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Nursing Theory Final Test > Liver, Biliary, And Pancreas > Flashcards

Liver, Biliary, And Pancreas Flashcards

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0
Q

What can happen to liver cells?

A

They can regenerate if no complications occur

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1
Q

What is jaundice?

A

A symptom, not a disease

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2
Q

What is hepatitis?

A
  • Inflammation of the liver
  • viral is most common
  • five major: A, B, C, D, E, and G
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3
Q

What are some viruses that can cause inflammation of the liver?

A
  • cytomegalovirus
  • Epstein-Barr virus
  • herpes virus
  • coxsackievirus
  • rubella virus
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4
Q

What are the symptoms of acute hepatitis?

A
  • 1-4 months
  • anorexia, vomiting, constipation, diarrhea, taste alterations, malaise, fatigue, headaches, low grade fever, arthralgia, skin rashes
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5
Q

What might be present with acute hepatitis if puritis is not?

A

Jaundice

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6
Q

What are symptoms of chronic hepatitis?

A
  • if jaundice is gone, infection may still be present
  • lifelong is most cases (B and C)
  • A has no symptoms in this stage
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7
Q

What are the complications of hepatitis?

A
  • low mortality rate
  • severe hepatic failure (rare)
  • chronic hepatitis
  • cirrhosis
  • hepatocellular carcinoma
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8
Q

How is hepatitis diagnosed?

A
  • serum liver enzymes
  • liver function
  • liver biopsy (final dx)
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9
Q

Important information about Hepatitis A

A

Vaccine available

Provides 6-8 weeks of temporary passive immunity

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10
Q

Important information about Hepatitis B

A

Vaccine available
Common form
Can live up to 7 days outside body

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11
Q

Important information about Hepatitis C

A

Can be cured with drug treatment

No vaccine available

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12
Q

Important information about Hepatitis D

A

Also tested for B because requires B to replicate
Response to treatment is poor, relapse is common
No vaccine

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13
Q

Important information about Hepatitis E

A

No vaccine

Two vaccines being considered

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14
Q

Collaborative care for hepatitis

A 
Smaller meals more often 
Daily weight
Treat pruritis 
Rest
Oral care to stimulate appetite 
Only symptom management 
Avoid alcohol and hepatoxins 
Hand hygiene
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15
Q

What is cirrhosis?

A

Final stage liver disease
Chronic and progressive
Liver cells try to regen but is too unorganized
Now known that cirrhosis can be reversible because of fibrosis regression

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16
Q

What are the types of cirrhosis?

A

Alcohol, most common
Nutrition related
Primary sclerosis (affecting small bile ducts in the liver)
Primary sclerosis cholangitis (colitis association)
Cardia cirrhosis (R sided heart failure association)

17
Q

What are the clinical manifestations of cirrhosis?

A

Thrombocytopenia (strongest indicator)
See page 3 on review
Symptoms related to neurologic, integumentary, gastrointestinal, hematologic, reproductive, metabolic, and cardiovascular systems

18
Q

Complications of cirrhosis

A 
Portal hypertension
Esophageal and gastric varices
Peripheral edema and ascites 
Hepatic encephalopathy
Hepato-renal syndrome
19
Q

What are the diagnostic tests done for cirrhosis?

A

Liver tests (most are abnormal)
Laboratory values
Liver biopsy
Liver ultrasound

20
Q

Collaborative care for cirrhosis

A 
No specific therapy
Rest
Manage ascites (diuretics, shunts, or paracentesis, removal of fluid)
Liver transplant
Prevent gastric or esophageal varices
I/O's, daily weight, abd girth
Monitor for resp distress
Nutritional therapy
Monitor for bleeding
21
Q

What is acute pancreatitis?

A

Acute inflammatory process of the pancreas
Mild edema to severe hemorrhagic necrosis
May recover, may develop chronic type
Can be life threatening

22
Q

What are the risk factors for acute pancreatitis?

A

Alcohol (most common)
Gallbladder disease
High triglyceride levels
May be idiopathic

23
Q

What are the symptoms of acute pancreatitis?

A 
Abd pain (most predominant) aggravated by eating
Nausea, vomiting, decrease or absent bowel sounds, fever, hypotension, tachycardia, jaundice, abd tenderness, crackles, ecchymosis, shock (if hemorrhage occurs)
24
Q

What are the diagnostic tests done for acute pancreatitis?

A

Serum lipase
Increased liver enzymes, triglycerides, glucose, and bilirubin
Decrease calcium level
Increase urinary amylase level

25
Q

Collaborative care for acute pancreatitis

A 
Pain management
Prevent shock
Decrease pancreatic secretions
Normal fluid/electrolyte balance
Remove cause
Prevent infection
Treat hypotension
Teach S&S of infection
Avoid OTC's unless ordered
26
Q

What is chronic pancreatitis?

A

Continuous inflammation and fibrosing process of pancreas
Tissue becomes progressively destroyed and replaced by fibrotic tissue
Strictures and calcification can occur
May follow acute, may also occur in absence of acute phase

27
Q

What are the two major types of chronic pancreatitis?

A

Obstructive and calcifying

28
Q

What are the symptoms of chronic pancreatitis?

A 
Abd pain and tenderness
Malabsorption and weight loss
Constipation
Jaundice
Dark urine
Steatorrhea
Diabetes mellitus
29
Q

What are the diagnostic tests done for chronic pancreatitis?

A 
Laboratory tests
Secretin stimulation to assess pancreatic function
Examine stools for fat
ERCP, CT, MRI
Ultrasound
30
Q

Collaborative care for chronic pancreatitis?

A 
Prevent attacks
Control pain
If acute attack, management is same of acute pancreatitis
Control pancreatic insufficiency
Bland, low fat, high carb diet
Bile salts
Enzyme replacement
Surgery to divert bile flow or relieve ductal obstruction
31
Q

What is choletithiasis? (In gallbladder disease)

A

Gall stones
Common in women
Unknown cause
Different types (cholesterol gallstone is most common)

32
Q

What is cholecystitis? (In gallbladder disease)

A

May involve pus
Can become very distended
Commonly associated with obstruction

33
Q

What are the symptoms of acute cholecystitis?

A

Pain and tenderness in RUQ r/t phrenic nerve
Abd rigidity
Indigestion
Fever

34
Q

What are symptoms of chronic cholecystitis?

A

Hx of fat intolerance and heartburn
May produce severe symptoms or none at all
Severity depends on presence of obstruction or wether the stones move or not
Attacks occur 3-6 hours after heavy meal or side lying

35
Q

What are Complications of cholecystitis?

A 
Gangrenous cholecystitis 
Subphrenic abscess 
Pancreatitis
Cholangitis 
Biliary cirrhosis 
Fistulas
Gallbladder rupture
36
Q

What are diagnostic tests done for cholecystitis?

A

Ultrasound

Hx and physical exam

37
Q

Collaborative care for cholecystitis

A 
If acute: 
Pain control
Infection control
Maintain fluid and electrolyte balance
NG if nausea and vomiting are severe
Control secretions and counteract smooth muscle spasms with anticholinergic
38
Q

Collaborative care for cholelithiasis

A

Bile acids may be given to dissolve the stones if they reoccur
ERCP to clear stones
Lithotripsy to break up stones

39
Q

Other collaborative care for gallbladder diseases

A 
Surgery
T tube (keep bile duct patent) 
Fat soluble vitamin supplements
Bile salts
Cholestyramine may be prescribed 
Smaller more frequent meals
Diet low in saturated fat, high in fibre and calcium 
Place in sims to alleviate pain

Nursing Theory Final Test (7 decks)

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