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Adult Health Pt 2 > Hepatic/Biliary Disorders > Flashcards

Hepatic/Biliary Disorders Flashcards

1
Q

Hepatitis B

A
  • transmitted primarily by blood
  • long incubation period
  • most develop antibodies and recover w/o complications
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2
Q

Risk Factors for Hep B

A
  • blood transfusion
  • frequent exposure to blood/blood products
  • multiple sex partners
  • IV drug use
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3
Q

Hep B S/S

A
  • anorexia
  • insomnia
  • low grade fevers
  • indigestion
  • RUQ pain
  • jaundice
  • rashes
  • arthralgia
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4
Q

Chronic Hep B Complications

A
  • cirrhosis
  • end stage liver disease
  • death usually imminent w/in 1-3 yrs w/o successful liver transplant
  • liver cancer
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5
Q

Hep B Prevention

A
  • Hep B vaccine
  • eliminate risky behavior
  • Hep B hyperimmune globulin
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6
Q

When to get Hep B Hyperimmune Globulin

A
  • post exposure prophylaxis for people at risk
  • recently exposed to body fluids of individuals w/ Hep B
  • babies of moms w/ hep , sexual partners, healthcare workers, police/fire men, morticians
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7
Q

Hep C

A
  • occurs most commonly after IV drug use or blood transfusions (prior to 1992)
  • multiple partners/needle sticks
  • asymptomatic for decades
  • leading cause of liver disease
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8
Q

Acute Hep C S/S

A
  • jaundice
  • n/v
  • malaise
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9
Q

Chronic Hep C S/S

A
  • usually on accidental findings or cirrhosis occurs
  • jaundice
  • bleeds/bruises easily
  • dry/itchy skin
  • ascites
  • pedal edema
  • hepatic encephalopathy
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10
Q

Alcoholic Hepatitis

A

over-ingestion of alcohol leads to liver disease

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11
Q

S/S of Alcoholic Hepatitis

A
  • jaundice
  • anorexia, n/v, abdominal pain
  • spider angiomas
  • palmar erythema
  • enlarged liver or small & hardened
  • splenic enlargement
  • ascites, pedal edema, hepatic encephalopathy
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12
Q

Treatment for Alcoholic Hepatits

A
  • alcohol cessation
  • monitor for withdrawal
  • rest
  • adequate hydration
  • treatment of symptoms
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13
Q

Alcohol Withdrawal Stage 1

A
  • after 8 hrs
  • anxiety
  • insomnia
  • nausea
  • abdominal pain
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14
Q

Alcohol withdrawal Stage 2

A
  • after 1-3 days
  • high BP
  • increased body temp
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15
Q

Alcohol Withdrawal Stage 3

A
  • after 1 week
  • hallucinations
  • fever
  • seizure
  • agitation
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16
Q

Drug-Induced Hepatitis

A

-acute liver failure caused by ingestion of certain meds

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17
Q

What meds can cause drug-induced Hep?

A
  • acetaminophen
  • Dilantin
  • statins
  • sulfa antibiotics
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18
Q

S/S of Drug-Induced Hep

A 
Abrupt
-fever/chills
-rash/itching
-arthralgia
-anorexia/nausea
Late
-jaundice
-enlarged liver
-dark urine
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19
Q

Treatment for Drug-Induced Hep

A
  • discontinue offending meds
  • antidote if available
  • monitor liver damage-albumin, total protein
20
Q

What is the antidote for acetaminophen?

A

oral mucomyst

21
Q

Cirrhosis

A

final stage of chronic liver disease that results in scarring of the liver

  • damage can not be undone but if treated early can be limited
  • compensated and uncompensated
22
Q

Compensated Cirrhosis

A

-liver can still do its job b/c there are enough healthy cells to make up for the damage and scarring

23
Q

Uncompensated Cirrhosis

A

liver has to much scarring and patient develops complications

24
Q

Compensated Cirrhosis S/S

A 
-asymptomatic or vague early 
Later
-intermittent low grade fevers
-epistaxis
-vascular spiders, palmer erythema
-dyspepsia, mild abdominal pain
25
Q

