Acute Liver Failure and Pancreatitis
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What are the criteria for acute liver failure? | show 🗑
|
||||
| show | Hepatitis or Cirrhosis
🗑
|
||||
| show | Acetaminophen toxicity, suicide attempts, the rest is unintentional, idiosyncratic drug reactions, infections, Hepatitis A or B, CMV - Cytomegalovirus, Ischemia, and other diseases.
🗑
|
||||
| Diagnostic findings in acute liver failure (ALF). | show 🗑
|
||||
| Why shouldn't we be fooled if the ALT and AST are normal? | show 🗑
|
||||
| When the enzymes return to normal in ALF, what do we see? | show 🗑
|
||||
| show | It performs a lot of filtration function s and a lot of detoxifying that the liver does.
🗑
|
||||
| show | Wcternal Liver Assistant Device
🗑
|
||||
| show | Nursing care related to the complications, liver assist devices, ELAD, liver dialysis, and possible transplant.
🗑
|
||||
| When providing nursing care in ALF, we provide care related to what complications? | show 🗑
|
||||
| If nursing care and liver assist devices aren't effective in managing ALF what is our next option? | show 🗑
|
||||
| show | Fulminant Hepatic Failure - meaning that it just sort of rushes in like a storm!
🗑
|
||||
| show | There is an alteration in nutrition because the liver stores and metabolizes all your nutrients.
🗑
|
||||
| How are calorie needs affected in liver disease? | show 🗑
|
||||
| show | Thin arms, thin legs, muscle atrophy, cachexic appearance.
🗑
|
||||
| show | If a paracentesis is done, you are going to pull out all those proteins, this causes hypermetabolism.
🗑
|
||||
| show | It breaks down your glycogen stores.
🗑
|
||||
| show | The patient literally melts away as muscle and fat breakdown. They have a cachexic appearance.
🗑
|
||||
| show | Taste preferences change, ascites impact, anoreixia, intake can vay depending on encephalopathy, and effects of Interferon can effect appetite.
🗑
|
||||
| How do taste preferences change in people with liver disease? | show 🗑
|
||||
| show | There may be less encephalopathy in the morning, therefore they may be more alert, and have more of an appetite.
🗑
|
||||
| How would ascites impact the diet in patients with liver failure? | show 🗑
|
||||
| What would you do for a patient with anorexia due to liver disease? | show 🗑
|
||||
| show | Make sure they drink lots of fluids throughout the day.
🗑
|
||||
| What do the pancreas do? | show 🗑
|
||||
| What do the Alpha cells of the pancreas do? | show 🗑
|
||||
| show | They secrete insulin and insulin decreases blood sugar by allowing blood sugar to enter the cell.
🗑
|
||||
| show | Amylase, lipase, tripsin, and pepsinogen.
🗑
|
||||
| Why do you see autodigestion with acute pancreatitis? | show 🗑
|
||||
| show | They aren't sure, but no matter what causes it, the digestive enzymes can't get out and therefore they start gobbling up the pancreas.
🗑
|
||||
| show | Gallbladder disease and alcoholism.
🗑
|
||||
| Who is most likely to experience gallbladder disease? | show 🗑
|
||||
| Gallbladder disease is more common in: | show 🗑
|
||||
| show | Alcohol is a toxin to the liver and because of its proximity, it causes a lot of damage to the pancreas as well.
🗑
|
||||
| show | Abdominal trauma, perforated ulcers, certain drugs , infections, heredity.
🗑
|
||||
| What kinds of drugs can cause pancreatitis? | show 🗑
|
||||
| What are the signs and symptoms of pancreatitis? | show 🗑
|
||||
| Why do patients with acute pancreatitis curl up in the fetal postion when they are experiencing pain? | show 🗑
|
||||
| Why do patients with acute pancreatitis have mild jaundice. | show 🗑
|
||||
| What causes the discoloration of the abdomen and the flank in patients with pancreatitis? | show 🗑
|
||||
| show | Becaue pancreatitis can lead to peritonitis or acute bowel obstruction.
🗑
|
||||
| What types of shock would you watch for signs and symptoms of as a nurse caring for a patient with pancreatitis? | show 🗑
|
||||
| show | With pancreatitis, there is some respiratory involvement because the pancreas is putting pressure on the diaphragm. This could cause the patient to go into hypoxia. Sepsis could also effect LOC in this patient.
🗑
|
||||
| Why does the patient with pancreatitis get hyperglycemia? | show 🗑
|
||||
| show | The end up with low calcium and when you have low calcium, it can cause tetany, and twitching.
🗑
|
||||
| Why do we need to carefully monitor lung sounds in a patient with pancreatitis? | show 🗑
|
||||
| show | Patients with pancreatitis.
🗑
|
||||
| What is Cullen's sign? | show 🗑
|
||||
| What is Turner's sign? | show 🗑
|
||||
| show | Labs - elevated amylase and lipase
🗑
|
||||
| This enzyme would be the most reliable for 24 hours after the onset of symptoms of acute pancreatitis. | show 🗑
|
||||
| show | Amylase
🗑
|
||||
| show | Serum Lipase
🗑
|
||||
| Typically if it is after a day of symptoms of acute pancreatitis, we start to look to see if what is elevated? | show 🗑
|
||||
| This enzyme can stay elevated up to 14 days longer than amylase. | show 🗑
|
||||
| show | Amylase
🗑
|
||||
| show | It can cause moderte increases, and women who take oral contraceptives have slightly decreased amylase levels.
🗑
|
||||
| show | The stimulation for amylaseis food in the belly, so if they are newborn, no food in the belly and no stimulation for amylase.
