milk thistle,

licorice root,

ginger,

St. John’s wort

212
Q

Hepatitis nursing diagnosis- Transmission Issues

what precautions
what with fecal incontincene
encourage what

A

Standard precautions/Good hand washing

Contact isolation (with fecal incontinence)

Encourage prophylactic Tx of contacts

213
Q

Hepatitis nursing diagnosis-Fatigue

what periods
monitor what

A

Rest periods/ Limitations of activities

Monitor fatigue in order to determine activity

214
Q

hepatitis nursing diagnosis-Nutritional Deficits

what facilitates healing
what type of meals
avoid
use of what

A

High calorie, high carbs to facilitate healing

Small frequent meals/snacks / Low fat (↓ nausea)

Avoid alcohol

Use of nutritional supplements

215
Q

Treatments for Acute Hepatitis -

physical what
avoid what
may take how long

A

Physical rest, avoid strenuous activities

avoid hepatic toxic drugs/alcohol,

may take 3-16 weeks

216
Q

Treatments for Acute Hepatitis

increase c x2
what type of meals

A

increase carbs (pasta white bread, crackers)

calories,

small frequent meals.

217
Q

what meds for acute hepatitis

supplemental
anti

A

supplemental vitamins

antiemetics

218
Q

Fatty Liver (Steatohepatitis)

what is it
caused by what

A

Accumulation of fat in and around the hepatic cells

caused by DM, obesity, elevated lipid profile

219
Q

Fatty Liver (Steatohepatitis)-Assessment

slight what
mild
potential what

A

: slight abdominal girth increased,

mild pain,

potential SOB,

220
Q

Fatty Liver (Steatohepatitis)-Diagnosis

what panel
what issues

A

: elevated lipid/liver panel,

coag issues

221
Q

Fatty Liver (Steatohepatitis)-Interventions:

control what
what controls diabetes x2
what controls lipid
appriopate

A

control carb intake,

metformin/ insulin to control diabetes,

statins to control lipids,

approtiate amount of excercise

222
Q

Cirrhosis- what is it

replaced by what

A

Liver tissue destroyed and

replaced with fibrous scar tissue and metabolic function is lost.

223
Q

cirrhosis-due to what

a
chronic what 2 hepatitis

A

due to alcohol

chronic hepatitis B and C.

224
Q

what impacts the extent of problems and complications in liver

A

The degree of damage to the liver impacts the extent of problems and complications.

225
Q

Cirrhosis Manifestations

a
j
what stools
d
what pain

A

ascites,

jaundice,

clay colored stools,

diarrhea,

ruq pain

226
Q

cirrhosis diagnosis

what labs
u
what scan
what level

A

liver labs,

ultrasound,

ct scan

alc level

227
Q

cirrhosis tx

what to reduce fluid
what to lower ammonia
what to lower hr
what for anemia
what for agitation

A

diuretics-reduce fluid,

lactulose- lower ammonia,

betablocker (nadolol, propranolol)- hr

ferrus sulfate, folic acid-anemia,

oxazepam- agitation

228
Q

Loss of hepatic function leads to: Portal hypertension- manifestations

a
e v
prominent what

A

Ascites

Esophageal varices

Prominent abd. veins

229
Q

Loss of hepatic function leads to: Portal hypertension-manifestations

h
s
p s e

A

Hemorrhoids

Splenomegaly (blood cell destruction)

Portal systemic encephalopathy

230
Q

Loss of hepatic function leads to: Portal hypertension-manifestations

h s
b p
s j

A

Hepatorenal syndrome

Bacterial peritonitis

Severe jaundice

231
Q

Portal Hypertension- increase of bp where

A

is an increase in the blood pressure within a system of veins called the portalvenous system

232
Q

portal hypertension

what merges into portal vein
then branches where

A

Vessels coming from the stomach, intestine, spleen, and pancreas merge into the portalvein,

which then branches into smaller vessels and travels through the liver.

233
Q

Portal hypertension is an increase in the pressure in portal vein->

portal vein carries blood where

A

carries blood from the digestive organs to the liver.

