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54/64 Unit 3 > Liver And Pancreas > Flashcards

Liver And Pancreas Flashcards

1
Q

Other than the skin, what is the largest organ in the body?

A

The liver

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2
Q

Functions of the liver

A

Storage of glycogen (and many vitamins and minerals), protein metabolism, detox, and production of albumin, bile, and coagulation factors

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3
Q

Byproduct of protein metabolism

A

Ammonium

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4
Q

Ammonium is sent to the liver to be metabolized into ____ which is sent to the kidneys for excretion as urine

A

Urea

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5
Q

A phagocytic cell which forms the lining of the sinusoids of the liver and is involved in the breakdown of red blood cells

A

Kupffer cell

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6
Q

Functions of albumin

A

Attracts water, transports drugs, binds with calcium

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7
Q

What are the two primary functions of bile?

A
  1. Transports waste out of the body (bilirubin (dead RBCs) and cholesterol) 2. Break down fats during digestion
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8
Q

Purpose of coagulation factors

A

Formation of blood clots

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9
Q

Extensive scarring of the liver caused by necrotic injury or chronic inflammation over a prolonged period of time

A

Cirrhosis

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10
Q

End-stage liver disease that is characterized by irreversible destruction and degeneration of liver cells

A

Cirrhosis

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11
Q

In cirrhosis, normal liver tissue is replaced with _____ tissue that lacks function

A

Fibrotic

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12
Q

Cirrhosis can lead to

A

Liver failure (b/c scar tissue slows blood flow through liver)

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13
Q

Cirrhosis causes

A

Postnectrotic, Laennec’s, Biliary

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14
Q

Postnectrotic cirrhosis is caused by

A

Viral hepatitis, or some medications or toxins

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15
Q

Laennec’s cirrhosis is most commonly caused by

A

Chronic alcohol use

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16
Q

Biliary cirrhosis is caused by

A

Chronic biliary obstruction or autoimmune disease

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17
Q

Gastrointestinal S/S of cirrhosis

A

N/V, anorexia, ascites, gray/tan stools, melena, hematemesis, bleeding esophageal and gastric varices (medical emergency)

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18
Q

Musculoskeletal S/S of cirrhosis

A

Muscle wasting from poor nutritional status

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19
Q

Respiratory S/S of cirrhosis

A

Dyspnea and hyperventilation (b/c of ascites), hepaticus (sweet, musty odor of breath caused by accumulated liver byproducts)

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20
Q

Integumentary S/S of cirrhosis

A

Jaundice (yellowing of skin around eyes/mouth) and itching (d/t accumulation of salts under skin)

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21
Q

Neurologic S/S of cirrhosis

A

Hepatic encephalopathy

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22
Q

Early clinical manifestations of cirrhosis

A

Malaise, RUQ discomfort, GI disturbances (anorexia, indigestion, bowel habit changes)

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23
Q

Late clinical manifestations of cirrhosis

A

Jaundice, esophageal varices, ascites, hepatomegaly, splenomegaly, edema, changes in mental responsiveness and memory, spider angiomas (face, neck, shoulder), anemia, thrombocytopenia

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24
Q

Blood flows out of the liver through ___ hepatic veins into a big vein called the Inferior Vena Cava

A

3

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25
Q

Oxygen-rich blood flows into the liver through the

A

Hepatic artery

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26
Q

Nutrient-rich blood coming from the digestive tract, spleen, and pancreas flows into the liver through the

A

Portal vein

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27
Q

The liver received its blood supply from the hepatic artery and portal vein resulting in about _____ mL of blood flow through the liver every minute

A

1500

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28
Q

Bile flows out of the liver through the

A

Bile duct

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29
Q

High blood pressure in the portal vein resulting from an obstruction before, within, or after the liver

A

Portal hypertension

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30
Q

Portal hypertension most often results from an obstruction _____ the liver due to __________

A

Within; cirrhosis

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31
Q

S/S of portal hypertension

A

Ascites, splenomegaly, collateral vessels

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32
Q

Bloating or swelling due to fluid buildup in the abdomen and legs, and third spacing

