Abdominal organs

Question 1

What are some collab care for hep

Answer 1

PT and INR to see if they can coagulate
AST
ALT
scans to see if they have scarring 
Well-balanced diet
Vitamin supplements
Rest (degrees of strictness varies)
Avoidance of alcohol intake and drugs processed by liver

Question 2

What type of hep causes cirrhosis the most

Answer 2

hep C

Question 3

What are some problems of liver failure

Answer 3

decreased bile prod
coagulopathies
problems with blood sugar
probs with protein metab

Question 4

What is a con about a liver biopsy and liver cirrhosis

Answer 4

make sure to take a PT/INR and CBC for platelet count before takign a biopsy bec we need to make sure they can clot so they dont hemorrhage into the abdominal cavity

Question 5

What do we do for ascites

Answer 5

low sodium diet
paracentesis
sometimes diuretics

Question 6

What do we do for esophageal varrices and what do we need to consider

Answer 6

if bleeding
closing the cut with a laser
clamping it off
if severe - balloon tamponade 
for balloon tamp- monitor lungs sounds and sat bec the balloon may slip and cause blood to travel into lungs

Question 7

Hepatic Encephalopathy

Drug Therapy

Answer 7

Antibiotics (rifaximin (Xifaxan)}

lactulose

Question 8

What is a con with lactulose

Answer 8

major diarrhea so possibily have containment system for bowel like a foley for bowel movements

Question 9

After liver biopsy how should the pat be positioned

Answer 9

on right side to put pressure on liver usu for 4-6 hours

Question 10

What is another area that needs to be monitored during balloon tamp and why

Answer 10

the stomach for enlargement bec if the balloon traveled blood could be filling the stomach

Question 11

What dis causes additional probs with the pancrease

Answer 11

gall bladder dis (gall stones)

Question 12

Causes of pancreatitis

Answer 12

gall bladder dis 
alc 
smoking 
hypertriglycerides above 1000 
viruses

Question 13

What are some mani’s of pancreatitis

Answer 13

extreme ab pain in LUQ
suddenly onset usu, knife like 
may radiate to back 
pain usu occurs after eating 
cyanotic 
dyspnea
N/V
low grade fever 
grey turner spots- a bluish flank discoloration  
Cullen’s sign a bluish periumbilical discoloration

Question 14

collab care for pancreatitis

Answer 14

NPO with NG tube to suction
Albumin (if shock present)
IV calcium gluconate (10%) if tetany present
Lactated Ringer’s solution

Drug Therapy
Pain medication (morphine)
Proton pump inhibitor like Omeprazole (Prilosec)
Antibiotics (if necrotizing pancreatitis)

Question 15

care for endoscopic gall bladder removal surgery

Answer 15

get ambulating soon to remove gas built up

Question 16

risk factors of Cholelithiasis and Cholecystitis

Answer 16

estrogen replacement therapy

oral contra’s

Question 17

Mani’s of Cholecystitis

Answer 17

pain after meal, especially fatty meal witihin 3-6 hours
goes from severe to tendernes like pain URG

Total obstructions cause
dark urine
indigestion 
jaundice 
pain between shoulder blades 
might complain of heartburn 
fever

Question 18

collab care for cholecystitis and cholelithiasis

Answer 18

IV fluid
NPO with NG tube, later progressing to low-fat diet
Antiemetics
Analgesics
Fat-soluble vitamins (A, D, E, and K)
antispasmodics for gut (anticholernergic) 
Antibiotics for secondary infections 
Extracorporeal shock wave lithotripsy

Question 19

What are some symptoms of liver failure

Answer 19

anorexia
lethargy,
NV
Flu like symptoms 
CNS probs 
ascites and varacies
edema issues

Question 20

Do diuretic work well for acites

Answer 20

no

Question 21

What labs are most important for acute pancreatitis

Answer 21

amylase and lipase

tryglycerides levels

Question 22

What is a common prob with acute pancreatitis

Answer 22

high BS bec of loss of insulin

Question 23

nursing care for gall blad removal

Answer 23

monitor bowel sounds and incision site for infection and dehiscense