Hepatobiliary Disorder

Question 1

ductless system

Answer 1

endocrine gland

Question 2

secretes hormones directly into the blood

Answer 2

endocrine gland

Question 3

tells body to do or not do something

absorbed into capillaries around cells

Answer 3

hormone

Question 4

this decreases blood sugar

Answer 4

inslun

Question 5

this increases blood sugar

Answer 5

glucagon

Question 6

beta cells of the pancreas secrete what

Answer 6

insulin

Question 7

alpha cells of endocrine secrete what

Answer 7

glucagon

Question 8

duct system

Answer 8

exocrine gland

Question 9

secretes products ie/ digestive enzymes/juices

secreted via ducts

Answer 9

exocrine gland

Question 10

these release ENZYMES to digest food

Answer 10

gallbladder and pancreas

Question 11

this enzymes breaks down starches

Answer 11

amylase

Question 12

this enzymes breaks down fat

Answer 12

lipase

Question 13

this enzymes breaks down protein

Answer 13

trysin

Question 14

this is inflammation of pancreas

Answer 14

amylase

Question 15

what can acute pancreatitis affect

Answer 15

gall stones-blocks enzymes

Question 16

how does being a chronic alcoholic affect acute pancreatitis

Answer 16

Changes structures of pancreatic duct
Forms strictures (scar tissue)

Question 17

describe what occurs during acute pancreatitis

Answer 17

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

if blocked, the enzymes will autodigest the pancreas

Question 18

what does autodigestion cause

Answer 18

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

Question 19

acute and chronic pancreatitis have…

Answer 19

different outcomes

Question 20

S/S of acute pancreatitis

Answer 20

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

Question 21

what happens to fluid during acute pancreatitis

Answer 21

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

Question 22

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

Answer 22

BLEEDING

Question 23

this can occur during acute pancreatitis

bruising around umbilical cord

Answer 23

Cullen’s sign

Question 24

this can occur during acute pancreatitis

back pain

Answer 24

Turner’s sign

Question 25

what happens to the BP during acute pancreatitis

Answer 25

``` LOW BP (hypotension) due to bleeding and ascites (larger abdomen will decrease BP) ```

Question 26

lab diagnoses for acute pancreatitis

Answer 26

ultrasound | blood work

Question 27

what blood work indicates acute pancreatitis

Answer 27

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

Question 28

why does lipase in blood indicate pancreatitis

Answer 28

lipase is not supposed to be in blood | should be in PANCREAS

Question 29

what do ACT and AST indicate

Answer 29

liver function

Question 30

what are acute pancreatitis interventions

Answer 30

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

Question 31

how do you decrease gastric secretions of pancreatitis pt

Answer 31

*keep stomach empty and dry | keep NPO, NGT to suction, bed rest

Question 32

what pain meds are given for acute pancreatitis

Answer 32

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

Question 33

what other meds are commonly given for pancreatitis

Answer 33

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

Question 34

anything that enters the stomach triggers..

Answer 34

pancreas

Question 35

when you start eating after acute pancreatitis

Answer 35

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

Question 36

what is important for post acute pancreatitis pt

Answer 36

WEIGH client daily | same clothes, same scale, same time

Question 37

education for post acute pancreatitis pt

Answer 37

avoid caffeine | initially avoid alcohol use

Question 38

S/S of acute biliary disease

Answer 38

jaundice, clay colored stools, dark urine

Question 39

most common cause of CHRONIC pancreatitis

Answer 39

ALCOHOL

Question 40

what occurs to pancreas in chronic pancreatitis

Answer 40

calcified pancreas-permanent damage

Question 41

describe chronic pancreatitis

Answer 41

loss of exocrine and endocrine function * cant digest food which leads to fatty stool (steatorrhea) * wt loss, muscle wasting, foul smelling stool

Question 42

what do chronic pancreatitis pts need

Answer 42

lifelong insulin and meds for loss of function and malabsorption

Question 43

Chronic pancreatitis is a major risk factor for

Answer 43

pancreatic cancer

Question 44

what is given daily to chronic pancreatitis pts

Answer 44

pancreatic enzyme replacement (PER)= | daily meds to replace enzymes not being made

Question 45

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

Answer 45

pancrilipase (Creon)

Question 46

management of chronic pancreatitis is effective if

Answer 46

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

Question 47

what did TPN stand for

Answer 47

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)

Question 48

what can spike BS in chronic pancreatitis pt

Answer 48

TPN and steroids

Question 49

how are acute and chronic pancreatitis the same

Answer 49

same stabilization but outcomes are different because chronic is long term