A

Ascites

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33
Q

Portal hypertension is classified as > ___ mm Hg

A

10

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34
Q

_________ is caused by backup of blood into the spleen

A

Splenomegaly

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35
Q

Splenomegaly can cause

A

Thrombocytopenia and platelet destruction

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36
Q

Formation of new blood vessels that connect digestive organs directly to general circulation serving as alternate routes for blood to bypass the liver, reduce blood flow to portal vein, and relieving portal pressure

A

Collateral vessels

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37
Q

Complications of collateral vessels

A

Variceal bleeding and hepatic encephalopathy

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38
Q

S/S of hepatic encephalopathy

A

Confusion, drowsiness, tremor, and coma

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39
Q

A network of dilated veins surrounding the umbilicus caused by increased blood flow in the umbilical and paraumbilical veins and is often accompanied by Cruveilhier-Baumgarten murmur

A

Caput medusae

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40
Q

Audible venous hum over the umbilical vein

A

Cruveilhier-Baumgarten murmur

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41
Q

What is the root cause of caput medusae?

A

Portal hypertension

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42
Q

Paracentesis poses a huge risk for

A

Hemorrhage

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43
Q

Bile is made in the _____ and stored in the _________

A

Liver; gallbladder

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44
Q

Bile consists of

A

Waste products, cholesterol, bile salts

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45
Q

Bilirubin that is bound to a certain protein (albumin) in the blood

A

Unconjugated/indirect bilirubin

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46
Q

Bilirubin that is changed by the liver into a form that the body can get rid of

A

Conjugated/direct bilirubin

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47
Q

T or F: the liver makes all the cholesterol you need

A

True! (The remainder of cholesterol in the body comes from diet such as meat, poultry, and dairy)

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48
Q

Yellow discoloration of the skin and mucous membranes caused by an excess accumulation of bilirubin in the blood

A

Jaundice

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49
Q

Byproduct of red blood cell breakdown

A

Bilirubin

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50
Q

Jaundice becomes visible when the bilirubin level is approximately ___ - ___ mg/dL

A

2-3

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51
Q

What are the three main types of jaundice?

A

Prehepatic, hepatic, and posthepatic

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52
Q

__________ jaundice occurs when RBC lysis exceeds the liver’s capacity to conjugate bilirubin, resulting in large amounts of bilirubin to accumulate in the blood

A

Prehepatic (hemolytic)

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53
Q

Causes of Prehepatic jaundice

A

Transfusion reactions, sickle cell anemia, thalassemia, and autoimmune disease

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54
Q

__________ jaundice results from hepatocyte dysfunction which limits the uptake and conjugation of bilirubin, resulting in a rise in the levels of conjugated and unconjugated bilirubin in the blood.

A

Hepatic

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55
Q

Causes of hepatic jaundice

A

Hepatitis, cancer, cirrhosis congenital disorders, and drugs

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56
Q

_________ jaundice occurs when gallstones, inflammation, scar tissue, or tumors block the flow of bile into the intestines, resulting in water-soluble conjugated bilirubin to accumulate in the blood

A

Posthepatic (obstructive)

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57
Q

What type of bilirubin is water soluble?

A

Conjugated/direct

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58
Q

What type of bilirubin is lipid soluble?

A

Unconjugated/indirect

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59
Q

How to calculate total and indirect bilirubin

A

Total = direct + indirect; Indirect = total - direct

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60
Q

An enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, this enzyme is released into the bloodstream and levels increase

A

Alanine transaminase (ALT)

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61
Q

ALT range

A

4-36 units/L

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62
Q

An enzyme found in the liver AND bone important for breaking down proteins

A

Alkaline phosphatase (ALP)

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63
Q

Elevated ALP may indicate

A

Liver damage/disease (such as blocked bile duct) or certain bone diseases

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64
Q

ALP range

A

30-120

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65
Q

An enzyme that helps metabolize amino acids, normally present in the blood at low levels. An increase in this enzyme may indicate liver damage, disease, or muscle damage

A

Aspartate transaminase (AST)

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66
Q

AST range

A

0-35 units/L

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67
Q

Bilirubin passes through the liver and is excreted in

A

Stool

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68
Q

Why is serum bilirubin elevated in liver damage/disease?