234
Q

why do alcoholics have digestive problems and gallbladder problems

A

Because it will cause portal hypertension, which then Cuts perfusion to esophagus and pancreas and all that

235
Q

decreased proteins / increased aldosterone lead to:

Loss of hepatic function leads to: Portal hypertension

236
Q

Ascites-> Loss of hepatic function leads to: Portal hypertension
tx-

what med
how much na
how much fluid
p

A

Diuretics (spironolactone)

Na restricted 2g/day

Fluid restriction 1500 ml/day

Paracentesis

237
Q

paracentesis

if large volume may need->

watch for what

A

(if large volume, may need albumin IV)

– watch for hypovolemia afterwards

238
Q

fluid restriction management

A

suck on hard candy

239
Q

Esophageal varices - what can happen

Loss of hepatic function leads to: Portal hypertension

A

(can rupture and cause hemorrhage  death)

240
Q

Esophageal varices -Prevention of bleeding:

what lower hr
what for anemia

Loss of hepatic function leads to: Portal hypertension

A

Beta-blocker (nadolol / propranolol)

Vitamin K / Ferrous sulfate / folic acid

241
Q

Esophageal varices -waht if active bleed

v l
b

Loss of hepatic function leads to: Portal hypertension

A

Variceal ligation

/ banding

242
Q

Esophageal varices -waht if active bleed

give what
b t
what inserted

Loss of hepatic function leads to: Portal hypertension

A

give RBCs, FFP, platelets

Balloon tamponade

Central line inserted

243
Q

Esophageal varices -

treated w what
put in what
do what
varices are then what

Loss of hepatic function leads to: Portal hypertension

A

can be treated w endoscopy

put in ng tube-

do gastric lavage

varsices are then sclerosed

244
Q

Esophageal varices -
Ballon tamponade- does what

Loss of hepatic function leads to: Portal hypertension

A

Balloon puts pressure on direct bleed so that they have enough time to get to surgery

245
Q

esophageal varices- if coming in and bleeding

what from who
2 what
replace what
what med for bp
what drip
what in them

A

intubation from provider

2 large bore ivs

replace fluids/blood

dopamine for bp

ppi drip

catheter in them

246
Q

prominent abdominal veins leads to what

Loss of hepatic function leads to: Portal hypertension

247
Q

hemorrhoids

prevent what
could lead to what

Loss of hepatic function leads to: Portal hypertension

A

Prevent constipation

could lead to rectal bleeding

248
Q

hemorrhoids

prevent constipation w what
what also happen In this med

Loss of hepatic function leads to: Portal hypertension

A

Laxative (lactulose)

– also given to lower ammonia levels

249
Q

Splenomegaly-(blood cell destruction) ->

e
p
vit what deficiency

Loss of hepatic function leads to: Portal hypertension

A

ecchymotic

purpura

Vit. K deficiency

250
Q

Portal systemic encephalopathy

from what

Loss of hepatic function leads to: Portal hypertension

A

from the accumulation of neurotoxins in blood

251
Q

Portal systemic encephalopathy

what builds up
decrease what intake

Loss of hepatic function leads to: Portal hypertension

A

Ammonia build up (ammonia is byproduct of protein metabolism)

decrease protein intake

252
Q

Portal systemic encephalopathy -s/s

a
what changes
c h

Loss of hepatic function leads to: Portal hypertension

A

Asterixis (liver flap),

LOC changes,

cerebral hypoxia

253
Q

Portal systemic encephalopathy meds

L
n
m
e

Loss of hepatic function leads to: Portal hypertension

A

Lactulose /

neomycin /

metronidazole

Enemas

254
Q

Portal systemic encephalopathy

pt may look how
from what

Loss of hepatic function leads to: Portal hypertension

A

Pt may look like stroke/ drunk,

but that is from elevated ammonia level being neurotoxic

255
Q

Portal systemic encephalopathy

impaired what
give where

Loss of hepatic function leads to: Portal hypertension

A

Impaired speech and swallowing,

so give stuff recatlly

256
Q

Hepatorenal syndrome-

what happens

Loss of hepatic function leads to: Portal hypertension

A

when liver puts all waste filtering into kindeys, and kindeys now don’t work

257
Q

Hepatorenal syndrome- s/s

a
what level na
what bp

Loss of hepatic function leads to: Portal hypertension

A

Azotemia (excess nitrogenous waste products)

Na retention,(high)