Uncompensated Cirrhosis S/S

A
  • jaundice
  • ascites
  • pedal edema
  • esophageal varices
  • hepatic encephalopathy
26
Q

Nursing Management for Cirrhosis

A
  • assess symptoms, hx, mental status, med list
  • promote adequate rest
  • sitting to promote max lung expansion
  • O2 may help
  • daily weights
  • strict I&O’s
  • nutrition
  • skin
  • injury precautions
27
Q

Complications w/ Cirrhosis

A
  • bleeding/hemorrhage
  • hepatic encephalopathy
  • fluid volume excess
28
Q

Cholelithiasis

A

formation of stones in the gallbladder

  • pigment stones
  • cholesterol (bile) stones
29
Q

Pigment Stones

A

common in people w/ certain medical conditions

30
Q

Cholesterol (bile) Stones

A

Most common

  • excess cholesterol in bile
  • gallbladder doesn’t empty properly
31
Q

Risks for Cholelithiasis

A
  • obesity/rapid weight loss
  • female
  • multiple pregnanc
  • estrogen therapy
  • diabetes
  • fam hx
32
Q

S/S of Cholelithiasis b/c Gallbladder Disease

A
  • RUQ pain especially after meal of fried/fatty foods

- biliary colic-pain comes on suddenly

33
Q

S/S of Cholelithiasis b/c Obstruction of Bile Duct

A
  • fever
  • GB enlarged/may be palpable
  • biliary colic
  • nausea
  • unable to get comfortable
34
Q

Cholecystitis

A

inflammation of the gallbladder

-becomes distended and inflamed from repeated episodes of obstruction of cystic duct

35
Q

Symptoms of Cholecystitis

A
  • RUQ pain and rigidity radiating to below right shoulder and to back b/t scapula
  • n/v
    • Murphy’s sign (stops inhaling due to pain caused by palpation)
36
Q

Treatment for Cholecystitis

A
  • bowel rest
  • ursodiol to help dissolve small stones
  • cholecystectomy
37
Q

Post-Op Cholecystectomy

A
  • no lifting > 5 lbs for 1-2 weeks
  • may shower on day 2
  • ambulate early
  • wash puncture sites w/ soap and water
  • allow steri strips to fall of on their own
  • regular diet as tolerated
  • Norco/Percocet
  • diarrhea up to 6 months is not uncommon
38
Q

What is performed after lap chole when their is suspicion that remaining stones are obstructing bowel duct?

A

Endoscopic Retrograde Cholangiopancreatography

ERCP

39
Q

Pancreatitis

A

inflammation of the pancreas

40
Q

Acute Pancreatitis

A
  • sudden inflammation of pancreas
  • gallstones or alcohol are common cause
  • mild or life threatening but usually subsides
  • usually has undiagnosed chronic pancreatitis
41
Q

Acute Pancreatitis S/S

A
  • severe abdominal pain-24-48 hours after heavy meal or alcohol
  • n/v
  • abdominal distention/decreased BS
  • guarding
  • low grade fever
  • increased pain w/ movement
  • pain relieved somewhat by leaning over
  • elevated amylase and lipase
42
Q

Treatment for Acute Pancreatitis

A
  • strict NPO
  • IV fluids
  • IV analgesics
  • IV antibiotics
  • antiemetic
  • close monitoring
  • may need transfer to ICU
43
Q

Complication from Acute Pancreatitis

A
  • F/E imbalances
  • hypovolemic shock
  • pancreatic necrosis
  • multi-system organ failure
44
Q

Chronic Pancreatitis

A
  • inflammation of pancreas that does not improve over time
  • common cause is heavy alcohol consumption w/ smoking
  • caused by gallstones inside duct
45
Q

S/S of Chronic Pancreatitis

A
  • recurring attacks of pain
  • vomiting
  • anorexia
  • weight loss
  • malnutrition/malabsorption
46
Q

Treatment for Chronic Pancreatitis

A
  • prevention-smoking/alcohol cessation
  • proper nutrition
  • pain meds
  • pancreatic enzyme replacement
  • PPI

Adult Health Pt 2 (8 decks)

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