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Exam 6 > Gallbladder & Liver > Flashcards

Gallbladder & Liver Flashcards

1
Q

What is the main functin of the gallbladder?

A

Store & release bile in small intestine for fat emulsification

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2
Q

Cholecystitis

A

Inflammation of the gallbladder

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3
Q

Cholelithiasis

A

Gallstones

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4
Q

Choledocholithiasis

A

Gallstones in the comon bile duct

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5
Q

What damage can gallstones cause?

A

Block the duct

Injure the wall, which can lead to infection

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6
Q

Four F’s in relation to gallbladder problems

A

Female
Fertile
Forty
Fat

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7
Q

Risk factors for gallbladder problems

A 
Obese women
Excessive cholesterol intake
Sedentary lifestyle
Age >45 
Diet change
Frequent pregnancies
Strenuous dieting or rapid weight loss
Diabetes
Use of birth control pills
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8
Q

What is the cause of gallstones?

A

Unknown

Possibly may be due to abnormally thick bile

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9
Q

What kind of base do some gallstones have?

A

Calcium

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10
Q

Chronic gallbladder disease can damage what organ?

A

The liver

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11
Q

S&S of cholecystits/cholelithiasis

A 
Sudden onset of acute RUQ pain
Epigastric pain
Indigestion
Feeling of fullness after eating (especially after high fat meal)
Steatorrhea
N/V
Belching
Fever (usually low grade)
Jaundice
Malaise
Positive murphy sign
Rebound tenderness
Guarding
Referred pain
Anorexia
Flatulence
Increased HR and RR
Diaphoresis
Elevated WBC
Dark amber urine
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12
Q

What is a positive murphy sign?

A

The abrupt cessation of inspiration because of pain when RUQ is palpated

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13
Q

What kind of referred pain is experienced in relation to cholecystitis and cholelithiasis?

A

Pain radiates to the right shoulder or midline of scapulas

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14
Q

Why is the urine dark amber in relation to cholecystitis and cholelithiasis?

A

Urine contains urobilonogen as the kidneys try to remove excess bilirubin from the blod stream

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15
Q

Diagnositc tests r/t cholecystitis and cholelithiasis

A 
ALP & AST
Ultrasound
X-ray
Cholecystogram
EGD
ERCP
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16
Q

Medical management of cholecystitis and cholelithiasis

Mild attacks

A 
Bed rest
NG tube to suction
NPO
IVFs
Antispasmodics/Analgesics
Antibiotics
Antiemetics
Avoid spicy food (when allowed PO intake)
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17
Q

Treatment of cholecystitis and cholelithiasis

A

Diet change
Medications: chenix(chenodiol) and ursodiol (actigall)
Surgery: EWSL, cholecytostomy, cholecystectomy, choledocholithotomy

18
Q

Pre-op NIs for cholecystitis and cholelithiasis

A

Education

19
Q

Post-op NIs for cholecystitis and cholelithiasis

A 
Nursing care similiar to other surgeries
Assess & monitor bile drainage
Turn, deep breath
IS
I&Os
Assess bowel sounds
20
Q

Common bile duct obstruction

A

bilary stones

21
Q

S&S of common bile duct obstruction

A 
Severe abdominal pain
N/V
Fever
Jaundice
Elevated WBC
Elevated liver and pancreatic enzymes
22
Q

Cancer of the gallbladder

A 
Very rare
Not easy to detect in early stage (often already end stage when it is found)
Often liver is invaded as well
Poor prognosis
More common in women than men
23
Q

Functions of the liver

A 
Detoxification of blood
Formation of vitamin A
Synthesis of urea
Storage of fat-soluble vitamins
Secretion of bile
Breaking down fats
Storage of minerals
24
Q

Liver diagnositc tests

A 
Serum bilirubin test
Liver enzyme test
AST, ALT
Serum protein test
Ultrasound
Needle liver biopsy
Serum ammonia test
CT scan
25
Q

What else is liver failure known as?

A

Hepatic coma

26
Q

Causes of liver failure

A

Massive GI hemorrhage
Massive infection
Alcoholic liver disease

27
Q

S&S of liver failure

Initial

A

Fatigue
Gi upset
Diarrhea

28
Q

S&S of liver failue

Those that follow initial

A

Jaundice
Bleeding
Ascites/Abdominal distention
Edema

29
Q

S&S of liver failue

End stage

A 
Tremors
Mental change
Confusion
Clotting disorder- coagulopathy
Shrinking liver
30
Q

Diagnostic tests r/t liver failure

A

Liver function tests

Blood ammonia levels (because ammonia cannot convert to urea)

31
Q

Treatment of liver failure

A 
Bed rest
All drugs are discontinued
Control bleeding (if present)
High calorie, Low sodium, Low protein diet
Management of F&E balance
Antibiotics may be used
32
Q

Nursing considerations for patients with liver failure

A

Starch baths, calamine lotions and tepid sponging for relief of itching
If Ascites place in high or semi-fowlers
Assess for signs of bleeding (stool or urine)
Look for bruises
Provide support
Explain jaundice

33
Q

S&S of liver abcess

A 
Chills
Intermittent fever
Extreme weight loss
N/V
Abdominal distention/pain tenderness
Right side abdomen pain and shoulder/ (pain over liver is a later symptom)
Jaundice
34
Q

Extensive trauma/damage to the liver can be ____?

A

Fatal

35
Q

S&S of liver trauma

A

Orthostatic Hypertension
Hypotension
Tachycardia
Shock

36
Q

Treatment of liver trauma

A

Surgery

37
Q

Liver cancer

A

Rarely site of primary cancer

Usually metastatic

38
Q

Risk factors for liver cancer

A

Chronic Hep B or Hep C
Heavy alcohol abuse
Smoking

39
Q

S&S of liver cancer

A

Encephalopathy
Abnormal breathing
Jaundice
Ascites

40
Q

Treatment of liver cancer

A

Surger (rare)

Chemotherapy

41
Q

Liver transplantation

A

Used in end-stage liver disese

Can be total or a segment of a liver

42
Q

What is the medication involved with liver transplantation?

A

Clyclosporine

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