Hypotension

258
Q

Hepatorenal syndrome- tx

restrict what

Loss of hepatic function leads to: Portal hypertension

A

restrict fluids and sodium

259
Q

why could bacterial peritonitis happen

Loss of hepatic function leads to: Portal hypertension

A

maybe from frequent pericardiocentesis, or just contaimination of cavity

260
Q

bacterial peritonitis s/s

increased what
what temp
worsening what
e
overall what

Loss of hepatic function leads to: Portal hypertension

A

increased abdominal pain/discomfort,

little fever

, worsening ascites,

enceloplathy,

overall decline

261
Q

Severe jaundice-

leads to what on skin
can show what

Loss of hepatic function leads to: Portal hypertension

A

Leads to bile salt deposit on skin

pruritus

262
Q

Severe jaundice- what helps

what h20
L
m
what schedule

Loss of hepatic function leads to: Portal hypertension

A

Warm h20,

lotions,

mittens,

turning schedule

263
Q

Severe jaundice-

what med
what for malnutrition

Loss of hepatic function leads to: Portal hypertension

A

Antihistamines

Vitamins to help w/ malnutrition

264
Q

emergency measure to treat

portal hypertension, esophageal varacies and ascites

A

Transjugular intrahepatic portosystemic shunt (TIPS)-

265
Q

Transjugular intrahepatic portosystemic shunt (TIPS)-

used for what
what type of treatment

A

Used for as a short term measure before a liver transplant can be done –

last chance treatment

266
Q

General interventions for cirrhoisis-

what diet until ammonia levels are wnl
increase what
supplemental
low what

A

low protein diet until ammonia levels are wnl,

increase carbs,

supplemental vitamins,

low sodium diet

267
Q

what do you do with fluids when gi bleed

in cirrhosis, always measure what

A

npo

measure abdominal girth

268
Q

Liver Cancer
related to what x3

A

Hep b,

hep c,

cirrhosis

269
Q

Liver Cancer Manifestations
often masked by cirrhosis or chronic hepatitis,

w
a
what pain

A

:weakness,

anorexia,

abdominal pain (RUQ

270
Q

liver cancer interventions:

c
r
t

A

Chemo

radiation

transplant depending on severity

271
Q

liver cancer

no I s
no f
check what levels
diet
no a

A

No impact sports,

no falls,

check coag levels,

diet that they can process,

no alcohol,

272
Q

Liver Trauma

why can it happen

A

Commonly injured with penetrating trauma and blunt trauma resulting in lacerations, avulsions, and crush injuries

273
Q

Liver Trauma Assessment

what pain
abdominal what
d
g
r

A

: RUQ pain,

abd tenderness,

distention

, guarding,

rigidity

274
Q

Liver Trauma Diagnosis

signs of what
p l
c
u

A

: signs of shock related to excessive blood loss(large abdominal girth),

peritoneal lavage,

CT scan

ultrasound

275
Q

Liver Trauma Interventions

e L
what interventions
what transfusions

A

: exploratory laparotomy,

surgical interventions to stop bleeding,

blood transfusions

276
Q

Liver Trauma Meds-

iv
f
p

A

iv fluids,

ffp,

platelets- clotting factors

277
Q

Liver Abscess Invading bacteria or protozoa leads to what

A

-destruction of liver tissue->

production of a necrotic cavity filled with infective agents, liquefied liver cells and tissue, and leukocytes.

278
Q

liver abscess Diagnosis

c
u
b
a

A

: CT scan,

ultrasound,

biopsy,

aspirate

279
Q

liver abscess what meds

A
  • antibiotics-metronidazole, iodoquinol
280
Q

liver abscess Prevention

A
  • avoid contaminated food/water
281
Q

liver abscess Supportive care

p
n
/

A

pharmacy,

nutrition,

pt/ot,

282
Q

pancreas functions

h
d e

A

Hormones (alpha - glucagon, beta - insulin, detla, F)

