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Med Surg > Hepatobiliary Disorder > Flashcards

Hepatobiliary Disorder Flashcards

1
Q

ductless system

A

endocrine gland

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2
Q

secretes hormones directly into the blood

A

endocrine gland

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3
Q

tells body to do or not do something

absorbed into capillaries around cells

A

hormone

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4
Q

this decreases blood sugar

A

inslun

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5
Q

this increases blood sugar

A

glucagon

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6
Q

beta cells of the pancreas secrete what

A

insulin

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7
Q

alpha cells of endocrine secrete what

A

glucagon

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8
Q

duct system

A

exocrine gland

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9
Q

secretes products ie/ digestive enzymes/juices

secreted via ducts

A

exocrine gland

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10
Q

these release ENZYMES to digest food

A

gallbladder and pancreas

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11
Q

this enzymes breaks down starches

A

amylase

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12
Q

this enzymes breaks down fat

A

lipase

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13
Q

this enzymes breaks down protein

A

trysin

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14
Q

this is inflammation of pancreas

A

amylase

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15
Q

what can acute pancreatitis affect

A

gall stones-blocks enzymes

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16
Q

how does being a chronic alcoholic affect acute pancreatitis

A 
Changes structures of pancreatic duct
Forms strictures (scar tissue)
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17
Q

describe what occurs during acute pancreatitis

A

once activated, the enzymes will break down the cells/organs

if blocked, the enzymes will autodigest the pancreas

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18
Q

what does autodigestion cause

A 
extreme pain 
immune response (swelling, bleeding out, decreased proteins)
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19
Q

acute and chronic pancreatitis have…

A

different outcomes

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20
Q

S/S of acute pancreatitis

A 
severe pain (increases when eat)
abdominal distention
palpable abdominal mass (pancreas)
rigid abdomen (guarding)
bruising, fever, N/D, jaundice
21
Q

what happens to fluid during acute pancreatitis

A

fluid leaves the vascular space due to body responding to decrease in protein

22
Q

what does a rigid and board like abdomen indicate***

A

BLEEDING

23
Q

this can occur during acute pancreatitis

bruising around umbilical cord

A

Cullen’s sign

24
Q

this can occur during acute pancreatitis

back pain

A

Turner’s sign

25
Q

what happens to the BP during acute pancreatitis

A 
LOW BP (hypotension)
due to bleeding and ascites (larger abdomen will decrease BP)
26
Q

lab diagnoses for acute pancreatitis

A

ultrasound

blood work

27
Q

what blood work indicates acute pancreatitis

A

elevated serum: lipase and amylase
elevated WBC, glucose, bilirubin, ACT+ AST
decrease in Ca and Mg

28
Q

why does lipase in blood indicate pancreatitis

A

lipase is not supposed to be in blood

should be in PANCREAS

29
Q

what do ACT and AST indicate

A

liver function

30
Q

what are acute pancreatitis interventions

A

goal: control pain

decrease gastric secretions, hydrate (IV fluids), replace Ca and Mg, assess for return of bowel sounds, pain meds

31
Q

how do you decrease gastric secretions of pancreatitis pt

A

*keep stomach empty and dry

keep NPO, NGT to suction, bed rest

32
Q

what pain meds are given for acute pancreatitis

A

Fentanyl patch
morphine and dilaudid
PCA( pt controlled analgesic) is commonly used

33
Q

what other meds are commonly given for pancreatitis

A

steroids- decrease inflammation
Zantac- decrease acid production
anticholinergics- antiSLUDGE (dry up pt)

34
Q

anything that enters the stomach triggers..

A

pancreas

35
Q

when you start eating after acute pancreatitis

A 
small frequent meals
moderate increase in carbs
increase in protein
low fats
AVOID GI stimulants (ie/ coffee or alcohol)
36
Q

what is important for post acute pancreatitis pt

A

WEIGH client daily

same clothes, same scale, same time

37
Q

education for post acute pancreatitis pt

A

avoid caffeine

initially avoid alcohol use

38
Q

S/S of acute biliary disease

A

jaundice, clay colored stools, dark urine

39
Q

most common cause of CHRONIC pancreatitis

A

ALCOHOL

40
Q

what occurs to pancreas in chronic pancreatitis

A

calcified pancreas-permanent damage

41
Q

describe chronic pancreatitis

A

loss of exocrine and endocrine function

  • cant digest food which leads to fatty stool (steatorrhea)
  • wt loss, muscle wasting, foul smelling stool
42
Q

what do chronic pancreatitis pts need

A

lifelong insulin and meds for loss of function and malabsorption

43
Q

Chronic pancreatitis is a major risk factor for

A

pancreatic cancer

44
Q

what is given daily to chronic pancreatitis pts

A

pancreatic enzyme replacement (PER)=

daily meds to replace enzymes not being made

45
Q

type of PER
do NOT crush or chew
take with ALL meals and snacks

A

pancrilipase (Creon)

46
Q

management of chronic pancreatitis is effective if

A

weight goes back to normal, no fatty food, not malnourished, no steatorrhea, no alcohol, increased calorie count (4000-6000 cal a day)

47
Q

what did TPN stand for

A

Total parenteral nutrition (Intravenous feeding that provides patients with all the fluid and the essential nutrients they need when they are unable to feed themselves by mouth)

48
Q

what can spike BS in chronic pancreatitis pt

A

TPN and steroids

49
Q

how are acute and chronic pancreatitis the same

A

same stabilization but outcomes are different because chronic is long term

Med Surg (23 decks)

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