Gall Bladder & Pancreas: PowerPoint Flashcards by Jade Ring

Acute inflammation of the gallbladder happens due to Calculous/ Stones/Cholelithiasis

Which structure do they block (3)

Cystic duct
Gall bladder neck
Common bile duct

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What causes Cholecystitis?

Abnormal cholesterol/ bile salt metabolism

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Biliary stasis, also known as cholestasis, is a condition that occurs when…

bile flow slows or stops

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Sphincter of Oddi dysfunction
Decrease in blood flow to Gall bladder

Twisting of Gall bladder neck or cystic duc

All cause…

Biliary statis

Which causes

Acute inflammation of the gallbladder

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Sepsis, trauma/burns, long-term TPN, MODS, Ab surgery, hypovolemia

May produce this problem

Acute inflammation of Gall Bladder

Acalculous - Inflammation of the Gallbladder w/o Stones

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3 big risk factors for getting gallstones

High cholesterol diet

Sedentary lifestyle

HRT or birth control pill

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Where is pain from Cholecystits

RUQ

Radiate to R shoulder/ scapula

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Clay-color3d stools, dark urine, statorrhea

With

RUQ pain, radiating to shoulder is…

Cholecystitis

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Older adult considerations for Gallstones

Localized tenderness

Acute delirium as 1st sign

Why delirium

Dehydration

Low blood volume

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Lab ass for Gallstones

WBC
Alkaline Phosphate
AST
LDH
Serum Bilirubin

All

Increase

(Below are NORMAL VALUES)

ALP (Alkaline Phosphate)
Normal Values 44 to 147

AST (Aspertate Aminotransferase)
Normal 10 - 36

LDH 140 - 280 Elevated = tissue damage

Serum bilirubin <1 mg/dl , Jaundice = >2.5 mg/dl

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Best diagnostic assessment for Gall Stones

Ultrasound

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Shock can occur from gallstones getting loged in the duct

Call Rapid response if in shock

Place HOB in which position, if shock occurs

Flat

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Ketorolac is….

NSAID can treat gallstones

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Ursodiol & Chenodal

Are used to…

Disolve gallstones

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Extracorporeal shock wave lithotripsy (ESWL) is….

a non-invasive procedure that uses shock waves to break up stones in the urinary system, bile ducts, and pancreatic duct

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percutaneous transhepatic biliary drain

Does..

Drains bile from liver

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Which is the GOLD STANDARD of surgical intervention for Gallstones

Laparoscopic

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Diet for Gallstones

High fiber- Low fat

Small frequent meals

Avoid gas producing meals

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After removing Gall Stones teach about Post-Cholecystectomy Syndrome

Which….

May result in new stones with pain

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Autodigestion & fibrosis of pancreas

Can be life threatening

Is called

Acute pancreatitis

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Acute pancreatitis

Causes

Gallstones

Trauma (Surgery) Whipple Procedure

Obstruction

Hyperlipidemia

Renal failure

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Pancreatitis can have an Attack from drinking alcohol

T or F

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Mid- epigastric or LUQ

Jaundice

Gray-blue discoloration

Shock like symptoms

Acute pancreatitis

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ALP Alkaline Phosphate

Normal range

44 - 147

Increase = liver damage

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AST (aspartate aminotransferase) Normal Levels

10 - 36 > Liver Damage

LDH (Lactose dehydranse) Normal Range

140 - 280 Increase = Tissue Damage

Serum Bilirubin Normal levels

< 1mg/ dl Jaundice = >2.5 mg/dl

The _____ duct is a tube that carries bile from the gallbladder to the common bile duct The _____ duct is a tube that carries bile from the liver and gallbladder to the small intestine carries digestive juices and fluid from the pancreas to the duodenum

cystic common bile Pancreatitic duct

Choledocholithiasis.... Can cause jaundice and liver cell damage

Common bile duct stone, Gallstones form in the common bile duct. The common bile duct is a small tube that carries bile from the gallbladder to the intestine.

Cholangitis.. Symptoms include fever, chills, and abdominal pain. In some cases, the skin may turn Treatment includes antibiotics and medications

A serious infection of the liver's bile ducts. Stone blocks the normal passage of bile, a fluid made by the liver to help digest fats. As the fluid backs up, an infection can occur.

Total Cholesterol Range

125 - 200 mg/dL

Non-HDL Level

<130 mg/dL

LDL Level

<100 mg/ dL

HDL Levels

40mg/dL or higher

Biliary colic is caused by...

Obstruction of the cystic duct

Difference between Cholecystitis & Cholelithiasis

Cholecystitis: Inflammation of the gallbladder Cholelithiasis: Gallstones

For incisional pain use Heat or Ice

Ice

Lab values to assess nutrition Decrease = malnutrition BUN

BUN 10 - 20 mg/dL

Lab values to assess nutrition Decrease = malnutrition Prealbumin

16 - 30 mg/dL

Lab values to assess nutrition Decrease = malnutrition Albumin

3.5 - 5

Lab values to assess nutrition Decrease = malnutrition Total protein

6 - 8.3 g/ dL

Lab values to assess nutrition Decrease = malnutrition Transferrin

250 - 300 mg/ dL

Transferrins job in the body

Transferrin is a protein produced by the liver that transports iron from storage and absorption sites to tissue cells

BUN Prealbumin Albumin Total Protein Transferrin All are used to assess which status

Nutrition

Infection/ Shock Necrotizing hemorrhagic pancreatitis AKI Paralytic ileus Hypovolemia shock Pleural effusion Acute respiratory Distress syndrome Atelectasis Pneumia MultiOrgan system failure Disseminated intravascular coagulation Are all complications of...

Pancreatitis

Opiates, sulfonamides, thiazides, steroids May all cause this problem

Acute pancreatitis

Which type of problem may occur after consumption of alcohol, Cholelithiasis, or biliary tract problems

Acute pancreatitis

Gray-blue discoloration is seen in this problem

Acute pancreatitis

With acute pancreatitis Describe Temp, HR, BP

Temp UP HR UP BP DOWN

Grey turner's & Cullens sign are located where

Grey turner's Flank Cullens PeriUmbilical

Priority of care for Pancreatitis

Monitor for signs of shock. Changes in LOC due to Alcohol Withdrawal Hypoxia Impending Sepsis w/ shock

Acute pancreatitis Medication

Opoids Histamine receptor Antagonist PPI

Chronic pancreatitis may have similar S/S as...

DM Polyuria, Polydipsia, polyphagia

Pancreatitic enzymes replacement therapy (PERT) is used for...

Chronic pancreatitis

Diet for Chronic Pancreatitis

Possible TPN or TEN 4000 - 6000 calories per day High carb, high protein, low fat

In chronic pancreatitis Have blood work checked to monitor uric acid levels

normal uric acid level is between 3.5 and 7.2 milligrams

pancreaticoduodenectomy, removes the head of the pancreas, the first part of the small intestine, the gallbladder, and part of the bile duct. In some cases, the surgeon may also remove the body of the pancreas, the entire duodenum, and a portion of the stomach This procedure is AKA

Whipple procedure

Serum lipase range

10 to 140 units per liter (U/L), while for adults 60 and older, it's 24 to 151

Serum amylase level norms

19 units per liter (U/L) and 86 U/L

Normal glucose range

82 - 110 mg/ dL

Normal WBC range

4800 - 10,800 ccm

Gall Bladder & Pancreas: PowerPoint Flashcards

(61 cards)