Digestive enzymes

283
Q

what labs are pancreas

a
l

A

amylase

lipase

284
Q

Pancreatitis- inflammation of pancreas leads to what

release of what

h and n

A

→release of pancreatic enzymes→

hemorrhage and necrosis

285
Q

PancreatitisCauses: _

what abuse
m
g

A

alc abuse,

malformation of pancrease,

gallstones,

286
Q

acute Pancreatitis Manifestations

what pain
/
f
j
what bleeding

A

: sudden onset of severe LUQ pain,

N/V

, fever,

jaundice,

retroperitoneal bleeding

287
Q

PancreatitisDiagnosis:

a
L
waht ultrasound
what scan

A

amylase,

lipase,

abdominal ultrasound,

ct scan,

288
Q

Pancreatitis Complications

a
s
what shock
what failure

A

ARDS,

sepsis,

hypovolemic shock,

organ failure

289
Q

Acute Pancreatitis

why npo
when can patient resume eating

A

NPO- decreases enzyme secretion.

Pt resume eating when Lipase WNL

290
Q

acute pancreatitis interventions

what supplemental
treat what
balance what
what to feed
what diet

A

supplemental oxygen

treat pain

balance electrolytes

npo to feed

low fat diet

291
Q

what meds to stay away from in pancreatitis

n
s
what diuretics
waht hormone

A

nsaids

steroids

thaiszide

estrogen

292
Q

Acute Pancreatitis

what is placed
no what
r

A

NG tube usually placed.

no contact spot

rest

293
Q

Acute Pancreatitis
diet

what type of diet
low what as well
no

A

Clear liquid diet ADAT to

low fat diet,

no alcohol

294
Q

Chronic pancreatits s/s

what pain to where
wt
c
what stools

A

luq pain to back

wt loss,

constipation,

steatorrhea (fatty, foul smelling stools

295
Q

chronic pancreatitis causes

e
m
what pancreas
abdominal what

A

etoh

malnutrition

malformed pancreas

abd truama

296
Q

chronic pancreatitis nursing interventions

p
a
what envireomnt
what checks

A

ppi

analegesics

relaxing envireomnt

wt checks

297
Q

Chronic pancreatits complicaitions

m
m
possible

A

malabsorption,

malnutrion,

possible pud

298
Q

Pancreatitis interventions

what analgesics
a
what gastric ones
o

A

Opioid analgesics,

antibiotics,

H2 blockers, PPI,

octreotide

299
Q

Pancreatitis interventions-Nutrition

what initially
what to feed pt

A

: NG initially,

IV fluids/TPN(bypass gi tract) –

300
Q

Pancreatitis interventions-Nutrition

after tpn, start food when

what is present
what lab is normal\

A

BS present and slow,

amylase levels normal.

301
Q

Pancreatitis interventions-Nutrition

after start food back up-what diet

low what
no what

A

low fat
no alchohol

302
Q

Pancreatitis interventions

watch what functions x2

A

Watch respiratory and renal function

303
Q

Pancreatic Cancer- Manifestations:

wt
f
what pain
j
what stools
what urine

A

weight loss,

flatulence,

dull epigastric pain,

jaundice,

clay colored stools,

dark urine

304
Q

Pancreatic Cancer Diagnosis:

c
e
what study

A

CT scan

, ERCP,

cytologic study

305
Q

Pancreatic Cancer Risk w

o a
s
hx of what

A

old age,

smoker,

hx of pancreatitis,

306
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

how does it work
what is used as well

A

Removes part of pancreas and reattaches-

radiation and chemo are used as well

307
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

risk for what
put where
assis w what

A

Risk for resp compromise in-

put in semi fowlers,

assist w cdb,

308
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

needs what

A

Needs ng tube w low suction

309
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

what helps drain secretions

A

Changing positions helps facilitate drainage of secretions

310
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

maintain what

can give pt what

A

Maintain pain control

Can give pt diabetes

311
Q

Pancreatic Cancer: Pancreatodueode-nectomy (Whipple)

monitor for what signs

A

Monitor for s/s of hypovolemic shock

312
Q

reyes syndome

what causes it

what use
what viruses

A

aspirin use w viral illness

viruses- URI, gastroenteritis, influenza

313
Q

reyes syndrome s/s

f
decreased
c
decreased what function

A

fever
decreased loc
coma
decreased liver function

314
Q

reyes syndorme tx

what checks
maintain what
assess what
what precautions

A

nuero checks

maintain hydration + electrolytes

assess resp status

seizure precautions

4-Fourth Semester (4 decks)

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