A

Due to the inability of the liver to excrete bile

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69
Q

Serum protein range

A

6.4-8.3 g/dL

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70
Q

Serum albumin range

A

3.5-5 g/dL

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71
Q

RBC range for males and females

A

Males: 4.7-6.1; Females: 4.2-5.4

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72
Q

Hematocrit range

A

12-16

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73
Q

Hemoglobin range

A

37-47%

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74
Q

Platelets range

A

150-400k

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75
Q

PT and INR range

A

PT: 11-12.5; INR: 0.8-1.1

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76
Q

The time it takes blood to clot is called

A

Prothrombin time (PT)

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77
Q

Ammonia range

A

6-47

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78
Q

Labs elevated with liver damage/disease

A

ALT, ALP, AST, bilirubin, PT/INR (prolonged), ammonia

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79
Q

Labs decreased with liver damage/disease

A

Protein, albumin, RBCs, H&H, platelets

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80
Q

Inflammation of the liver

A

Hepatitis

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81
Q

HAV transmission

A

Fecal-oral route

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82
Q

Symptoms of HAV

A

Loss of appetite, diarrhea, fever, nausea, malaise, jaundice

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83
Q

HAV recovery time

A

6 weeks

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84
Q

T or F: HAV does not result in permanent liver damage

A

True

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85
Q

HBV transmission

A

Via blood or bodily fluids (tears/saliva)

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86
Q

HCV transmission

A

Via blood or bodily fluids

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87
Q

HCV symptoms

A

Asymptomatic, flu-like symptoms

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88
Q

HDV transmission

A

Via blood or bodily fluids; Can only be infected with HDV if you have HBV already

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89
Q

HEV transmission

A

Fecal-oral route

90
Q

HEV duration

A

2-8 weeks

91
Q

HEV symptoms

A

Jaundice, nausea, fatigue

92
Q

What types of hepatitis carry a greater risk of liver failure and cirrhosis?

A

HDV and HEV

93
Q

What types of hepatitis have vaccines?

A

HAV and HBV

94
Q

Symptoms of acute hepatitis

A

Yellowing of the skin and eyes, nausea, fever, and fatigue

95
Q

Symptoms of chronic hepatitis

A

May be asymptomatic

96
Q

Populations at risk for chronic hepatitis C virus

A

Those who had blood transfusion before 1992, those who have experimented with IV drugs or snorted cocaine, those who have gotten tattoos with a non-sterile needle, those who have had unprotected multiple sexual partners

97
Q

Hepatitis phases

A

Preicteric, icteric, posticteric

98
Q

Describe the preicteric (prodromal) phase of hepatitis

A

Flui-like symptoms: joint pain, fatigue, N/V, abdominal pain, change in taste; increasing levels of liver enzymes and bilirubin

99
Q

Describe the icteric phase of hepatitis

A

Decrease in flu-like symptoms but will have jaundice, dark urine, clay-colored stool, enlarged liver and pain in this area

100
Q

Describe the posticteric (convalescent) phase of hepatitis

A

Jaundice and dark urine start to subside and stool returns to normal brown color, liver enzymes and bilirubin decrease to normal

101
Q

Populations at risk for HAV and HEV

A

Crowded conditions, poor hygiene of food handlers, poor sanitation

102
Q

HAV incubation

A

15-50 days

103
Q

Prevention of HAV

A

Good handwashing, HAV vaccine (need 2 doses at least 6 months apart)

104
Q

Populations at risk for HBV and HDV

A

Health care workers, IV drug abusers, individuals who reside with persons who have HBV, individuals who undergo dialysis

