lewis ch 43 liver, pancreas, and biliary tract problems Flashcards
how are hepatitis A and E transmitted
fecal oral
which types of hepatitis have vaccines
A and B
how is hepatitis B transmitted
blood
semen
saliva
how is hepatitis C transmitted
blood
semen
how is hepatitis D transmitted
blood
S+S all types of hepatitis (5)
- RUQ discomfort
- N/V
- fever and chills
- jaundice
- dark urine
treatment for all types of hepatitis (3)
- rest
- nutrition
- hydration
complications of hepatitis (4)
- chronic active hepatitis
- fulminant hepatitis (severe acute hepatitis)
- cirrhosis
- hepatocellular carcinoma
most important precaution to prevent spread of Hep A
hand washing after bowel movements and before eating
important precautions to prevent spread of Hep B (3)
- using gloves
- don’t share razors, toothbrushes
- use condom
primary measures to prevent Hep C transmission (3)
- screen blood, organ, and tissue donors
- use of infection control precautions
- modifying high-risk behavior
teaching for patients with hepatitis (6)
- rest
- no sexual contact (Hep B)
- no alcohol
- no blood donation
- no OTC meds (tylenol)
- private bathroom
risk factors for liver cirrhosis (5)
- excessive alcohol use
- nutritional deficiencies
- chronic hepatitis
- biliary infections
- obesity
S+S liver cirrhosis (7)
- change in bowel habits
- gastritis
- jaundice
- anemia
- kypokalemia
- hyponatremia
- peripheral edema
late S+S cirrhosis (8)
- jaundice
- LOC changes
- spider angiomas
- anemia
- ascites
- sexual changes
- edema
- peripheral neuropathy
nursing care cirrhosis (6)
- measure abdominal girth
- daily weight measurement
- turn q2h
- monitor color urine and stools
- measure and elevate lower extremities
- ROM exercises
complications of cirrhosis (5)
- portal hypertension
- peripheral edema
- ascites
- hepatic encephalopathy
- hepatorenal syndrome
2 options for procedures to treat cirrhosis
- paracentesis
- balloon tamponade
nursing care for patient having paracentesis procedure for ascites (4)
- have patient void immediately before
- patient in high fowlers position
- monitor for hypovolemia
- monitor bp and heart rate
nursing care for patient having balloon tamponade procedure for esophageal or gastric varicies (4)
- patient in semi-fowlers position
- keep scissors at bedside
- monitor for complications
- oral/nasal care
S+S portal systemic encephalopathy
- changes in LOC
- neuromuscular disturbances
- asterixis (“liver flap”)
- hyperreflexia
- increased blood ammonia
treatment for portal systemic encephalopathy (2)
- decrease protein in diet
- give lactulose and neomycin
S+S cholecystitis (6)
- jaundice
- N/V
- fat intolerance
- abdominal distention
- RUQ pain
- fever and leukocytosis
risk factors for developing cholelithiasis (5)
- high cholesterol
- upset of bile/cholesterol balance
- females and pregnancy
- over 40 yo
- obesity
risk factors for developing cholecystitis (4)
- cholelithiasis
- E coli infection
- cancer or adhesions
- anesthesia
S+S biliary duct obstruction by gallstones (5)
- jaundice
- clay-colored stools
- dark foamy urine
- fever
- increased WBC count
3 options for surgical treatment with gallbladder problems
- ERCP
- lap chole
- incisional chole
how long is patient supposed to be NPO when having ERCP treatment
until return of gag reflex
when can patient who had lap chole return to work
1 week after surgery
S+S acute pancreatitis (8)
- severe constant pain ULQ
- vomiting
- low grade fever
- hypotension
- tachycardia
- abdominal distention
- cullen’s sign
- grey turner’s sign
what is cullens sign with pancreatitis
bruising around umbilicus
what is grey turners sign with pancreatitis
bruising around flanks
S+S chronic pancreatitis (5)
- burning, cramping pain
- jaundice
- abdominal distention
- hyperglycemia
- weight loss
risk factors pancreatitis (4)
- biliary tract obstructive disease
- alcohol
- HLD
- smoking
2 possible complications pancreatitis
- pseudocyst
- abscess
what electrolyte imbalance is common with pancreatitis
hypocalcemia
what diet should patient with pancreatitis eat
bland
low-fat
high-carb
