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NURS 1345 > Gall Bladder & Pancreas: PowerPoint > Flashcards

Gall Bladder & Pancreas: PowerPoint Flashcards

1
Q

Acute inflammation of the gallbladder happens due to Calculous/ Stones/Cholelithiasis

Which structure do they block (3)

A

Cystic duct
Gall bladder neck
Common bile duct

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2
Q

What causes Cholecystitis?

A

Abnormal cholesterol/ bile salt metabolism

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3
Q

Biliary stasis, also known as cholestasis, is a condition that occurs when…

A

bile flow slows or stops

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4
Q

Sphincter of Oddi dysfunction
Decrease in blood flow to Gall bladder

Twisting of Gall bladder neck or cystic duc

All cause…

A

Biliary statis

Which causes

Acute inflammation of the gallbladder

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5
Q

Sepsis, trauma/burns, long-term TPN, MODS, Ab surgery, hypovolemia

May produce this problem

A

Acute inflammation of Gall Bladder

Acalculous - Inflammation of the Gallbladder w/o Stones

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6
Q

3 big risk factors for getting gallstones

A

High cholesterol diet

Sedentary lifestyle

HRT or birth control pill

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7
Q

Where is pain from Cholecystits

A

RUQ

Radiate to R shoulder/ scapula

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8
Q

Clay-color3d stools, dark urine, statorrhea

With

RUQ pain, radiating to shoulder is…

A

Cholecystitis

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9
Q

Older adult considerations for Gallstones

Localized tenderness

Acute delirium as 1st sign

Why delirium

A

Dehydration

Low blood volume

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10
Q

Lab ass for Gallstones

WBC
Alkaline Phosphate
AST
LDH
Serum Bilirubin

All

A

Increase

(Below are NORMAL VALUES)

ALP (Alkaline Phosphate)
Normal Values 44 to 147

AST (Aspertate Aminotransferase)
Normal 10 - 36

LDH 140 - 280 Elevated = tissue damage

Serum bilirubin <1 mg/dl , Jaundice = >2.5 mg/dl

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11
Q

Best diagnostic assessment for Gall Stones

A

Ultrasound

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12
Q

Shock can occur from gallstones getting loged in the duct

Call Rapid response if in shock

Place HOB in which position, if shock occurs

A

Flat

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13
Q

Ketorolac is….

A

NSAID can treat gallstones

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14
Q

Ursodiol & Chenodal

Are used to…

A

Disolve gallstones

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15
Q

Extracorporeal shock wave lithotripsy (ESWL) is….

A

a non-invasive procedure that uses shock waves to break up stones in the urinary system, bile ducts, and pancreatic duct

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16
Q

percutaneous transhepatic biliary drain

Does..

A

Drains bile from liver

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17
Q

Which is the GOLD STANDARD of surgical intervention for Gallstones

A

Laparoscopic

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18
Q

Diet for Gallstones

A

High fiber- Low fat

Small frequent meals

Avoid gas producing meals

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19
Q

After removing Gall Stones teach about Post-Cholecystectomy Syndrome

Which….

A

May result in new stones with pain

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20
Q

Autodigestion & fibrosis of pancreas

Can be life threatening

Is called

A

Acute pancreatitis

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21
Q

Acute pancreatitis

Causes

A

Gallstones

Trauma (Surgery) Whipple Procedure

Obstruction

Hyperlipidemia

Renal failure

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22
Q

Pancreatitis can have an Attack from drinking alcohol

T or F

A

T

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23
Q

Mid- epigastric or LUQ

Jaundice

Gray-blue discoloration

Shock like symptoms

A

Acute pancreatitis

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24
Q

ALP Alkaline Phosphate

Normal range

A

44 - 147

Increase = liver damage

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25
Q

AST (aspartate aminotransferase)

Normal Levels

A

10 - 36

> Liver Damage

26
Q

LDH (Lactose dehydranse)

Normal Range

A

140 - 280

Increase = Tissue Damage

27
Q

Serum Bilirubin

Normal levels

A

< 1mg/ dl

Jaundice = >2.5 mg/dl

28
Q

The _____ duct is a tube that carries bile from the gallbladder to the common bile duct

The _____ duct is a tube that carries bile from the liver and gallbladder to the small intestine

carries digestive juices and fluid from the pancreas to the duodenum

A

cystic

common bile

Pancreatitic duct

29
Q

Choledocholithiasis….
Can cause jaundice and liver cell damage

A

Common bile duct stone,

Gallstones form in the common bile duct.