105
Q

HBV incubation

A

45-160 days

106
Q

HBV and HDV prevention

A

Good handwashing, HBV vaccine, needle precautions, avoid unprotected contact with bodily fluids of infected persons, blood donor screening, testing of women who are pregnant

107
Q

Populations at risk for HCV

A

Health care workers, IV drug users, high-risk sexual practices, blood transfusions administered prior to 1992

108
Q

HCV incubation

A

14-180 days

109
Q

HCV prevention

A

Good handwashing, blood donor screening, needle precautions, avoid unprotected sex with infection persons

110
Q

HDV incubation

A

2-26 weeks

111
Q

HEV incubation

A

15-64 days

112
Q

Liver cancer risk factors

A

Older age, cirrhosis, male, gender, tobacco use

113
Q

S/S of liver cancer

A

Abdominal pain, weight loss, weakness/fatigue

114
Q

Liver cancer assessment

A

Enlarged liver, jaundice, ascites, pruritis, encephalopathy, bleeding/bruising

115
Q

Liver cancer diagnosis

A

Biopsy

116
Q

What is the most frequently occurring type of liver cancer?

A

Hepatocellular carcinoma (HCC)

117
Q

Primary liver cancer can originate in the

A

Bile duct or liver vasculature

118
Q

Cancers can be __________ tumors originating in the liver or __________ that spread from other organs to the liver

A

Primary; metastatic

119
Q

Cancer that starts in the cells that line the small bile ducts

A

Intrahepatic cholangiocarcinomas

120
Q

Rare cancer that starts in cells lining the blood vessels of the liver

A

Angiosarcoma/hemangioma

121
Q

Rare liver cancer that develops in children, typically younger than 4 years old

A

Hepatoblastoma

122
Q

An endoscopic procedure that allows the doctor to examine the esophagus, stomach and duodenum

A

Esophagogastroduodenoscopy (EGD)

123
Q

EGD characteristics

A

Outpatient procedure, patient goes home the same day, takes approximately 30-60 min to perform

124
Q

Priority for patient getting an EGD

A

Preventing aspiration (no food or drink until gag returns)

125
Q

A procedure that combines upper gastrointestinal (GI) endoscopy and X-rays to treat problems of the bile and pancreatic ducts

A

Endoscopic retrograde cholangiopancreatography (ERCP)

126
Q

A liver biopsy identifies

A

The progression and extent of cirrhosis

127
Q

Liver biopsy is done under __________ for safety due to risk for bleeding

A

Fluoroscopy

128
Q

Liver biopsy most common route

A

Percutaneous route

129
Q

Describe the process of percutaneous liver biopsy

A

Patient supine with right hand resting above head, local anesthetic applied to biopsy site (expect burning), IV tube used for sedatives or pain meds during or after procedure, incision less than 1/4 in made on right side of chest wall between ribs, biopsy needle inserted, patient should exhale and hold breath while needle is inserted, several sample may be collected

130
Q

Post percutaneous liver biopsy interventions

A

Patients must lie on right side for up to 2 hours to reduce risk of bleeding; patients monitored an additional 2-4 hrs after biopsy before being sent home

131
Q

Why is transjugular liver biopsy not the preferred method of liver biopsy?

A

Because it provides small liver samples

132
Q

Transjugular liver biopsy is reserved for patient with

A

Significant blood clotting disorders or ascites

133
Q

Describe the process of transjugular liver biopsy

A

Patient supine, local anesthetic applied to right side of neck, small incision made on neck and sheath (hollow tube) is inserted into jugular vein, sheath is threaded down the jugular vein, along the side of heart, and into one of hepatic veins (located above liver). Contrast dye used to show proper location of sheath. Biopsy needle threaded through sheath and into liver. Liver sample is quickly withdrawn. Several samples may be collected.

