Term
|
Definition
| normal liver tissue is replaced with fibrotic scar tissue |
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Term
|
Definition
1. postnecrotic: due to viral hepatitis, toxins, or medications
2. *Laennec's: due to chronic alcoholism*
3. Biliary: due to chronic biliary obstruction |
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Term
|
Definition
jaundice
ascites
petechiae
spider angiomas
palmar erythema
pruritis
confusion
fatigue
GI bleeding
asterixis
fetor hepaticus (fruity breath)
peripheral edema |
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Term
|
Definition
-increased ALT, AST, bilirubin, ammonia levels
-decreased serum protein, albumin, RBC, Hbg, Hct, platelets |
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Term
|
Definition
*Liver biopsy (most definitive!)
ultrasounds
CT
MRI |
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Term
| nursing care for cirrhosis |
|
Definition
-strict I&Os
-restrict fluids and sodium as ordered
-elevate HOB to help with breathing
-diet: high carb, moderate fat, high protein, low sodium diet. vitamin mineral supplements
-several small meals
-measure abdominal girth daily (over largest part)
-wash skin w/ cold water and apply lotion to reduce itching
-encourage alcohol recovery program! |
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Term
|
Definition
| *lactulose* to remove excess ammonia through stool (monitor for hypokalemia)* |
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Term
|
Definition
-paracentesis: void before procedure! supine position w/ HOB elevated. Assess extracted fluid (color, amount)
-liver transplant |
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Term
|
Definition
encephalopathy (reduce ammonia levels w/ lactulose!)
esophageal varices |
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Term
|
Definition
-inflammation of the pancreas
autodigestion of the pancreas by pancreatic digestive enzymes that are prematurely activated before reaching the intestines |
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Term
|
Definition
- *Turner's sign- ecchymoses on flanks
-*Cullen's sign- blue/grey discoloration around umbilicus
-jaundice
-ascites
-tetany
-severe LUQ or epigastric pain (radiating to the back or left shoulders
-n/v |
|
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Term
|
Definition
increased amylase, lipase, WBC, bilirubin, glucose
decreased calcium, magnesium, platelets |
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Term
| nursing care for pancreatitis |
|
Definition
NPO
NG tube
antiemetics
insulin
IV fluids/ electrolytes
opiod analegesics
pancreatic enzymes (pancrelipase) with meals/snacks
progress to bland/low fat diet |
|
|
Term
| patient teaching pancreatitis |
|
Definition
no alcohol consumption
encourage AA
no smoking
reduce stress |
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|
Term
hepatitis routes of transmission
(Hep A,B,C) |
|
Definition
Hep A: fecal/oral
Hep B: blood/body fluids
Hep C: blood/body fluids |
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Term
|
Definition
IV drug use
body piercing
tattoos
unprotected sex
travel to underdeveloped countries
crowded living enviroments |
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Term
|
Definition
| increase ALT, AST, bilirubin |
|
|
Term
| define irritable bowel syndrome |
|
Definition
| an intestinal disorder causing abdominal pain, gas, diarrhea, and constipation |
|
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Term
|
Definition
avoid dairy, eggs, wheat products, alcohol, caffeine
increase fiber intake (30-40 g/day) and fluid intake (2-3 L/day)
keep diary of food intake and bowel patterns |
|
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Term
|
Definition
1. alosetron: for IBS with diarrhea (side effect is constipation)
2. Lubiprostone: for IBS with constipation (side effect is diarrhea) |
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|
Term
| define peptic ulcer disease |
|
Definition
| erosion in the stomach, esophagus or duodenum |
|
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Term
| risk factors of peptic ulcer disease |
|
Definition
*H. pylori infection
NSAIDS use
stress |
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Term
|
Definition
N/V
heartburn
bloating
bloody emesis or stools |
|
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Term
|
Definition
gastric: pain 30-60 min AFTER meal; worse in DAY, worse with eating !
