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Patho/Pharm 378 > Non Gastrointestinal Tube > Flashcards

Non Gastrointestinal Tube Flashcards

1
Q

Functions of the Liver

A

Metabolizes glucose and regulates blood glucose concentration
Converts glucose to glycogen to glucose to maintain normal levels
converts ammonia to urea
metabolizes protein, fats and drugs
forms and excretes bile
synthesizes factors needed for blood coagulation
excretes bilirubin

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2
Q

Gluconeogenesis

A

synthesizes amino acids to form glucose

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3
Q

Kupffer cells

A

engage in immunologic, detoxifying and blood filtering actions

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4
Q

Gallbladder

A

stores bile produced by the liver
bile helps the body break down fats
upon eating the gallbladder empties bile into the intestines to help digest food

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5
Q

Pancreas exocrine

A

produces enzymes that aid in digestion

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6
Q

Pancreases endocrine

A

islets of Langerhands

key role in glucose regulation

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7
Q

What do Beta Cells produce?

A

insulin and amylin

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8
Q

Why do Delta cells secrete?

A

somatostatin

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9
Q

What do PP cells secrete?

A

pancreatic peptide

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10
Q

Bilirubin

A

RBC breakdown product
initially insoluble and transported in blood bound to protein
bilirubin is conjugated to become water soluble and stored in the liver as part of bile

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11
Q

Jaundice

A

Serum bilirubin levels increase when

  • there is excessive destruction of RBCs
  • the liver cannot excrete bilirubin normally
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12
Q

three forms of jaundice

A

Hemolytic: excess destroyed RBC
Hepatocellular: liver disease
Obstructive: block in the passage of bile between the liver and the intestinal tract

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13
Q

Hepatitis

A

non specific term for inflammation of the liver
liver inflammation causes elevation in liver enzymes
viral infections: A,B,C,D,E,NANE

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14
Q

Causes of Hepatitis

A 
tumors
exposure ot hepatotoxic chemicals
drugs
alcohol abuse
invasion by an infectious microorganisms
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15
Q

Viral Hepatitis

A

Hep B: has a vaccine series
Hep C: has no vaccine and is progressive to liver failure, cancer, and death
Hep C: virus has multiple genotypes with various characteristics

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16
Q

Dx of Hepatitis

A 
liver enzymes
bilirubin levels
prothrombin time
antibody test
direct viral measure
imaging-MRI, CT, Sono
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17
Q

S/S of Hepatitis

A

Preicteric Phase: N/V, anorexia, fever, malaise, arthralgia, headache, RUQ pain, enlargement of spleen/liver/lymph nodes, weight loss, rash
Icteric Phase: Jaundice, pruritus, clay colors or light stools, dark urine, fatigue, anorexia, RUQ pain
Posticteric Phase: liver enlargement, malaise, fatigue

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18
Q

Hepatitis Tx

A

symptomatic tx including rest, balanced, diet of small feedings, IV fluids
removal of offending agents
relief of any obstructive problems
if viral: some Rx of benefit
liver transplantation may be performed for those not responding to treatment

19
Q

Drugs for Viral Hepatitis

A

interferons: naturally occurring cytokine with important role in immunity
given by injection 1x a week
side effects: flu like symptoms, depression

20
Q

Cirrhosis

A

liver cell irreversibly damaged leading to scarring of liver tissue
impaired ability to metabolize hormones and detoxify chemicals
disturbances in digestion and metabolism
defects in blood coagulation
fluid and electrolyte imbalances

21
Q

S/S of Cirrhosis

A 
Chronic fatigue
anorexia
dyspepsia
N/V/Diarrhea
constipation with weight loss
gray/whitish stool
dark or tea colored urine
abdominal discomfort and dyspnea
enlarged liver and ascites
impaired coagulation
22
Q

Liver Biopsy

A

reveals hepatic fibrosis, the most conclusive diagnostic procedure

23
Q

Tx for Cirrhosis

A 
No specific cute
Tx aimed at preventing further deterioration
Tx of nutritional problems
Vitamin K to correct coagulotherapy
restrict protein intake
avoid hepatotoxic drugs
24
Q

Nursing implications for Cirrhosis

A 
Monitor for alcohol withdrawal if relevant
daily weight
measure abdominal girth if enlarged
monitor response to drug therapy
monitor mental status
25
Q

Advanced Cirrhosis

A

portal hypertension: intrahepatic veins may be compressed from scarring
blood backs up unto portal system causing congestion and increased fluid pressure
Ascites
Hepatic Encephalopathy

26
Q

Esophageal Varices

A

treat portal hypertension
Antitussives and stool softeners
Injection sclerotherapy via endoscopy
variceal banding via endoscopy: placement of rubber band to restrict flow

27
Q

Hepatic Encephalopathy

A

ammonia forms in the intestine as a result of bacterial action on ingested proteins and would normally be converted to urea by the liver and eliminated
inability of the liver to convert ammonia leads to build up in the blood

28
Q

S/S Hepatic Encephalopathy

A 
Disorientation
personality changes
memory loss
positive babinski reflex
sulfurous breath oder
lethargy to deep coma
29
Q

Tx for Hepatic Encephalopathy

A

poor prognosis
eliminate dietary protein
deplete intestinal bacteria with abx
Lactulose: reduces serum ammonia by attracting it from the blood forming a compound that is eliminated in the feces
Levodopa: helps to restore neurotransmission in the brain

30
Q

Tumors of the Liver

A

an abnormal mass of ells
benign or malignant
Primary lesions are rare or represent metastases

31
Q

Tumors of the Liver Tx

A

Hepatic Lobectomy: removed malignant of benign tumor
Metastatic tumors are inoperable
IV chemotherapy

32
Q

Gall Bladder disorders

A

Cholelithiasis

Cholecystitis

33
Q

Cholelithiasis

A

gallstone formation with bile stasis

sx: beltching, flatulence, nausea, RUQ discomfort

34
Q

Cholecystitis

A

inflammation or infection of the gall bladder

acutely ill and worsened sx, fever,

35
Q

Nonsurgical Tx for Gall Blader disorders

A 
antibiotic
iv fluids
low fat diet
analgesics
nasogastric suction
36
Q

Surgical Tx for Gall Bladder disorders

A

laproscopic cholecystectomy

cholecystectomy

37
Q

Pancreatitis

A

Mild: inflammation and edema of the pancreas
Severe: generalized and complete enzymatic digestion of the pancreas occurs

38
Q

Autodigestion

A

reflux of bile and duodenal contents into the pancreatic duct which activates the exocrine enzymes of digestion

39
Q

S/S of Pancreatitis

A 
N/V, flatulence
fever
jaundice
hypotension
steatorrhea: fowel smelling stools resulting from fat in stool
40
Q

Cullens Sign

A

bluish gray discoloration at imbilicus

41
Q

Turners Sign

A

bluish gray discoloration at flanks

42
Q

Tx of Pancreatitis

A 
Pain relief measures (NOT morphine due to increasing spasms sphincter)
NPO
NG suction to relieve N/V
IV fluids (albumin)
Atropine
IV antibiotic therapy
43
Q

Pancreatic Cancer S/S

A 
epigastric and LUQ pain
jaundice
anorexia
weight loss
light colored stool
dark urine
pruritus
44
Q

Correlating factors to Pancreatic Cancer

A

pancreatitis
diabetes mellitus
high fat diet
chronic exposure to carcinogenic substances

Patho/Pharm 378 (2 decks)

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