134
Q

Transjugular liver biopsy post-procedure care

A

Sheath is withdrawn and incision is closed with a bandage. Patient monitored for 4-6 hours for signs of bleeding

135
Q

Percutaneous liver biopsy complications

A

Pain at biopsy site (most frequent), hemorrhage, puncture of other internal organs (lungs, bile ducts), leakage of bile inside the abdomen at biopsy site, spread of cancer cells (cancer seeding)

136
Q

Indications for abdominal paracentesis

A

Used to relieve ascites

137
Q

Abdominal paracentesis nursing care

A

Assist patient to void prior to procedure (safety), consent, position patient supine with HOB elevated, apply dressing over puncture site, measure fluid and document

138
Q

A procedure used to reduce portal HTN and its complications, especially variceal bleeding. A stent is placed in the middle of the liver and connects the hepatic vein with the portal vein, which reroutes blood flow in the liver and helps reliever pressure in abnormal veins

A

Transjugular intrahepatic portosystemic shunt (TIPS)

139
Q

Surgery to replace a diseased liver with a healthy liver from another person

A

Liver transplant

140
Q

A nervous system disorder brought on by severe liver disease

A

Hepatic encephalopathy

141
Q

Hepatic encephalopathy triggers

A

Infection, constipation, dehydration, GI bleeds, medications (sleep, pain, water pills), kidney disease, alcohol binge

142
Q

Early symptoms of hepatic encephalopathy

A

Forgetfulness, confusion, and breath with a sweet or musty odor

143
Q

Advanced symptoms of hepatic encephalopathy

A

Shaking of the hands or arms, disorientation, and slurred speech

144
Q

Hepatic encephalopathy treatment

A

Removal of toxic substances from the intestine

145
Q

Type ___ hepatic encephalopathy is brought on by acute liver failure (without underlying chronic liver disease)

A

A

146
Q

Type ___ hepatic encephalopathy occurs in some people who have a shunt that connects two veins inside the liver without underlying liver disease

A

B

147
Q

Type ___ hepatic encephalopathy results from chronic liver disease and cirrhosis

A

C

148
Q

What are the four main parts of the pancreas?

A

Head, neck, body, tail

149
Q

The widest part of the pancreas found in the right side of the abdomen, nestled in the curved of the duodenum

A

Head

150
Q

The thin section of the gland between the head and the body of the pancreas

A

Neck

151
Q

The middle part of the pancreas between the neck and the tail. The superior mesenteric artery and vein run behind this part of the pancreas

A

Body

152
Q

The thin tip of the pancreas in the left side of the abdomen, in close proximity to the spleen

A

Tail

153
Q

The _________ pancreas produces enzymes that help to digest food, particularly protein

A

Exocrine

154
Q

The __________ pancreas makes the hormone insulin, which helps control blood sugar levels

A

Endocrine

155
Q

Exocrine cells of the pancreas that produce and transport enzymes that are released into ducts and then passed into the duodenum where they assist in the digestion of food

A

Acinar cells

156
Q

Small islands of endocrine cells in the pancreas that release hormones such as insulin and glucagon into the bloodstream, which maintain proper blood glucose levels

A

Islets of Langerhans

157
Q

Sudden inflammation of the pancreas that is reversible if caught quickly and treated

A

Acute pancreatitis

158
Q

Causes of acute pancreatitis

A

Gallstone, alcohol, infection, tumors, medications, trauma

159
Q

S/S of acute pancreatitis

A

Sudden severe midepigastric pain, N/V, fever, tachycardia, hypotension, hyperglycemia, confusion/agitation, guarding abdomen, rigid abdomen, grey-turner’s sign

160
Q

Bluish discoloration at the flanks

A

Grey-Turner’s sign

161
Q

Irreversible inflammation of the pancreas

A

Chronic pancreatitis

162
Q

Causes of chronic pancreatitis

A

Repeated acute pancreatitis, alcohol, cystic fibrosis

163
Q

S/S of chronic pancreatitis

A

Chronic epigastric pain or NO pain, pain increases after ETOH or fatty meal, steatorrhea, weight loss, jaundice, DM, dark urine

164
Q

Bluish discoloration of the umbilicus

A

Cullen’s sign

165
Q

How does pain differ in acute versus chronic pancreatitis?