duodenal: pain 1.5-3h after meals, worse in NIGHT, better with eating or antacids |
|
|
Term
| peptic ulcer disease meds |
|
Definition
*multiple antibiotics to prevent resistance
-metronidazole
-amoxicilin
-tetracycline
-PPI ex: pantoprazole
-antacids (1-3h after meals, 1 hr apart from other meds)
-mucosal protectant
ex: sucralfate, given 1 hr before meals and at bedtime |
|
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Term
| patient teaching with peptic ucler |
|
Definition
avoid acid-producing foods
-milk, caffeine, spicy foods
avoid NSAIDs |
|
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Term
| complications of peptic ulcer disease* |
|
Definition
perforation resulting hemorrhaging
symptoms include severe epigastric pain,
*rigid/board-like abdomen
rebound tenderness
hypotension
tachycardia |
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Term
|
Definition
| gastic contents (including enzymes) backflow into the esophagus causing pain and mucosal damage |
|
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Term
|
Definition
-antacids (take 1-3 hours after eating, 1 hr after meds)
-H2 receptor antagonists: ranitidine
-PPI: pantroprazole
-Prokinetics: ex: metoclopramide: accelerates gastric emptying |
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Term
|
Definition
| fundoplication: fundus of stomach is wrapped around esophagus |
|
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Term
|
Definition
- sleep on right side
- lose weight
-eat smaller meals, avoid spicy foods
-elevate HOB |
|
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Term
|
Definition
dyspepsia (indigestion)
throat irritation, bitter taste
burning pain in esophagus. pain worses when laying down, improves with sitting up right
chronic cough |
|
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Term
|
Definition
-obesity
-caffeine
-citrus fruits
-spicy foods
-alcohol use
-older age |
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|
Term
| esophageal varices define * |
|
Definition
| swollen/fragile blood vessels in esophagus that can hemorrhage (life-threatning!) |
|
|
Term
| esophageal varices risk factors * |
|
Definition
| *portal HTN (increased BP in veins from intestines to liver) due to cirrhosis, hepatitis |
|
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Term
|
Definition
-elevated AST, ALT
with bleeding: hypotension, tachycardia, decreased hct/hgb |
|
|
Term
| procedure for esophageal varices |
|
Definition
sclerotherapy
variceal band ligation
transjugular shunt
esophagogastric balloon tamponade (compresses blood vessels in esophagus and stomach)
bypass |
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Term
|
Definition
| inflammation of gallbladder. It is usually caused by choleithiasis (gallstones). These gallstones block the cystic or common bile ducts and cause to back up into gallbladder |
|
|
Term
| risk factors cholecystitis |
|
Definition
-*high fat diet
-female
-obesity
-genetics
-older age |
|
|
Term
| where is the pain for someone with cholecystitis |
|
Definition
RUQ pain, possible radiation to right shoulder
pain and n/v with ingestion of high-fat food
jaundice
clay-colored stools
steatorrhea
dark urine
pruritis |
|
|
Term
| how does the lab looks for someone with cholecystitis |
|
Definition
WBC is high
bilirubin (if bile duct blocked) is high
increased in amylase/lipase- if oancrease is involved
AST/ALP is high if common bile duct blocked |
|
|
Term
| interventions for cholecystitis |
|
Definition
lithotripsy- to break down gallstones
cholecystectomy- removal of gallbladder |
|
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Term
|
Definition
removal of gallbladder
laparoscopy- shoulder pain is expected
(encourage ambulation to reduce free from pain)
open: T-tube may be placed in bile duct |
|
|
Term
nursing care of t-tube cholecystectomy
(open) |
|
Definition
record drainage: > 400 mL expected in first 24 hours, then will gradually decrease. drainage >1000 mL/day needs to be reported
empty drainage bag every 8 hours
clamp tube 1-2 hours to assess for tolerance to eating poor prior to removal
after removal, stools should return to brown color in 1 week |
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|
Term
| causes mechanical vs non mechanical obstructions |
|
Definition
mechanical: adhesions from surgery (most common)
tumors
diverticulitis
fecal impactions
non=mechanical obstruction (i.e. paralytic ileus) causes:
neurogenic disorder
vascular disorder
electrolyte imbalance
inflammation |
|
|
Term
| symptoms of small vs large bowel obstructions |
|
Definition
small:
projectile vomiting w/ fecal odor
severe F& E imbalances
metabolic alkalosis
large bowel:
diarrhea or ribbon-like stools around impaction
both: abdomical distention
constipation
abdominal pain
high pitched bowel sounds obstruction
hypoactive bowel sounds below obstruction |
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|
Term
|
Definition
NPO
NG TUBE
administer IV fluids and electrolytes |
|
|
Term
| define ulcerative colitis |
|
Definition
inflammation of the colon
causing *continuous lesions |
|
|
Term
| symptoms of ulcerative colitis* |
|
Definition
LLQ pain
*15-20 liquid stools/day
abdominal distention and pain
mucus/blood/pus in stools |
|
|
Term
|
Definition
inflammation and ulceration of the small intestines, causing
*sporadic lesions
RISK FOR FISTULAS |
|
|
Term
|
Definition
RLQ pain
*5 loose stools/day
mucus/pus in stools
abdominal distentions
steatorrhea |
|
|
Term
|
Definition
| inflammation of diverticula (small pouches in the colon) can perforate and cause peritonitis |
|
|
Term
| symptoms of diverticulitis |
|
Definition
LLQ PAIN
N/V
FEVER
CHILLS |
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