lewis ch 43 liver, pancreas, and biliary tract problems Flashcards

(37 cards)

1
Q

how are hepatitis A and E transmitted

A

fecal oral

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2
Q

which types of hepatitis have vaccines

A

A and B

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3
Q

how is hepatitis B transmitted

A

blood
semen
saliva

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4
Q

how is hepatitis C transmitted

A

blood

semen

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5
Q

how is hepatitis D transmitted

A

blood

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6
Q

S+S all types of hepatitis (5)

A
  • RUQ discomfort
  • N/V
  • fever and chills
  • jaundice
  • dark urine
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7
Q

treatment for all types of hepatitis (3)

A
  • rest
  • nutrition
  • hydration
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8
Q

complications of hepatitis (4)

A
  • chronic active hepatitis
  • fulminant hepatitis (severe acute hepatitis)
  • cirrhosis
  • hepatocellular carcinoma
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9
Q

most important precaution to prevent spread of Hep A

A

hand washing after bowel movements and before eating

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10
Q

important precautions to prevent spread of Hep B (3)

A
  • using gloves
  • don’t share razors, toothbrushes
  • use condom
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11
Q

primary measures to prevent Hep C transmission (3)

A
  • screen blood, organ, and tissue donors
  • use of infection control precautions
  • modifying high-risk behavior
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12
Q

teaching for patients with hepatitis (6)

A
  • rest
  • no sexual contact (Hep B)
  • no alcohol
  • no blood donation
  • no OTC meds (tylenol)
  • private bathroom
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13
Q

risk factors for liver cirrhosis (5)

A
  • excessive alcohol use
  • nutritional deficiencies
  • chronic hepatitis
  • biliary infections
  • obesity
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14
Q

S+S liver cirrhosis (7)

A
  • change in bowel habits
  • gastritis
  • jaundice
  • anemia
  • kypokalemia
  • hyponatremia
  • peripheral edema
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15
Q

late S+S cirrhosis (8)

A
  • jaundice
  • LOC changes
  • spider angiomas
  • anemia
  • ascites
  • sexual changes
  • edema
  • peripheral neuropathy
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16
Q

nursing care cirrhosis (6)

A
  • measure abdominal girth
  • daily weight measurement
  • turn q2h
  • monitor color urine and stools
  • measure and elevate lower extremities
  • ROM exercises
17
Q

complications of cirrhosis (5)

A
  • portal hypertension
  • peripheral edema
  • ascites
  • hepatic encephalopathy
  • hepatorenal syndrome
18
Q

2 options for procedures to treat cirrhosis

A
  • paracentesis

- balloon tamponade

19
Q

nursing care for patient having paracentesis procedure for ascites (4)

A
  • have patient void immediately before
  • patient in high fowlers position
  • monitor for hypovolemia
  • monitor bp and heart rate
20
Q

nursing care for patient having balloon tamponade procedure for esophageal or gastric varicies (4)

A
  • patient in semi-fowlers position
  • keep scissors at bedside
  • monitor for complications
  • oral/nasal care
21
Q

S+S portal systemic encephalopathy

A
  • changes in LOC
  • neuromuscular disturbances
  • asterixis (“liver flap”)
  • hyperreflexia
  • increased blood ammonia
22
Q

treatment for portal systemic encephalopathy (2)

A
  • decrease protein in diet

- give lactulose and neomycin

23
Q

S+S cholecystitis (6)

A
  • jaundice
  • N/V
  • fat intolerance
  • abdominal distention
  • RUQ pain
  • fever and leukocytosis
24
Q

risk factors for developing cholelithiasis (5)

A
  • high cholesterol
  • upset of bile/cholesterol balance
  • females and pregnancy
  • over 40 yo
  • obesity
25
risk factors for developing cholecystitis (4)
- cholelithiasis - E coli infection - cancer or adhesions - anesthesia
26
S+S biliary duct obstruction by gallstones (5)
- jaundice - clay-colored stools - dark foamy urine - fever - increased WBC count
27
3 options for surgical treatment with gallbladder problems
- ERCP - lap chole - incisional chole
28
how long is patient supposed to be NPO when having ERCP treatment
until return of gag reflex
29
when can patient who had lap chole return to work
1 week after surgery
30
S+S acute pancreatitis (8)
- severe constant pain ULQ - vomiting - low grade fever - hypotension - tachycardia - abdominal distention - cullen's sign - grey turner's sign
31
what is cullens sign with pancreatitis
bruising around umbilicus
32
what is grey turners sign with pancreatitis
bruising around flanks
33
S+S chronic pancreatitis (5)
- burning, cramping pain - jaundice - abdominal distention - hyperglycemia - weight loss
34
risk factors pancreatitis (4)
- biliary tract obstructive disease - alcohol - HLD - smoking
35
2 possible complications pancreatitis
- pseudocyst | - abscess
36
what electrolyte imbalance is common with pancreatitis
hypocalcemia
37
what diet should patient with pancreatitis eat
bland low-fat high-carb