A

Individuals with an acute attack will have severe pain all the time. With chronic pancreatitis, the affected individual will not always have pain, but pain will be exacerbated after consuming alcohol or a fatty meal.

166
Q

An autodigestion of the pancreas by pancreatic enzymes that activate prematurely before reaching the intestines

A

Pancreatitis

167
Q

Inflammation of pancreatic tissue causes…

A

Duct obstruction

168
Q

Pancreatitis can result in

A

Pancreatic inflammation, necrosis, and hemorrhage

169
Q

Classic presentation of an acute pancreatitis attack

A

Severe, knifelike pain in the LUQ, midepigastric region, and/or radiating to the back

170
Q

Chronic pancreatitis that is calcifying is often associated with

A

Alcohol abuse

171
Q

Chronic obstructive pancreatitis is associated with

A

Cholethiasis

172
Q

Pancreatitis risk factors

A

Biliary tract disease, alcohol use, older adults, GI surgery, metabolic disturbances, kidney failure, trauma, medication toxicity, viral infections, cigarette smoking

173
Q

S/S of pancreatitis

A

Severe abdominal pain, board-like abdomen, ecchymosis (flank and/or umbilicus), N/V, hypotension

174
Q

Elevated labs with pancreatitis

A

Serum amylase and lipase (lipase remains elevated longer), WBC, bilirubin, alkaline phosphatase, triglycerides, LDH/AST, Hct, glucose, PTT prolongation

175
Q

Decreased labs with pancreatitis

A

Serum albumin and protein, calcium, potassium, Hgb
Note: potassium low with GI loss; potassium high secondary to tissue necrosis, acidosis, renal insufficiency

176
Q

Pancreatitis urinalysis

A

Glucose, myoglobin, blood, and protein may be present

177
Q

A disorder of motor control characterized by an inability to actively maintain a position and consequently irregular myoclonic lapses of posture affecting various parts of the body independently

A

Asterixis

178
Q

Asterixis is a type of negative myoclonus characterized by a brief loss of muscle tone in _________ muscles followed by a compensatory jerk of the _________ muscles

A

Agonist; antagonist

179
Q

Asterixis is most commonly associated with

A

Metabolic encephalopathies and structural brain lesions (unilateral Asterixis)

180
Q

How to test Asterixis

A

Extend the arms, dorsiflex the wrists, and spread the fingers to observe the “flap” at the wrist

181
Q

How to test for Asterixis at the hip joint

A

Keep patient supine with knees bent and feet flat on table, leaving the legs to fall to side (assess the knees)

182
Q

Risks for pancreatic cancer

A

Genetics, age > 45, males, African American, Tobacco use, chronic pancreatitis, high intake of red meat, long-term gas and pesticide exposure, DM, family hx

183
Q

S/S of pancreatic cancer

A

Pain that radiates to back, fatigue, anorexia, pruritis

184
Q

Pancreatic cancer assessment

A

Weight loss, palpable abdominal mass, hepatomegaly, clay-colored stool, dark/frothy urine, ascites

185
Q

Diagnosis of pancreatic cancer

A

Biopsy, ERCP

186
Q

Characteristics of pancreatic cancer tumors

A

Usually adenocarcinoma, originate in pancreatic head, and grow rapidly in glandular patterns

187
Q

A complex operation to remove the head of the pancreas, duodenum, the gallbladder, and the bile duct to treat tumors and other disorders of the pancreas, intestine, and bile duct

A

Whipple procedure (pancreaticoduodenectomy)

188
Q

On average, the whipple procedure takes about ___ hours to complete and most patients stay in the hospital for ___-___ weeks following the surgery.

