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Adult Health 2 > Hepatic & GI > Flashcards

Hepatic & GI Flashcards

1
Q

Liver functions

A
  1. Drug, glucose, fat, and protein metabolism
  2. Ammonia conversion
    3.Vitamin & Fe storage
  3. Bile formation
  4. Bilirubin excretion
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2
Q

Chronic liver disease

A

-More common than acute
-Causes: cirrhosis, malnutrition r/t alcoholism, infections

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3
Q

Liver function test (LFT)
ALT normal range:

A

8-40

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4
Q

AST normal range:

A

10-40

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5
Q

Albumin normal range

A

3.5-5.2

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6
Q

Bilirubin normal range

A

0.3-1

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7
Q

PT/INR normal range

A

<1.1

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8
Q

Ammonia normal range

A

15-45

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9
Q

cholesterol normal range

A

0.6-0.7

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10
Q

HDL male

A

35-70

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11
Q

HDL female

A

35-85

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12
Q

LDL

A

< 130

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13
Q

4 types of jaundice

A
  1. hemolytic
  2. hepatocellular
  3. obstructive
  4. hereditary hyperbilirubin
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14
Q

Portal hypertension can cause…?

A

Ascites=
-rapid weight gain
-increased abdominal girth
-SOB
-distended veins
-striae
-umbilical hernias
-fluid & electrolyte imbalances

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15
Q

Portal hypertension is commonly caused by…?

A

cirrhosis

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16
Q

With portal hypertension your body retains what?

A

-H2O & Na+
-up to 20L

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17
Q

Portal Hypertension Nursing considerations with ascites

A

-I&Os
-Daily weight
-Measure abdomen
-Reposition for SOB
-Monitor labs (BUN & creatine)

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18
Q

Portal hypertension Education

A

-Dietary (low Na+ , 2g per day only)
-Be careful of salt substitutes- may have ammonia!
-Alcohol cessation support group
-May need diuretic -spironolactone

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19
Q

Portal hypertension can also cause what medical emergency?

A

esophageal varices

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20
Q

esophageal varices CM’s

A

-Medical Emergency!
-hematemesis
-melena (bloody stools, black tarry)
-general mental deterioration

21
Q

esophageal varices nursing considerations

A

-Medical emergency
-Monitor vitals
-Monitor mental status / LOC
-Gastric suctioning may be needed
-monitor nutritional status
-Dental needs

22
Q

Hepatic encephalopathy Risk Factors

A
  1. TIPS, portal vein thrombosis
  2. Infections
  3. AKI, electrolyte derangements
  4. GI Bleed
  5. Hypoxemia, hypercapnia
23
Q

Hepatic encephalopathy–what happens to ammonia & K+

A

-Ammonia levels increase
-K+ level decrease

24
Q

Hepatic encephalopathy can cause…

A

Seizures & coma

25
hepatic encephalopathy nursing considerations
-may need liver transplant -lower ammonia -electrolyte balance - Monitor LOC -May treat w/ benzo antagonists
26
Hepatitis A transmission
-passed on from small amounts of stool on food, objects, drinks, casual contact
27
Is Hep A vaccine preventable? Is it curable?
-Yes, promote the vaccine -Curable
28
Hep A s/s:
-Flu-like symptoms -low temp -
29
Hep B transmission? Vaccine?
-Passed via body fluids -Vaccine preventable -no cure --can become chronic
30
Hep C transmission? Vaccine? Curable?
-passed via body fluids -No Vaccine -curable -Increases chance of liver cancer & cirrhosis
31
Acute liver faiure
-Sudden & severely impaired liver function in a previously healthy person -onset can vary from short to weeks -prognosis is worse than in chronic liver disease
32
Acute liver disease causes
- Hep B -Drug overdose (acetaminophen)
33
Acute liver disease s/s:
-jaundice -anorexia As it progresses: -kidney disease -infections -Cardiovascular disease -hypoglycemia -cerebral edema -electrolyte imbalance
34
cirrhosis -alcoholic, postnecrotic, biliary
Normal liver tissue replaced with diffuse fibrous tissue --scar tissue
35
cirrhosis s/s:
-liver enlargement -ascites -portal obstruction -infections -GI varices -generalized edema -vitamin deficiency -anemia -mental deterioration
36
Cirrhosis nursing considerations
Treat symptoms: -rest -vitamin replacement -Diuretics for edema -I&Os -Daily Weights
37
Liver Cancer
Primary liver tumors -hepatocellular carcinoma most common type (75%) Liver metastases -GI, Breast, & lung are 2.5x more likely to found in liver
38
Liver cancer treatment
Chemo Radiation Surgical resection
39
Liver Transplants
-very stringent criteria -Manage complications -bleeding - infection -rejection
40
Liver transplant Nursing considerations
-incision site care -IS -focused assessments of renal, pulmonary, metabolic, cardio, respiratory function
41
Small bowel obstruction CMS:
-crampy pain -hypoactive bowel sounds/absent -no flatus usually -vomiting -dehydration -abdominal distention
42
Small bowel obstruction nursing considerations
-NPO -NG decompression -Surgery may be needed if it is complete obstruction & not resolving -risk of strangulation & necrosis
43
Large bowel obstruction CM's
-Progresses slowly -lower abdominal distension -crampy lower abdominal pain -hypoactive to absent bowel sounds -Constipation may be only symptom
44
Large bowel obstruction medical management
-Restore fluid volume & balance electrolytes -NPO -NG decompression -Colonoscopy -rectal tube may be used if obstruction is low enough -resection may be needed
45
Bowel obstruction nursing considerations
-I&Os -Assess NG function (color & amount) -Assess for fluid & electrolyte imbalances -Monitor nutritional status -Monitor for resolution/symptom improvement -if not improvement, prepare for surgery
46
Ostomies Pre-op Educations
-diet -fluid, electrolytes, blood -Education about wound care -involve family & support system
47
Happy stomas are...
-bright red -shiny -skin intact
48
ostomies nursing care
-Monitor for skin breakdown -I&OPs -emotional support -empty every 4-6 hours
49
Ostomies complications
-skin irritation -leaking -ill-fitting appliance -scar tissue

Adult Health 2 (3 decks)

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