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sav nur 334 final exam week 7 > Hepatobiliary Labs & Diagnostics > Flashcards

Hepatobiliary Labs & Diagnostics Flashcards

1
Q

Abdominal ultrasound detects ____, _____, and ____

A

tumor, cysts, and stones

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2
Q

True or False? Abdominal ultrasound is invasive.

A

False. Abdominal ultrasounds are non invasive.

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3
Q

What is used for an abdominal ultrasound?

A

Conductive gel

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4
Q

What is an important nursing intervention that the nurse should teach the patient about before getting the abdominal ultrasound?

A

Instruct to be NPO 8 hrs. beforehand 2’ food causing gallbladder contraction (altering results). Keep the gut quiet.

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5
Q

How accurate is the abdominal ultrasound in finding gallstones?

A

95% accurate in finding gallstones

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6
Q

A computed tomography allows for exposure at _____ ______

A

different exposures

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7
Q

What is used to see different depths in a computed tomography (CT)?

A

Use of oral and IV contrast medium accentuates density differences.

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8
Q

What is an important nursing intervention that you should assess before doing a computed tomography (CT) if contrast is being used?

A

Assess renal function if using contrast. Always assess BUN and creatinine because contrast can be nephrotoxic.
Also, assess for iodine or shellfish allergies.

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9
Q

What is important for the nurse to teach to the patient about feeling during the CT scan?

A

Warn about “flushed” feeling

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10
Q

If contrast is being used during a CT scan, what should the nurse promote afterwards?

A

Force fluids to get dye out of the body.

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11
Q

A magnetic resonance imaging (MRI) is used to detect _____, _____, and ____ __ __ _____.

A

disease, lesions, and sources of GI bleed

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12
Q

A magnetic resonance image (MRI) is ______ and uses _____ ____ and a ______ _____.

A

non-invasive

radio-frequency waves and a magnetic field

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13
Q

What may be used for an MRI?

A

IV contrast (gadolinium)

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14
Q

_____ _____ and _____ are contradicted for MRI’s.

A

Metal implants and pregnancy

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15
Q

A ________ is done if diagnosis of cholecystitis remains uncertain following ultrasound.

A

Hepatobiliary Scintigraphy (HIDA) scan

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16
Q

Hepatobiliary Scintigraphy (HIDA) scan is a _____ _____ study.

A

Nuclear medicene

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17
Q

How does the HIDA scan work?

A

It is injected IV and is taken up by hepatocytes and excreted into bile.

18
Q

The HIDA scan demonstrates patency of _____ _____ _____ and _____

A

common bile duct and ampulla

19
Q

An endoscopic retrograde cholangiopancreatography (ERCP) visualizes and assess the _____, _____, and ____ ____ ____

A

pancreatic, hepatic, and common bile duct

20
Q

What are 3 things that should be done before and ERCP and all endoscopies?

A
  1. NPO x 8 hrs
  2. Consent form signed
  3. Administer sedation
21
Q

What is the most common complication of an ERCP?

A

pancreatitis

22
Q

What are 2 things nurses should do after an ERCP?

A
  1. Check VS (looking for manifestations of perforation or infection)
  2. Check for return of gag reflex (usually returns in 2-4 hours. Do this before giving fluid intake)
23
Q

Before a liver biopsy procedure:

  1. Check ____
  2. Ensure patient’s blood is ____ and ______
  3. _____ is signed
  4. Baseline ____ _____
  5. Explain- ___ ____ ____ ______ ___ ____ ____
A
  1. coags (INR and PT)
  2. typed and cross-matched
  3. consent
  4. vital signs
  5. hold breath after expiration when needle inserted
24
Q

After liver biopsy procedure:

  1. Frequent _____
  2. Keep on __ __ x ___ hrs.
  3. HOB ____ _____ hrs.
  4. Asses for ______
A
  1. VS (assessing for internal bleeding)
  2. right side x 2 hrs
  3. flat 12-24 hrs.
  4. complications (pneumothorax, peritonitis, shock)
25
Q

What is the most specific liver enzyme to the liver?

A

ALT

26
Q 
Liver Function Tests (LFTs)
Test:                              Abnormal trend
Liver enzymes               \_\_\_\_\_\_\_\_\_
ALT
AST
Alk Phos

Bilirubin (total) _________
conjugated (direct)
unconjugated (indirect)

Serum Ammonia (NH3) _________

Serum Protein (total) _________

Serum albumin __________

Prothrombin time (PT) _________

A

Liver Function Tests (LFTs)
Test: Abnormal trend
Liver enzymes increase
ALT
AST
Alk Phos

Bilirubin (total) increase
conjugated (direct)
unconjugated (indirect)

Serum Ammonia (NH3) increase

Serum Protein (total) decrease

Serum albumin decrease

Prothrombin time (PT) prolonged

27
Q

What is the product of RBC breakdown?

A

Serum bilirubin

28
Q

Total bilirubin is made up of _____ _____ and _____ ____.

A

Conjugated bilirubin and unconjugated bilirubin

29
Q

Bilirubin that has been conjugated by the liver; water soluble and can be found in urine found in obstructive jaundice is ____ _____.

A

Conjugated bilirubin

30
Q

Bilirubin that has not been conjugated by the liver; it is not water soluble so won’t be found in urine; elevated in hepatocellular and hemolytic conditions is ____ ____.

A

Unconjugated bilirubin

31
Q

What happens when bilirubin is in excess?

A

It is deposited in skin/urine; if obstruction is blocking flow of bile into intestine, stool will be clay-colored stools.

32
Q

When it comes to serum ammonia to urea it usually occurs in the ____.

A

Liver

33
Q

True or False? A decrease in serum ammonia can result in hepatic encephalopathy r/t cirrhosis.

A

False. An increase in serum ammonia can result in hepatic encephalopathy r/t cirrhosis.

34
Q

Ammonia crosses the blood-brain-barrier (BBB), altering what 3 things?

A
  1. LOC
  2. Intellectual function
  3. Neurological function
35
Q

What test is the only way to distinguish among the various forms of viral hepatitis?

A

Antigen/Antibody Testing (viral hepatitis)

36
Q

Viral genotype is done for both Hepatitis __ & __.

A

B & C

37
Q

What are the 2 pancreatic enzymes?

A
  1. serum amylase

2. serum lipase

38
Q

Which pancreatic enzyme digests carbohydrates?

A

amylase

39
Q

Which pancreatic enzyme digests fats?

A

lipase

40
Q

If a patient has acute pancreatitis, amylase will be elevated within __ of acute insult; peaks in __ hrs.

A

12 hrs

24 hrs

41
Q

If a patient has acute pancreatitis, lipase will be elevated within _____ hrs. of acute insult and remains ____ for ____ days.

A

24-48 hrs
increased
5-7 days

sav nur 334 final exam week 7 (8 decks)

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