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Adult Health 2 > Hepatic & GI > Flashcards

Hepatic & GI Flashcards

1
Q

Liver functions

A
  1. Drug, glucose, fat, and protein metabolism
  2. Ammonia conversion
    3.Vitamin & Fe storage
  3. Bile formation
  4. Bilirubin excretion
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2
Q

Chronic liver disease

A

-More common than acute
-Causes: cirrhosis, malnutrition r/t alcoholism, infections

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3
Q

Liver function test (LFT)
ALT normal range:

A

8-40

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4
Q

AST normal range:

A

10-40

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5
Q

Albumin normal range

A

3.5-5.2

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6
Q

Bilirubin normal range

A

0.3-1

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7
Q

PT/INR normal range

A

<1.1

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8
Q

Ammonia normal range

A

15-45

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9
Q

cholesterol normal range

A

0.6-0.7

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10
Q

HDL male

A

35-70

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11
Q

HDL female

A

35-85

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12
Q

LDL

A

< 130

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13
Q

4 types of jaundice

A
  1. hemolytic
  2. hepatocellular
  3. obstructive
  4. hereditary hyperbilirubin
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14
Q

Portal hypertension can cause…?

A

Ascites=
-rapid weight gain
-increased abdominal girth
-SOB
-distended veins
-striae
-umbilical hernias
-fluid & electrolyte imbalances

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15
Q

Portal hypertension is commonly caused by…?

A

cirrhosis

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16
Q

With portal hypertension your body retains what?

A

-H2O & Na+
-up to 20L

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17
Q

Portal Hypertension Nursing considerations with ascites

A

-I&Os
-Daily weight
-Measure abdomen
-Reposition for SOB
-Monitor labs (BUN & creatine)

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18
Q

Portal hypertension Education

A

-Dietary (low Na+ , 2g per day only)
-Be careful of salt substitutes- may have ammonia!
-Alcohol cessation support group
-May need diuretic -spironolactone

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19
Q

Portal hypertension can also cause what medical emergency?

A

esophageal varices

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20
Q

esophageal varices CM’s

A

-Medical Emergency!
-hematemesis
-melena (bloody stools, black tarry)
-general mental deterioration

21
Q

esophageal varices nursing considerations

A

-Medical emergency
-Monitor vitals
-Monitor mental status / LOC
-Gastric suctioning may be needed
-monitor nutritional status
-Dental needs

22
Q

Hepatic encephalopathy Risk Factors

A
  1. TIPS, portal vein thrombosis
  2. Infections
  3. AKI, electrolyte derangements
  4. GI Bleed
  5. Hypoxemia, hypercapnia
23
Q

Hepatic encephalopathy–what happens to ammonia & K+

A

-Ammonia levels increase
-K+ level decrease

24
Q

Hepatic encephalopathy can cause…

A

Seizures & coma

25
Q

hepatic encephalopathy nursing considerations

A

-may need liver transplant
-lower ammonia
-electrolyte balance
- Monitor LOC
-May treat w/ benzo antagonists

26
Q

Hepatitis A transmission

A

-passed on from small amounts of stool on food, objects, drinks, casual contact

27
Q

Is Hep A vaccine preventable? Is it curable?

A

-Yes, promote the vaccine
-Curable

28
Q

Hep A s/s:

A

-Flu-like symptoms
-low temp
-

29
Q

Hep B transmission? Vaccine?

A

-Passed via body fluids
-Vaccine preventable
-no cure
–can become chronic

30
Q

Hep C transmission? Vaccine? Curable?

A

-passed via body fluids
-No Vaccine
-curable
-Increases chance of liver cancer & cirrhosis

31
Q

Acute liver faiure

A

-Sudden & severely impaired liver function in a previously healthy person
-onset can vary from short to weeks
-prognosis is worse than in chronic liver disease

32
Q

Acute liver disease causes

A
  • Hep B
    -Drug overdose (acetaminophen)
33
Q

Acute liver disease s/s:

A

-jaundice
-anorexia
As it progresses:
-kidney disease
-infections
-Cardiovascular disease
-hypoglycemia
-cerebral edema
-electrolyte imbalance

34
Q

cirrhosis -alcoholic, postnecrotic, biliary

A

Normal liver tissue replaced with diffuse fibrous tissue –scar tissue

35
Q

cirrhosis s/s:

A

-liver enlargement
-ascites
-portal obstruction
-infections
-GI varices
-generalized edema
-vitamin deficiency
-anemia
-mental deterioration

36
Q

Cirrhosis nursing considerations

A

Treat symptoms:
-rest
-vitamin replacement
-Diuretics for edema
-I&Os
-Daily Weights

37
Q

Liver Cancer

A

Primary liver tumors
-hepatocellular carcinoma most common type (75%)
Liver metastases
-GI, Breast, & lung are 2.5x more likely to found in liver

38
Q

Liver cancer treatment

A

Chemo
Radiation
Surgical resection

39
Q

Liver Transplants

A

-very stringent criteria
-Manage complications
-bleeding
- infection
-rejection

40
Q

Liver transplant Nursing considerations

A

-incision site care
-IS
-focused assessments of renal, pulmonary, metabolic, cardio, respiratory function

41
Q

Small bowel obstruction CMS:

A

-crampy pain
-hypoactive bowel sounds/absent
-no flatus usually
-vomiting
-dehydration
-abdominal distention

42
Q

Small bowel obstruction nursing considerations

A

-NPO
-NG decompression
-Surgery may be needed if it is complete obstruction & not resolving
-risk of strangulation & necrosis

43
Q

Large bowel obstruction CM’s

A

-Progresses slowly
-lower abdominal distension
-crampy lower abdominal pain
-hypoactive to absent bowel sounds
-Constipation may be only symptom

44
Q

Large bowel obstruction medical management

A

-Restore fluid volume & balance electrolytes
-NPO
-NG decompression
-Colonoscopy
-rectal tube may be used if obstruction is low enough
-resection may be needed

45
Q

Bowel obstruction nursing considerations

A

-I&Os
-Assess NG function (color & amount)
-Assess for fluid & electrolyte imbalances
-Monitor nutritional status
-Monitor for resolution/symptom improvement
-if not improvement, prepare for surgery

46
Q

Ostomies Pre-op Educations

A

-diet
-fluid, electrolytes, blood
-Education about wound care
-involve family & support system

47
Q

Happy stomas are…

A

-bright red
-shiny
-skin intact

48
Q

ostomies nursing care

A

-Monitor for skin breakdown
-I&OPs
-emotional support
-empty every 4-6 hours

49
Q

Ostomies complications

A

-skin irritation
-leaking
-ill-fitting appliance
-scar tissue

Adult Health 2 (3 decks)

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