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JAUNDICE
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TYPES & CAUSES OF JAUNDICE
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GI Finals
| Question | Answer |
|---|---|
| JAUNDICE | yellow tinge to the skin that may indicate obstruction flow of bile. |
| TYPES & CAUSES OF JAUNDICE | hemolytic, hematocellular, obstructive |
| HEMOLYTIC (JAUNDICE) | overabundance of breakdown products of blood |
| HEMATOCELLULAR (JAUNDICE) | internal liver disease, prevents normal transformation of bile by liver cells |
| OBSTRUCTIVE (JAUNDICE) | inability of normally formed liver bile to be passed into the intestine because of blockage in bile ducts |
| CIRRHOSIS | liver damage followed by development of excessive fibrous connective tissue |
| TYPES & CAUSES OF CIRRHOSIS | laennec's, post necrotic, billiary |
| LAENNEC'S (CIRRHOSIS) | alcoholic, toxic chronic poisoning |
| POST NECROTIC (CIRRHOSIS) | follows types of hepatitis |
| BILLIARY (CIRRHOSIS) | unknown cause, or result of chronic obstruction or infection of bile ducts |
| CIRRHOSIS S/S | some jaundice and disorders of metabolism (protein, fats, carbs, and vitamins) |
| ASCITES | fluid in abdomen |
| ECCHYMOSIS | easy bruising, superficial bleeding under skin |
| People with liver disease | assess daily weight and measure abdominal girth |
| CIRRHOSIS - diagnosis | history & physical, liver biopsy. |
| LIVER BIOPSY post op | have pt lie on right side to splint the liver dressing for 1 hour. |
| LIVER BIOPSY complications | internal bleeding (due to liver is very vascular!); monitor dressing, decrease blood pressure, increase heart rate, increase respiratory rate |
| CIRRHOSIS (LIVER DISEASE) treatment | only treatment for nth stage is liver transplant |
| CIRRHOSIS complications | reasons for development are complicated and not clear |
| CIRRHOSIS treatment | paracentesis to removal of fluid from the abdomen |
| CIRRHOSIS fyi | can cause a drastic shift between vascular and extravascular compartments causing circulatory collapse |
| LAVEEN SHUNT (cirrhosis) | redirects fluid from the peritoneal cavity to the systemic circulation. THEY OFTEN HAVE LAVEEN SHUNT IN PLACE OF PARACENTHESIS TO PREVENT LOSE OF PROTEIN |
| ESOPHAGEAL VARICES | life threatening complication associated with liver disease and aggravated by clotting disorders (possible hemorrhaging) |
| SENGSTAKE - BLAKEMORE | this type of tube has a balloon that when it is inflated, it puts pressure on bleeding vessels. it applies pressure on bleeding site. |
| HEPATIC ENCEPHALOPATHY | liver detoxifies ammonia by converting into urea which kidneys excrete. |
| increased level of ammonia diet | to restrict protein because it is harder for liver to digest |
| S/S HEPATIC ENCEPHALOPATHY | twitching, confusion, stupor, death, SEIZURE PRECAUTIONS |
| HEPATIC ENCEPHALOPATHY nursing diagnosis | check gums for bleedikng, check skin for itching, stool for GI bleeding. HAVE PT WRITE THEIR NAME, IF THEY CAN'T IT MEANS THEY ARE GOING INTO HEPATIC ENCEPHALOPATHY. NO ASA AND STEROIDS |
| HEP A | it is infectious. spread by feces and contaminated food and water. avoid sharing food because it can spread through saliva |
| HEP A drug treatment | GAMMAGLOBULIN |
| HEP B | pt will always be a carrier. it is also called serum hepatitis (blood); transmitted by transfusions, plasma, needles, syringe, dental equipment. |
| HEP C | transmitted by blood. maybe asymptomatic for years but can result to a higher risk of cancer of the liver. |
| HEP D | only people who can contract HEP D are people with HEP B |
| HEP E | from oral, fecal, contaminated water; miniminal symptoms with hep c |
| PRURITIS | may be related to an accumulation of BILE SALTS under the skin |
| Hepatitis treatment | remove causative agent; bedrest (complication: pneumonia, need to turn, cough and deep breath), small frequent meal and increase fluids |
| ALL CASES OF HEPATITIS | have to report to health care officials so they can get hep meds |
| CHOLELITHIASIS | gall bladder stones ( Fourty year old woman, Overweight and 4-5 kids). It blocks the common bile duct; MIGHT HAVE CLAY COVERED STOOLS |
| CHOLELITHIASIS | most common abnormality of biliary system: incidence increases with age/obesity. Between 20-50 age, six times more common in women, after age 50-equal wit men |
| CHOLELITHIASIS S/S | severe mid-epigastric RUQ pain, radiates to back, right scapula, frequently following a meal high in fat, flatulence, indigestion, nausea, jaundice |
| CHOLELITHIASIS Treatment | low fat diet, put NG tube, IV fluid, might do surgery |
| CHOLECYSTECTOMY | most commonly attempted by LAPAROSCOPY |
| ACUTE CHOLECYSTITIS | cause is gall bladder stones completely blocks the flow of bile from the gall bladder |
| ACUTE CHOLECYSTITIS S/S | patient is very ill. Fever, vomiting, severe abdominal pain, biliary colic, WBC elevated, jaundice |
| ACUTE CHOLECYSTITIS treatment | medical management, IV fluids, antibiotics, N/G tube if medical management works, remove GB after healing |
| PANCREATITIS | inflammatory disease of pancreas characterized by inflammation of pancreatic tissue |
| PANCREATITIS S/S | severe epigastric pain centered close to umbilicus. Pain may radiate to sides and straight through to back. Classic position = knees drawn up, clutching abdomen |
| PANCREATITIS diagnosis | dramatically elevated amylase: 500/somogyi units/dl returns to normal within 24 hours (normal 60-160 U/dl) |
| PANCREATITIS treatment | to relieve pain : DEMEROL. NPO, N/G tube, rest GI tract (to rest pancreas), ATROPINE |
| PANCREATITIS nursing care | almost initially put pt into ICU. Observe for calcium deficiency, tetany (rigidity of muscle) |
| CHRONIC PANCREASTITIS | usually associated with alcoholism. It might cause diabetes. Inflammation and fibrosis cause progressive pancreatic insufficiency and eventually destroy pancreas |
| CHRONIC PANCREASTITIS nursing care | address pain immediately. Severe chronic pain makes addiction a great risk |
| CHRONIC PANCREASTITIS treatment | pancrease = mix with juice! |
Created by:
jekjes
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