HCC Hepato Biliary
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| Pancreas Function | show 🗑
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| Pancreatitis | show 🗑
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| show | severe, constant, knife-like pain RUQ gastric and or radiating to the back and is unrelieved by N&V, jaundice, hyperglycemia. Worse when lying down or eating. Some relief in fetal position.
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| show | Alcoholism, ERCP, and biliary tract disease (gallstones can cause blockage where the common bile duct and pancreatic duct meet).
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| Pancreatitis Triggers | show 🗑
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| Serum Amylase | show 🗑
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| Serum Lipase | show 🗑
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| show | Amylase 2-3 times the normal value and Lipase 3-5 times the normal value
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| Other Lab Values Assoc. c Pancreatitis | show 🗑
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| Pancreatitis Assessment/Monitor | show 🗑
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| show | NPO until pain free! nasogastric tube(gas decompression), TPN, no alcohol, no smoking, limit stress.
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| Post pancreatitis diet | show 🗑
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| show | DEMEROL, know this medication. Position client side lying fetal c HOB elevated or sitting up/leaning forward.
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| Donnazyme(pancreatin) and Viokase(pancrelipase) | show 🗑
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| Pancreatitis Monitoring | show 🗑
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| Trousseau's Sign | show 🗑
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| Chvostek's Sign | show 🗑
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| Pancreatitis Hypovolemia | show 🗑
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| Pancreatic Cancer | show 🗑
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| show | Age 60-80, smoker.
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| show | Removal of the head of the pancreas, duodenum, parts of the jejunum and stomach, gallbladder, and possibly the spleen. The pancreatic duct is connected to the common bile duct and the stomach to the jejunum.
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| show | MORPHINE. Post-op care, monitor glucose levels, nutritional support
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| show | Most common is venous thromboembolism. Fistulas, peritonitis
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| Demerol (meperidine) | show 🗑
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| show | Opioid analgesic. Binds to opiate receptors in CNS, causes CNS depression. SE's: RESPIRATORY DEPRESSION, CONFUSION, SEDATION, HYPOTENSION, CONSTIPATION
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| Hepatitis | show 🗑
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| Hepatitis A(HAV) | show 🗑
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| Hepatitis B(HBV) | show 🗑
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| Hepatitis C(HBV) | show 🗑
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| Hepatitis D(HDV) | show 🗑
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| show | Oral-fecal route, ingestion of contaminated water.
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| show | Failure to use universal precautions, percutaneous exposure(puncture-needle/tattoo), unprotected sex, unscreened blood, hemodialysis, food prepped by infected person, tap water in underdeveloped country.
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| Hepatitis Labs | show 🗑
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| Hepatitis X-ray | show 🗑
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| show | Most definitive. Identifies intensity of infection and degree of tissue damage. CLIENT WILL LIE ON SURGICAL SITE SIDE FOR A SHORT TIME AFTER THE BIOPSY.
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| Hepatitis S/sx | show 🗑
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| Hepatitis Diet | show 🗑
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| show | Med given to treat HBV and HCV. SE's: FLU-LIKE Sx, ALOPECIA, AND BONE MARROW SUPPRESSION. Monitor CBC
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| Chronic Hepatitis | show 🗑
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| show | Fatal form of hepatitis is due to inability of liver cells to regenerate with increased progression of the necrotic process. Results in encephalopathy and death.
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| Cirrhosis | show 🗑
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| Causes of Cirrhosis | show 🗑
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| Cardiac Cirrhosis | show 🗑
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| show | ALT, AST, and ALP initially elevated then normal when liver cells no longer able to create an inflammatory response. Bilirubin elevated. Protein and albumin low due to lack of hepatic synthesis.
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| Cirrhosis Labs 2 | show 🗑
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| show | FATIGUE, wt loss, abd pain & distention, PRURITUS(itching), confusion, GI bleeding, ASCITES, JAUNDICE, PETECHIAE, palmar erythema, ASTERIXIS(liver flapping tremor).
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| Cirrhosis Assessment/Monitoring | show 🗑
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| Lactulose (constilac) | show 🗑
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| Flagyl (metronidazole) | show 🗑
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| Portal Systemic Encephalopathy (PSE) | show 🗑
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| show | Swollen, fragile blood vessels in the esophagus. Blood flow through the liver is restricted and diverted to other vessels such as the vessels of the esophagus due to liver damage.
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| Complications of Esophageal Varicies | show 🗑
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| Portal Hypertension | show 🗑
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| Transjugular Intrahepatic Portal-systemic Shunt(TIPS) | show 🗑
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| Esophagogastric Balloon Tamponade | show 🗑
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| show | Performed through a large-bore NG tube. Position client in side-lying, up to 200 mL of NS is inserted then suctioned, causing vasoconstriction. Continued until return is clear.
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| show | HEMATEMESIS, melena, HYPOTENSION, tachycardia
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| show | Antianginals, beta blockers. Blocks stimulation of beta1(myocardial) and beta2(pulmonary, vascular, and uterine)-adrenergic receptor sites. Decreased HR and BP. SE's: FATIGUE, WEAKNESS, ARRHYTHMIAS, BRADYCARDIA, CHF, PULMONARY EDEMA, ED.
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| show | Antidiuretic Hormones. Enhanced reabsorption of water in the kidneys. Control of bleeding. SE's: hypertension, hypotension, tachycardia, flushing.
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| show | Antidiarrheals, hormones. Increases absorption of F&E's from GI tract and increases transit time. SE's: edema, orthostatic hypotension, palpitations, flushing.
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| Liver Cancer (hepatocellular carcinoma HCC) | show 🗑
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| show | Cirrhosis-chronic HBV and HCV infection and alcoholic liver disease. Metastasis from another site.
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| show | A tumor marker, elevated in liver cancer.
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| Liver Cancer Labs | show 🗑
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| show | Liver biopsy is the most definitive diagnostic procedure. CLIENT WILL LIE ON SURGICAL SITE SIDE FOR A SHORT TIME AFTER THE BIOPSY.
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| show | Given through surgically implanted controlled infusion pumps to be infused directly into the liver tumor.
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| show | Portions of healthy livers are used. Transplanted liver will regenerate and grow in size based on need. Takes 12hrs, Immunosuppressant therapy.
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| Chemoembolization | show 🗑
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| show | Antineoplastics. Inhibits DNA and RNA synthesis by forming a complex with DNA. Immunosuppressive properties. SE's: CARDIOMYOPATHY, DIARRHEA, ESOPHAGITIS, N&v, STOMATITIS, RED URINE, ALOPECIA, ANEMIA, LEUKOPENIA, PHLEBITIS, THROMBOCYTOPENIA.
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| Liver Cancer S/sx | show 🗑
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| Liver Cancer Assessments/Monitoring | show 🗑
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| show | High-calorie mod fat, possibly low-sodium or low-protein. Small, frequent, well-balanced meals. Supplemental vitamin-enriched liquids. AVOID ALCOHOL.
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| show | Can occur between 4-10 days after surgery.
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| Liver Transplant Rejection Symptoms | show 🗑
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| show | Immunosuppressants, polypeptides. Inhibits normal immune responses. SE's: SEIZURES, TREMOR, HTN, DIARRHEA, HEPATOTOXICITY, NAUSEA, VOMITING, NEPHROTOXICITY, HIRSUTISM, INFECTIONS!!
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