🗑
|
||||
| show | Higher
🗑
|
||||
| show | The pressure of the common bile duct , the bilirubin cant get through so it is going to back up and you will have elevated bilirubin.
🗑
|
||||
| Why is alkaline phosophate increased in patients with pancreatitis? | show 🗑
|
||||
| Why would serum calcium, potassium, and magnesium be decreased in a patient with pancreatitis? | show 🗑
|
||||
| Why is albumin decreased in patients with pancreatitis? | show 🗑
|
||||
| What causes the increase of WBC's in patients with pancratitis? | show 🗑
|
||||
| What is the #1 nursing priority in patients with pancreatitis? | show 🗑
|
||||
| What is the medication of choice for managing pain caused by pancreatitis? | show 🗑
|
||||
| show | They increase pressure in the common bile duct.
🗑
|
||||
| Aside from causing pressure in the common bile duct, what other effect does morphine have here? | show 🗑
|
||||
| show | We can counteract it with smooth muscle relaxants such as nitroglycerine 0.6mg sublingually or amyl nitrate (inhaled). This will relax the coronay arteries, and relax the GI
🗑
|
||||
| If you administer Narcan/Naloxone to help relieve pain being caused by pancreatitis, what do you need to make sure you do? | show 🗑
|
||||
| Why will a patient with pancreatitis be NPO? | show 🗑
|
||||
| show | Because they are at a greater risk for pleural effusions.
🗑
|
||||
| What is a pseudocyst? | show 🗑
|
||||
| show | Inflamed gallbladder, hemorrhage, abscess, pseudocyst, and fistula.
🗑
|
||||
| What could the complication of a fistula cause? | show 🗑
|
||||
| Why would a CT or an ultrasound be used when a patient has pancreatitis? | show 🗑
|
||||
| As a patient is diagnosed and treated for acute pancreatitis, as they respond to treatment, you would expect their lipase levels to do what. | show 🗑
|
||||
| If the patient is responding to treatment for acute pancreatitis and their lipase levels remain elevated, they probably have: | show 🗑
|
||||
| What is it important to make sure the patient with acute pancreatitis understands? | show 🗑
|
||||
| What is viokase? | show 🗑
|
||||
| show | 1/2 hour befor meals and that will assist them in digestion.
🗑
|
||||
| show | The digestive enzymes tha the pancreas can't normally produce.
🗑
|
||||
| show | Chronic Pancreatitis
🗑
|
||||
| What are the signs and symptoms of chronic pancreatitis? | show 🗑
|
||||
| show | Because the bilirubin cant get through to the intestine, and it instead goes into the urine.
🗑
|
||||
| How does a patient manage chronic pancreatitis? | show 🗑
|
||||
| What are the risk factors for pancreatic cancer? | show 🗑
|
||||
| show | Chronic Pancreatitis
🗑
|
||||
| What activity is a MAJOR risk factor for pancreatic cancer? | show 🗑
|
||||
| show | A diet high in fat and meat.
🗑
|
||||
| How could industrial chemicals become a risk factor for pancreatic cancer? | show 🗑
|
||||
| show | Males and African Americans
🗑
|
||||
| The 5 year survival for patients with pancreatic cancer is what percentage? | show 🗑
|
||||
| What is the 4th leading cause of cancer deaths? | show 🗑
|
||||
| Most of the time people who are diagnosed with pancreatic cancer are diagnosed: | show 🗑
|
||||
| What are the symptoms of pancreatic cancer? | show 🗑
|
||||
| show | There is no screening test for pancreatic cancer.
🗑
|
||||
| show | Cholandiography
🗑
|
||||
| This procedure is done if a patient has jaundice and they can't figure out why they have jaundice. | show 🗑
|
||||
| show | ERCP
🗑
|
||||
| If a patient has abdominal pain, is jaundiced and they can't figure out what is going on and the labs are coming back inconclusive, what diagnostic test will be done? | show 🗑
|
||||
| show | ERCP
🗑
|
||||
| What is CEA? | show 🗑
|
||||
| show | In the head of the pancreas.
🗑
|
||||
| Three months is enough time for pancreatic cancer to: | show 🗑
|
||||
| show | 3-6 months
🗑
|
||||
| show | Family History
🗑
|
||||
| show | Whipple operation
🗑
|
||||
| What is immunotherapy for pancreatic cancer? | show 🗑
|
||||
| show | Chemotherapy, radiation, and surgical (whipple procedure).
🗑
|
||||
| show | A procedure where they remove a good portion of the pancreas, a portion of the lower stomach, the whole duodenum and then they pullup the jejunum and anastamose it to the common bile duct.
🗑
|
||||
| In this procedure, there are two anastomosis sites. One connecting the pancreas to the jejunum and the other connecting the stomach to the jejunum. | show 🗑
|
||||
| show | You could pull out the anastamoses, and keepin the patient in semi-fowlers position also promotes better lung expansion.
🗑
|
||||
| show | 24 Hours
🗑
|
||||
| Why don't we forcibly irrigate the NG tube and why do we NEVER repositon the NG tube? | show 🗑
|
||||
| show | The anastamosis are disrupted or there can be some leakage from the anastamosis sites.
🗑
|
||||
| show | Q 1-2 hours
🗑
|
||||
| show | Hypovolemic shock, hemorrhage, hepatorenal failure.
🗑
|
||||
| show | Because the blood gets shunded to the major organs, so it would go to the heart, lungs and the brain, NOT the kidneys or liver.
🗑
|
||||
| Why would a patient have blood sugar issues following a whipple procedure? | show 🗑
|
||||
| Just like pancreatitis, patients who have had the whipple procedure will have issues related to digestive enzymes, so they will have to take: | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
jjcthirdsemesterflashcards
Popular Nursing sets