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AH2 Exam 2 > Digestive (Saunders) > Flashcards

Digestive (Saunders) Flashcards

1
Q

cholecystitis is inflammation of what?

A

gallbladder

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2
Q

acute inflammation associated with gallstones is called what?

A

cholelithiasis

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3
Q

what is chronic cholecystitis

A

inefficient bile emptying and gallbladder muscle wall becomes fibrotic and contracts the gallbladder

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4
Q

S/S of cholecystitis

A

N/V
belching
flatulence
epigastric pain that radiates to right shoulder or scapula
guarding
rebound tenderness
murphy signs
high temp
tachycardia
jaundice
dark orange/foamy urine
steatorrhea/clay colored feces
pruritus

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5
Q

where do you feel the pain for cholecystitis

A

RUQ

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6
Q

interventions for cholecystitis

A

NPO until said so
antiemetics
analgesics
antispasmodic
SMALL, HIGH FIBER, LOW FAT MEALS

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7
Q

cirrhosis is a progressive disease to what organ?

A

liver

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8
Q

cholecystitis is to what organ?

A

gallbladder

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9
Q

early signs of cirrhosis

A

weight loss
n/v
abdominal pain

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10
Q

causes for cirrhosis

A

hepatitis c
alcoholism
NAFLD (nonalcoholic fatty liver)
NASH (nonalcoholic steatohepatitis)

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11
Q

complications for cirrhosis

A

ascites
portal HTN
bleeding problems
jaundice
encepalopathy

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12
Q

interventions for cirrhosis

A

elevate HOB
high protein and vitamins (if there’s no edema or coma)
vitamins (A,C,k,folic acid, thiamine)
restrict I and O/ fluids
daily weights
monitor for tremors/delirium
ASTERIXIS (duhhh hand)
give lactulose

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13
Q

what is esophageal varices

A

bleeding from the dilated veins

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14
Q

causes for esophageal varices

A

portal HTN
liver cirrhosis

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15
Q

s/s for esophageal varices

A

melena
hematemesis
jaundice
dilated abdominal veins

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16
Q

interventions for esophageal varices

A

elevate HOB
02
NPO
monitor LOC
give IVF
monitor hgb,htc
insert Ng tube/balloon

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17
Q

is hepatitis a treatable disease

A

yes

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18
Q

what hepatitis is most likely to cause liver dysfunction

A

Hep. B

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19
Q

what hepatitis has vaccines

A

A,B

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20
Q

how can you get hep C

A

through blood/paraneterally

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21
Q

complications of hep c

A

chronic liver disease
cirrhosis

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22
Q

how can you get Hep. D?