A

6; 1-2

189
Q

Cirrhosis nursing interventions

A

Elevate HOB (respiratory), monitor skin integrity w/ scratching, I&Os, daily weights, measure abdominal girth

190
Q

Cirrhosis diet

A

High carb, high protein, moderate fat, low sodium, vitamin supplements, fluid restriction

191
Q

Cirrhosis medications

A

Diuretics, beta-blockers (for varices), lactulose

192
Q

Medication used to promote excretion of ammonia from the body through the stool

A

Lactulose

193
Q

Lactulose MOA

A

Lowers colon pH, converts ammonia to ammonium so it is no absorbed, and works as a laxative to eliminate stool

194
Q

Medication that works by suppressing colon bacteria that convert ammonia in the gut

A

Neomycin/rifaximin

195
Q

Nursing interventions for pruritis

A

Cool clothes, soft bedding, tepid baths, restrict activities that increase temp and sweating, cool environment, short nails, no drying soaps, administer cholestyramine, oatmeal bath, pat skin dry

196
Q

Nursing interventions for ascites

A

HOB in semi-Fowler, measure and record abdominal girth, restrict sodium

197
Q

Medications for ascites

A

Spironolactone, albumin

198
Q

The presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine (B1)

A

Wernicke’s encephalopathy

199
Q

Diet for client with wernicke’s encephalopathy IF they have signs of coma

A

High carb, low protein

200
Q

Too little protein lead to __________, and too much protein can lead to __________

A

Muscle wasting; encephalopathy

201
Q

Thiamine and folic acid deficiency lead to

A

Peripheral neuropathy

202
Q

Components of a “banana bag” or “rally pack”

A

100 mg thiamine, 1 mg folic acid, multivitamins in NS or DW, 1-2 g of Mg

203
Q

How to measure abdominal girth

A

Client supine, measure at level of umbilicus, mark client’s abdomen along sides of tape on flanks and midline prior to removal of tape to ensure later measurements are taken in same place

204
Q

Drain placed in pleural cavity for the treatment of ascites

A

PleurX drain

205
Q

Hepatitis diet

A

High carb, high calorie, low-mod protein, small frequent meals, avoid alcohol

206
Q

Nursing interventions for hepatitis

A

Prevent transmission to others (priority!), hand washing

207
Q

Prevention of hepatitis A

A

Handwashing, education on proper preparation of shellfish, immunization (including post-exposure), educate day care workers

208
Q

Proper shellfish preparation education

A

Steam 90 sec or boil 4 min at 185-195 degrees; only buy from reputable source

209
Q

DTs related to alcohol withdrawal typically occur ___-___ hours after last drink and peaks at ___-___ hours

A

30-120; 24-48

210
Q

S/S of DTs

A

Increase HR, BP, and Temp, shaking, vomiting, sweating

211
Q

Medications for DTs related to alcohol withdrawal

A

Ativan, Valium, Librium

212
Q

Nursing interventions for hepatic encephalopathy

A

Administer lactulose, monitor potassium d/t hypokalemia related to lactulose (GI losses), assess LOC, watch for Asterixis (indicates worsening encephalopathy) and fetor hepaticus, bed rest (exercise produces ammonia)

213
Q

Nursing interventions for pancreatitis

A

NPO (until pain free), NGT, TPN (severe), NO alcohol, IV fluids/electrolyte replacement, antiemetics, pain management, limit stress

214
Q

Pancreatitis diet after recovery

A

Bland high protein, low fat with no stimulants (caffeine), small frequent meals

215
Q

Pancreas labs

A

ELEVATED: amylase, lipase, glucose, triglycerides, DECREASED: calcium

216
Q

Normal blood amylase

A

23-85 units/L, although some lab ranges may go up to 140 units/L

217
Q

Normal lipase levels

A

0-160 U/L

218
Q

__________ is one of the components of Ranson’s scoring system done to assess the severity of pancreatitis

A

Hypocalcemia

219
Q

Medication indicated for chronic pancreatitis and cystic fibrosis that aids in digestion of fats and proteins when taken with meals and snacks

A

Pancrelipase

220
Q

How to take pancrelipase

A

Can sprinkle on foods, drink a full glass of water

54/64 Unit 3 (8 decks)

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