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Med Surg > Hepatobiliary Disorders 2 > Flashcards

Hepatobiliary Disorders 2 Flashcards

1
Q

high mortality rate

not good treatment for

A

pancreatic cancer

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2
Q

when is pancreatic cancer typically found

A

in late stage (too late to help)

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3
Q

describe pancreatic cancer

A

highly METASTATIC -travels to other parts of body

bad screening methods for this cancer

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4
Q

where is the cancer typically found on pancreas

A

typically on head of pancreas

body and tail spread faster than head (too late if on this part)

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5
Q

S/S of pancreatic cancer

A

jaundice, pruitus, steatorrhea, abdominal pain, wt loss, fatigue, elevated amylase, elevated lipase, elevated CEA, ascites, loss of appetite

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6
Q

you are AT RISK for pancreatic cancer IF

A 
SMOKE
maybe alcohol(unsure of link- no direct evidence)
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7
Q

treatment for pancreatic cancer

A
  • referral to hospice (terminal diagnosis)
  • chemo will extend life somewhat
  • surgery
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8
Q

what type of surgery is sometimes done for pancreatic cancer

A

*WHIPPLE:
removes head of pancreas (can only be done if on head of pancreas)
outlook is GOOD with this procedure

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9
Q

what is albumin

A

PROTEIN

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10
Q

liver has over ____ functions

A

400

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11
Q

some functions of liver include

A

storage of vitamins
protective organ (keeper cells engulf bacteria)
metabolize
synthesize albumin
breaks down proteins (ie/ ammonia to urea)

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12
Q

a lot of blood moves through ______

A

portal vein

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13
Q

high pressure system

A

ARTERIES

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14
Q

NOT high pressure system

A

VEINS

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15
Q

hardening and destruction of liver cells

A

cirrhosis and liver failure

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16
Q

what happens during cirrhosis and liver failure

A

normal blood volume cant get in (blocks up)
veins become large and weak (can burst easily)
small symptoms that are not noticeable occur

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17
Q

complications of cirrhosis and liver failure

A

portal HTN, ascites, esophageal varices (bleeding: blakemore tube), jaundice, hepatic encephalopathy

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18
Q

describe why portal HTN occurs with cirrhosis and liver failure

A

high pressure system in the portal vein

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19
Q

explain why ascites occurs with cirrhosis and liver failure

A

fluid shift, attempt to be isotonic

test for fluid wave

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20
Q

describe why esophageal varices occurs with cirrhosis and liver failure

A

bleeding**

eventually high pressure leads to rupture (pressure blows veins)

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21
Q

what is given if esophageal varices

A

Balloon Tamponade- AKA Blakemore Tube to hold pressure on the bleeding varices

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22
Q

describe why jaundice occurs with cirrhosis and liver failure

A

bilirubin back in skin

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23
Q

describe what hepatic encephalopathy is

A

*coma
worst symptom of cirrhosis and liver failure
can be toxic (ammonia) and eventually cause death

24
Q

S/S of cirrhosis and Liver failure

A

vague symptoms

fatigue, wt change, random GI symptoms

25
Q

late stage S/S of cirrhosis and liver failure

A

GI bleeding, jaundice, ascites, bruising, palpable nodular liver, pain (abdominal), dyspepsia, GERD

26
Q

a sick liver CANNOT make _______

A

ALBUMIN

so serum albumin goes down

27
Q

what enzymes increase with liver failure

A

serum liver enzymes

28
Q

what decreases with liver failure

A

platelet test

29
Q

what tests are done to determine cirrhosis/liver failure

A

CT scan or ultrasound of liver

30
Q

what are you at risk for if have liver failure

A

THROMBOCYTOPENIA (decrease in platelets so risk for bleeding)

31
Q

what CONFIRMS cirrhosis

A

liver biopsy

32
Q

liver biopsy precautions

A

watch for *bleeding
watch VS changes
lay on LEFT side (expose right side)
take deep breaths and exhale

33
Q

what side do you lay on immediately after procedure of liver biopsy

A

right side

34
Q

priority liver biopsy interventions

A

1) manage FLUID VOLUME
2) manage/prevent hemorrhage
3) manage hepatic encephalopathy

35
Q

other liver biopsy interventions

A

watch Na intake, take multivitamin/follate, diuretic(for fluid volume)

36
Q

Paracentesis

A

management of fluid volume

MD inserts a catheter into the abdomen to remove and drain ascitic fluid from peritoneal cavity

37
Q

nursing priorities for paracentesis

A

watch vital signs and drain SLOWLY

position SITTING UP

38
Q

track is made between the portal vein, hepatic veins and systemic circulation. The shunts are kept open with stents that are inserted and this increases the systemic circulation and decreases the portal hypertension

A

TIPS

39
Q

shunts fluid from parietal cavity to heart

A

TIPS

40
Q

what are common bleeding precautions

A

soft bristle brush and electric shaver

41
Q

increased ammonia because it is not broken down

extra ammonia causes cognition changes

A

hepatic encephalopathy

42
Q

S/S of hepatic encephalopathy

A

asterixis, mental/motor change, decrease in reflexes, fetor

43
Q

asterixis

A

hand flapping tremor

44
Q

fetor

A

bad breath

45
Q

anything that increases ammonia will…

A

make symptoms worse (ie/ GI bleed)

46
Q

what must be decreased in diet if hepatic encephalopathy

A

ammonia (protein)

47
Q

aka “cleansing enema”

causes diarrhea and cramping

A

lactulose

48
Q

teaching for pt with hepatic encephalopathy

A

no alcohol, increase in fat/carb, decrease in protein, bed rest, bleeding precautions

49
Q

80% of people with this will have an acute infection and develop antibodies

A

Hep B

50
Q

what happens to the other 20% of Hep B pts

A

will carry the antigen, never makes antibodies

***we vaccinate AGAINST these people

51
Q

this is possibly sexually transmitted, blood borne

A

Hep C

52
Q

this is the primary cause of liver cancer

A

Hep C

53
Q

is there a vaccine for Hep C

A

no vaccine but good cures/treatments

54
Q

this is oftentimes just the “stomach bug”

A

Hep A

55
Q

this ONLY affects pts with Hep B

A

Hep D

Med Surg (23 decks)

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