A

must need Hep. B

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23
Q

how can you get Hep E

A

waterborne virus

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24
Q

what is pancreatitis

A

inflammation of the pancreas

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25
s/s of acute pancreatitis
cullens sign turners sign LUQ pain N/V weight loss pain aggrevated by fatty meal,alcohol tachycardia HOTN hyperthermia dyspnea pleural effusions
26
where do you feel pain/mass for pancreatitis
LUQ
27
interventions for acute pancreatitis
hold fluid, food give opiates NG tube feed
28
s/s of chronic pancreatitis
LUQ mass jaundice ascites s/s of DM s/s of respiratory distress weight loss steaorrhea
29
interventions for chronic pancreatitis
avoid alcohol, caffeine give insulin avoid heavy meals
30
complications of acute pancreatitis
HOTN gi bleed hyperglycemia hypocalcemia atelestasis, pneumonia, ards anemia
31
causes of acute pancreatitis
opiates steroids BC thiazides sulfas
32
labs for acute pancreatitis
everything high except albumin and calcium and magnesium
33
tx for acute pancreatitis
opioids famotidine pantoprazole antibiotics pulmonary hygiene surgical management
34
education for pancreatitis
low fat high protein moderate carbs avoid spicy educate s/s of jaundice, clay/pale poop, dark urine,
35
chronic pancreatitis complications
stearorrhea muscle waste pUD pancreatic pseudocust pancreatic CA
36
Tx for chronic pancreatitis
lifestyle diet/change pain meds PERT (pancreatic enzyme) surgery PRN
37
what are surgeries for pancreatic cancer
partial pancreatectomy (3cm or smaller) radical pancreaticoduodenectomy (whipple)
38
complications of whipple
MODS ARDS hemorrhage DM MI deadly
39
clinical management for whipple
NGT for decompression TPN blood glucose watch drain tube
40
what are the types of cirrhosis
post-necrotic (viral.toxins) laennec (alcoholic) biliary (obstructive)
41
what is the most common cause of cirrhosis worlwide
hep b and D
42
leading cause of cirrhosis in US
hep C
43
cirrhosis tx for meds
lactulose moisturizer corticosteroids electrolyte replacement
44
Tx for esophageal
vasopressin BB somatostatin elastic bands pressure on varices
45
what is the name for esophageal varices tx
sengstaken-blakemore tube
46
sengstaken-blakemore tube three openings
gastric suction inflating esophageal balloon inflating esophageal balloon to compress vein inflating gastric balloon applies pressure to fundul veins
47
what are health promotions for hepatitis
vaccines for A and B healthcare workers standard precautions needleless systems proper handwashing (especially after fish) avoid contaminated food/water
48
hepatitis management
high carb, low fat small frequent meals increase kcal tell women for extra BC because of drugs fo hepatitis emotional support
49
s/s of hepatic encephalopathy
altered LOC confusion somnolence insomnia impaired mentation
50
how does hepatic encephalopathy happen
liver failure
50
what happens in stage 4 hepatic encepatholagy
accumulation of toxins in bloodstream (ammonia) seizures positive babinski sign muscle rigidity unresponsiveness
51
what med for hepatic encepathology
lactulose
52
side effects for lactulose
gas bloating burping stomach pain nausea cramps
53
stage 1 hepatic encephalopathy
subtle manifestations drowsy inability to concentrate slurred speach sleep pattern disturbance
54
what worsens hepatic encephalopathy
high protein infection hypovolemia hypokalemia constipation gi bleed drugs
55
stage 2 hepatic encephalopathy
asterixis disorientated
56
stage 3 hepatic encephalopathy
asterixis more duhhhh
57
How does Hepatitis affect Metabolism of medications?
increases drug toxicity bc the liver is not working meaning the liver enzymes can't break down shit
58
What are some hepatotoxic medication?
tylenol nsaids statins antibiotics antifungal methotrexate
59
S&S of increase ammonia level in patients /management
mental status change n/v breath odor
60
management for hyperammonia
lactulose antibiotics (rifaximin) low protein high carbs
61
Appropriate DIET for patients with Hepatitis A B C
diet high in veggies, fruits, whole grains (anything healthy) limit fat and cholesterol avoid alcohol limit salt stay hydrated monitor protein intake *be careful*
62
modes of transmission of hepatitis
A,E: food and water B,C,D,G: blood or bodily C: sex or needle stick
63
Patient education for Hep. ABCDEG
modes of transmission prevention tacts s/s (jaundice, fatigue, n/v, clay colored stools
64
Medical management for chronic Hep
antiviral regular liver function test (AST,ALT, INR, bilirubin,albumin)
65
antiviral meds for hepatitis B
entecavir, tenofovir disoproxil
66
antiviral meds for hep c
direct acting antiviral (DAA)sofosbuvir ledipasvir glecaprevir
67
complications for pancreatic cancer
VTE (bc of thrombolytic factor) rapid and difficult to treat metastatic disease
68
associated factors for pancreatic cancer
dm fat old cigs male cirrhosis red meat chronic pancreatitis
69
diagnosis for pancreatic cancer
amylase lipase cholesterol ERCP
70
s/s for pancreatic cancer
DVT/VTE/PE weight loss weakness fatigue N/V jaundice (dark urine, clay poop) ascites new onset of DM
71
surgery for Pancreatic cancer
partial pancreatectomy (3cm or smaller) radical pancreaticofuodenectomy (whipple)
72
complications for whipple
infection fistula bowel obstruction DM MI ARDS MODS hemorrhage
73
nurse care for post op pancreatic cancer surgery
NGT (decompression) drainage TPN (jtube) strict i and o fluid and electrolyte emotional support

AH2 Exam 2 (4 decks)

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