The common bile duct is a small tube that carries bile from the gallbladder to the intestine.

30
Q

Cholangitis..

Symptoms include fever, chills, and abdominal pain. In some cases, the skin may turn

Treatment includes antibiotics and medications

A

A serious infection of the liver’s bile ducts.

Stone blocks the normal passage of bile, a fluid made by the liver to help digest fats. As the fluid backs up, an infection can occur.

31
Q

Total Cholesterol Range

A

125 - 200 mg/dL

32
Q

Non-HDL Level

A

<130 mg/dL

33
Q

LDL Level

A

<100 mg/ dL

34
Q

HDL Levels

A

40mg/dL or higher

35
Q

Biliary colic is caused by…

A

Obstruction of the cystic duct

36
Q

Difference between Cholecystitis & Cholelithiasis

A

Cholecystitis: Inflammation of the gallbladder

Cholelithiasis: Gallstones

37
Q

For incisional pain use Heat or Ice

38
Q

Lab values to assess nutrition

Decrease = malnutrition

BUN

A

BUN 10 - 20 mg/dL

39
Q

Lab values to assess nutrition

Decrease = malnutrition

Prealbumin

A

16 - 30 mg/dL

40
Q

Lab values to assess nutrition

Decrease = malnutrition

Albumin

41
Q

Lab values to assess nutrition

Decrease = malnutrition

Total protein

A

6 - 8.3 g/ dL

42
Q

Lab values to assess nutrition

Decrease = malnutrition

Transferrin

A

250 - 300 mg/ dL

43
Q

Transferrins job in the body

A

Transferrin is a protein produced by the liver that transports iron from storage and absorption sites to tissue cells

44
Q

BUN
Prealbumin
Albumin
Total Protein
Transferrin

All are used to assess which status

45
Q

Infection/ Shock
Necrotizing hemorrhagic pancreatitis
AKI
Paralytic ileus
Hypovolemia shock
Pleural effusion
Acute respiratory Distress syndrome
Atelectasis
Pneumia
MultiOrgan system failure
Disseminated intravascular coagulation

Are all complications of…

A

Pancreatitis

46
Q

Opiates, sulfonamides, thiazides, steroids

May all cause this problem

A

Acute pancreatitis

47
Q

Which type of problem may occur after consumption of alcohol, Cholelithiasis, or biliary tract problems

A

Acute pancreatitis

48
Q

Gray-blue discoloration is seen in this problem

A

Acute pancreatitis

49
Q

With acute pancreatitis

Describe

Temp, HR, BP

A

Temp UP
HR UP
BP DOWN

50
Q

Grey turner’s & Cullens sign are located where

A

Grey turner’s Flank

Cullens PeriUmbilical

51
Q

Priority of care for Pancreatitis

A

Monitor for signs of shock.

Changes in LOC due to

Alcohol Withdrawal
Hypoxia
Impending Sepsis w/ shock

52
Q

Acute pancreatitis

Medication

A

Opoids
Histamine receptor Antagonist
PPI

53
Q

Chronic pancreatitis may have similar S/S as…

A

DM

Polyuria, Polydipsia, polyphagia

54
Q

Pancreatitic enzymes replacement therapy (PERT) is used for…

A

Chronic pancreatitis

55
Q

Diet for Chronic Pancreatitis

A

Possible TPN or TEN

4000 - 6000 calories per day

High carb, high protein, low fat

56
Q

In chronic pancreatitis

Have blood work checked to monitor uric acid levels

A

normal uric acid level is between

3.5 and 7.2 milligrams

57
Q

pancreaticoduodenectomy,

removes the head of the pancreas, the first part of the small intestine,thegallbladder,and part of thebile duct.

In some cases, the surgeon may also remove the body of the pancreas, the entireduodenum,and a portion of the stomach

This procedure is AKA

A

Whipple procedure

58
Q

Serum lipase range

A

10 to 140 units per liter (U/L), while for adults 60 and older, it’s 24 to 151

59
Q

Serum amylase level norms

A

19 units per liter (U/L) and 86 U/L

60
Q

Normal glucose range

A

82 - 110 mg/ dL

61
Q

Normal WBC range

A

4800 - 10,800 ccm

NURS 1345 (12 decks)

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