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MedSurg > Final Exam: Liver, Pancreas, Biliary Tract > Flashcards

Final Exam: Liver, Pancreas, Biliary Tract Flashcards

1
Q

The most common cause of Hepatitis C is?

A

IV drug abuse

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2
Q

Risk factors for Hepatitis (6)

A
  • body piercings
  • unprotected sex
  • IV drug abuse
  • hemodialysis
  • blood transfusions before 1992 (no blood screenings)
  • alcohol abuse
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3
Q

Clinical manifestations of hepatitis in the preicteric phase? (5)

A

Fatigue, anorexia, weakness, headache, joint pain

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4
Q

Clinical manifestations of hepatitis in the icteric or anicteric phase? (2)

A

Complete jaundice from head to toe (results from an abnormal rise in bilirubin) and clay-colored stools

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5
Q

Which molecule is responsible for ascites and edema in patients with hepatitis (3rd spacing aka interstitial spacing)

A

Albumin (protein) attracts water

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6
Q

What is the best way to distinguish the type of viral hepatitis that the patient has?

A

Test patient’s blood for the specific antigen or antibody

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7
Q

What diet is used in the management of hepatitis?

A

A high-calorie diet with supplemental vitamins to address nutrient deficits, such as less than body requirements related to anorexia

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8
Q

Water-soluble vitamins? (4)

A

ADEK : vitamins A, D, E, K

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9
Q

What do you expect will be administered to a patient with hepatitis to address nutrient deficiency?

A

Banana bag: contains water-soluble vitamins

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10
Q

One of the most challenging nursing interventions to promote healing in the patient with viral hepatitis is?

A

Adequate nutrition

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11
Q

It is expected for patients with cirrhosis to present? (2)

A

Clay-colored stools and extreme anorexia at this stage in the disease process

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12
Q

S/S of Cirrhosis? (5)

A
  • jaundice
  • anorexia and ABD pain
  • ascites and hypoalbuminemia
  • hyponatremia
  • cognitive changes
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13
Q

What are serious complications of portal hypertension and esophageal/gastric varices? (2)

A

Constipation and straining: can lead to the rupture of esophageal varices which can be life-threatening

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14
Q

What are ascites?

A

Accumulation of serous fluid in the peritoneal and ABD cavity

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15
Q

What is the priority nursing measure for patients with peripheral edema and ascites?

A

Proper oxygenation and ventilation due to fluid accumulation

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16
Q

Nursing diagnosis for peripheral edema and ascites?

A

Inability to maintain an adequate oxygenation / expanding lungs

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17
Q

What are the first and last choices of treatment for peripheral edema and ascites?

A

First choices: lasix, sodium restriction, administer albumin
Last choice: paracentesis (needle to aspirate peritoneal cavity)

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18
Q

What should the patient do before a paracentesis procedure?

A

Patient should urinate because the bladder can be punctured

19
Q

Patient manifestations of hepatic encephalopathy? (3)

A

Asterix (flapping tremor), change in LOC, sleep disturbances

20
Q

Etiology of hepatic encephalopathy?

A

Excess ammonia crossing the blood-brain barrier and causing neurologic s/s

21
Q

Treatment for hepatic encephalopathy?

A

Administer lactulose (causes the patient to have bowel movements to excrete ammonia; s/s: mental status changes)

22
Q

Nursing management for patients with cirrhosis? (nutrition)

A

High calorie, high carbohydrate, and low-fat diet (do not restrict protein, may lead to more muscle wasting)

23
Q

During the treatment of the patient with bleeding esophageal varices, it is most important that the nurse:

A

Manages airway and prevents aspiration (remember ABC)

24
Q

A patient with advanced cirrhosis has a nursing dx of imbalanced nutrition: less than body requirements r/t anorexia and inadequate food intake. An appropriate midday snack for the patient would be:

A

A fresh tomato sandwich with salt-free butter

25
Q

In discussing long term management with the patient with alcoholic cirrhosis, the nurse advises the patient that:

A

Abstinence from alcohol is the most important factor in improving the patient’s condition

26
Q

When planning care for a patient with cirrhosis, the nurse will give the highest priority to which nursing diagnosis?

A

Ineffective breathing pattern related to pressure on the diaphragm and reduced lung volume

27
Q

Nursing management for patients with acute pancreatitis (first line of action)?

A

Place patient on NPO and drop an NG tube

28
Q

What is ERCP in treating acute pancreatitis?

A

Endoscopic retrograde cholangiopancreatography may be performed when pancreatitis is related to gallstones

29
Q

What should be assessed for after an emergent ERCP?

A

Assess for changes in temperature, could indicate an infection

30
Q

What type of diet causes gallstones?

A

Diet high in fat

31
Q

How often should blood sugar be checked when a patient is on TPN and lipid nutritional therapy?

A

Every 6 hrs if a patient is started on parenteral nutrition (unrelated to diabetes)

32
Q

Care for chronic pancreatitis is similar to?

A

Care of acute pancreatitis

33
Q

Combined with clinical manifestations, the lab finding that is most commonly used to diagnose acute pancreatitis is?

A

Increased serum amylase

34
Q

What is the most common disorder of the biliary system?

A

Cholelithiasis (stones in the gallbladder)

35
Q

What is cholecystitis?

A

Inflammation of the gallbladder wall

36
Q

Common s/s of cholelithiasis? (3)

A

Jaundice, pain, pruritus

37
Q

When common bile duct obstruction occurs, what s/s are related to the blockage? (2)

A

Dark amber urine and steatorrhea (fat-like stool that is foul-smelling and yellow)

38
Q

Nursing management for cholecystitis and cholelithiasis?

A

Surgical therapy that consists of laparoscopic cholecystectomy

39
Q

Following a laparoscopic cholecystectomy, the nurse would expect the patient to?

A

Have four small abdominal incisions covered with small dressings

40
Q

During discharge instructions for a patient following a laparoscopic cholecystectomy, the nurse advises the patient to?

A

Report any bile colored or purulent drainage from the incisions (infection)

41
Q

When providing discharge teaching for the patient after laparoscopic cholecystectomy, which information should the nurse include?

A

A lower-fat diet may be better tolerated for several weeks

42
Q

2 main risk factors for cirrhosis?

A
  • previous Hepatitis C infection

- alcohol consumption

43
Q

What treatment is used to decrease ascites formation in patients with cirrhosis?

A

Aggressive diuretic therapy

MedSurg (16 decks)

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