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Adult Health Pt 2 > Hepatic/Biliary Disorders > Flashcards

Hepatic/Biliary Disorders Flashcards

(46 cards)

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1
Q

Hepatitis B

A
  • transmitted primarily by blood
  • long incubation period
  • most develop antibodies and recover w/o complications
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2
Q

Risk Factors for Hep B

A
  • blood transfusion
  • frequent exposure to blood/blood products
  • multiple sex partners
  • IV drug use
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3
Q

Hep B S/S

A
  • anorexia
  • insomnia
  • low grade fevers
  • indigestion
  • RUQ pain
  • jaundice
  • rashes
  • arthralgia
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4
Q

Chronic Hep B Complications

A
  • cirrhosis
  • end stage liver disease
  • death usually imminent w/in 1-3 yrs w/o successful liver transplant
  • liver cancer
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5
Q

Hep B Prevention

A
  • Hep B vaccine
  • eliminate risky behavior
  • Hep B hyperimmune globulin
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6
Q

When to get Hep B Hyperimmune Globulin

A
  • post exposure prophylaxis for people at risk
  • recently exposed to body fluids of individuals w/ Hep B
  • babies of moms w/ hep , sexual partners, healthcare workers, police/fire men, morticians
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7
Q

Hep C

A
  • occurs most commonly after IV drug use or blood transfusions (prior to 1992)
  • multiple partners/needle sticks
  • asymptomatic for decades
  • leading cause of liver disease
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8
Q

Acute Hep C S/S

A
  • jaundice
  • n/v
  • malaise
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9
Q

Chronic Hep C S/S

A
  • usually on accidental findings or cirrhosis occurs
  • jaundice
  • bleeds/bruises easily
  • dry/itchy skin
  • ascites
  • pedal edema
  • hepatic encephalopathy
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10
Q

Alcoholic Hepatitis

A

over-ingestion of alcohol leads to liver disease

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11
Q

S/S of Alcoholic Hepatitis

A
  • jaundice
  • anorexia, n/v, abdominal pain
  • spider angiomas
  • palmar erythema
  • enlarged liver or small & hardened
  • splenic enlargement
  • ascites, pedal edema, hepatic encephalopathy
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12
Q

Treatment for Alcoholic Hepatits

A
  • alcohol cessation
  • monitor for withdrawal
  • rest
  • adequate hydration
  • treatment of symptoms
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13
Q

Alcohol Withdrawal Stage 1

A
  • after 8 hrs
  • anxiety
  • insomnia
  • nausea
  • abdominal pain
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14
Q

Alcohol withdrawal Stage 2

A
  • after 1-3 days
  • high BP
  • increased body temp
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15
Q

Alcohol Withdrawal Stage 3

A
  • after 1 week
  • hallucinations
  • fever
  • seizure
  • agitation
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16
Q

Drug-Induced Hepatitis

A

-acute liver failure caused by ingestion of certain meds

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17
Q

What meds can cause drug-induced Hep?

A
  • acetaminophen
  • Dilantin
  • statins
  • sulfa antibiotics
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18
Q

S/S of Drug-Induced Hep

A 
Abrupt
-fever/chills
-rash/itching
-arthralgia
-anorexia/nausea
Late
-jaundice
-enlarged liver
-dark urine
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19
Q

Treatment for Drug-Induced Hep

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A
  • discontinue offending meds
  • antidote if available
  • monitor liver damage-albumin, total protein
20
Q

What is the antidote for acetaminophen?

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A

oral mucomyst

21
Q

Cirrhosis

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A

final stage of chronic liver disease that results in scarring of the liver

  • damage can not be undone but if treated early can be limited
  • compensated and uncompensated
22
Q

Compensated Cirrhosis

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A

-liver can still do its job b/c there are enough healthy cells to make up for the damage and scarring

23
Q

Uncompensated Cirrhosis

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A

liver has to much scarring and patient develops complications

24
Q

Compensated Cirrhosis S/S

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A 
-asymptomatic or vague early 
Later
-intermittent low grade fevers
-epistaxis
-vascular spiders, palmer erythema
-dyspepsia, mild abdominal pain
25
Uncompensated Cirrhosis S/S
- jaundice - ascites - pedal edema - esophageal varices - hepatic encephalopathy
26
Nursing Management for Cirrhosis
- assess symptoms, hx, mental status, med list - promote adequate rest - sitting to promote max lung expansion - O2 may help - daily weights - strict I&O's - nutrition - skin - injury precautions
27
Complications w/ Cirrhosis
- bleeding/hemorrhage - hepatic encephalopathy - fluid volume excess
28
Cholelithiasis
formation of stones in the gallbladder - pigment stones - cholesterol (bile) stones
29
Pigment Stones
common in people w/ certain medical conditions
30
Cholesterol (bile) Stones
Most common - excess cholesterol in bile - gallbladder doesn't empty properly
31
Risks for Cholelithiasis
- obesity/rapid weight loss - female - multiple pregnanc - estrogen therapy - diabetes - fam hx
32
S/S of Cholelithiasis b/c Gallbladder Disease
- RUQ pain especially after meal of fried/fatty foods | - biliary colic-pain comes on suddenly
33
S/S of Cholelithiasis b/c Obstruction of Bile Duct
- fever - GB enlarged/may be palpable - biliary colic - nausea - unable to get comfortable
34
Cholecystitis
inflammation of the gallbladder | -becomes distended and inflamed from repeated episodes of obstruction of cystic duct
35
Symptoms of Cholecystitis
- RUQ pain and rigidity radiating to below right shoulder and to back b/t scapula - n/v - + Murphy's sign (stops inhaling due to pain caused by palpation)
36
Treatment for Cholecystitis
- bowel rest - ursodiol to help dissolve small stones - cholecystectomy
37
Post-Op Cholecystectomy
- no lifting > 5 lbs for 1-2 weeks - may shower on day 2 - ambulate early - wash puncture sites w/ soap and water - allow steri strips to fall of on their own - regular diet as tolerated - Norco/Percocet - diarrhea up to 6 months is not uncommon
38
What is performed after lap chole when their is suspicion that remaining stones are obstructing bowel duct?
Endoscopic Retrograde Cholangiopancreatography | ERCP
39
Pancreatitis
inflammation of the pancreas
40
Acute Pancreatitis
- sudden inflammation of pancreas - gallstones or alcohol are common cause - mild or life threatening but usually subsides - usually has undiagnosed chronic pancreatitis
41
Acute Pancreatitis S/S
- severe abdominal pain-24-48 hours after heavy meal or alcohol - n/v - abdominal distention/decreased BS - guarding - low grade fever - increased pain w/ movement - pain relieved somewhat by leaning over - elevated amylase and lipase
42
Treatment for Acute Pancreatitis
- strict NPO - IV fluids - IV analgesics - IV antibiotics - antiemetic - close monitoring - may need transfer to ICU
43
Complication from Acute Pancreatitis
- F/E imbalances - hypovolemic shock - pancreatic necrosis - multi-system organ failure
44
Chronic Pancreatitis
- inflammation of pancreas that does not improve over time - common cause is heavy alcohol consumption w/ smoking - caused by gallstones inside duct
45
S/S of Chronic Pancreatitis
- recurring attacks of pain - vomiting - anorexia - weight loss - malnutrition/malabsorption
46
Treatment for Chronic Pancreatitis
- prevention-smoking/alcohol cessation - proper nutrition - pain meds - pancreatic enzyme replacement - PPI

Adult Health Pt 2 (8 decks)

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