Test #3 Chapter 62 Care of Patients with Problems of the Biliary System and Pancreas Flashcards Preview

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Flashcards in Test #3 Chapter 62 Care of Patients with Problems of the Biliary System and Pancreas Deck (32):
1

Where is the Gallbladder located?

Located underneath the liver.

2

What does the gallbladder do?

Drained by Cystic Duct, which joins the hepatic duct from liver to form the Common Bile Duct.. Stores bile that comes from the liver. You can live without your gallbladder.

Collects, concentrates and stores bile that come from liver

Releases bile into duodenum via Common Bile Duct

3

What is Cholecystitis

Inflammation of the Gallbladder

4

What are the Two types of acute cholecystitis:

1. Calculous-
2. Acalculous

5

What is Calculous-

A type of acute cholecystitis that is characterized by a blockage of the flow of bile due to stones.

6

What is Acalculous

A type of acute cholecystitis that is characterized by inflammation without gallstones. May be from twisting or stasis of the duct.

7

What is Cholelithiasis

the gallstones in the gallbladder

8

Chronic Cholecystitis has periods of remission and exacerbation. Where is the etiology and the risk factors?

Familial or Genetic Tendency, Nutrition Habits

Risk Factors Four Fs: Female, Forty, Fat, Fertile typically

9

What are the Cholecystitis S&S

mainly pain, very severe and wont stop,


Diagnosed X-Ray and Ultrasound and CT

10

What are the non surgical interventions for Cholecystitis

Non-Surgical: Avoid fatty foods, Medications, for pain and nausea, and Fluids

11

What are the surgical interventions for Cholecystitis

Surgical: Cholecystectomy- removal of the gallbladder. Teach watch what they eat. Typically fatty foods aggravate it. They inject Carbon Dioxide into the abdomen which can cause referred shoulder/back pain. To prevent this, the patient must ambulate early which helps reabsorb the carbon dioxide. Also give pain meds.

12

What is obstructive jaundice?

Obstructive Jaundice- normal flow of bile is obstructed. Bile salts can accumulate in the skin which causes you to itch. Seen with Gallbladder and Liver Patients.

13

What are the important facts about cancer of the gallbladder?

Cancer of the Gallbladder

Rare

More Common in Women because they have more gallbladder issues.

Diagnosed: US, CT, Cholecystectomy

Prognosis poor r/t diagnosed late

Treatment: Surgery, Radiation, Chemo typical cancer treatment.

14

What is Acute Pancreatitis,

Inflammatory process of the Pancreas.

Excessive pancreatic Enzymes that destroy ductal tissue and pancreatic cells.

15

What is the etiology of Acute Pancreatitis,

Etiology: Trauma, Biliary tract disease w/ gallstones

16

What are the S&S of Acute Pancreatitis,

S&S: Abdominal Pain, Nausea and Vomiting.

17

*****What are the complications of Acute Pancreatitis,

Complications: Turner’s Sign- Bruising of the flanks. That can indicate that the pancreatic enzymes are leaking into the peritoneal area which causes bruising.


Diagnosed: S&S, Labs, CT

18

***What are the non surgical interventions for acute pancreatitis?

Non-Surgical: *****NPO, (will trump everything, even pain meds, we do not want to stimulate the pancreas to produce more enzymes) IV Fluids, Medications, Nutrition

19

What surgeries are done for acute pancreatitis?

Surgical: Endoscopic Retrograde Cholangiopancreatography (ERCP), Cholecystectomy

20

What is chronic pancreatitis?

Destructive disease of pancreas that has remission and exacerbations.

21

*****What is the etiology of chronic pancreatitis?

Etiology: Alcoholism

S&S: same as acute.

22

******What are the Chronic Pancreatitis Interventions

Non-Surgical: NPO, IV Fluids, Medications, Pancreatic-Enzyme Replacement Therapy (PERT) must take with food and can sprinkle on food but must rinse off lips, mouth, skin, fingers ect because it will break down what it is sitting on, Nutrition

Discharge Teaching- Alcohol help, diet needs to be low in fat, smoking is also an issue. The most important one to fix is the alcohol.


Surgical: Palliative

23

What is a Pancreatic Abscess

Collection of purulent liquefaction of the necrotic pancreas

24

What is the etiology of a Pancreatic Abscess

Etiology: Severe acute pancreatitis, Chronic pancreatitis, Gallbladder surgery

25

What are the S&S of a Pancreatic Abscess

S&S: Febrile, Malaise, Abdominal pain

26

What is the treatment for a pancreatic abscess?

Treatment: Drainage, Manage S&S, give antibiotics.

27

What is a Pancreatic Pseudocyst,

False cyst because they do not have an epithelial lining. Encapsulated, saclike structures that form on or surround the pancreas.

The pseudocyst is inflamed, vascular and fibrotic.

28

What are the risk factors and etiology of a Pancreatic Pseudocyst

Risk Factors/Etiology: Acute Pancreatitis, Abdominal Trauma, Chronic Pancreatitis

29

What are the S&S of a Pancreatic Pseudocyst

S&S: Sometimes palpable, Epigastric pain with radiation to back, Nausea and Vomiting


Treatment: Resolve independently or surgery

30

What are the important facts about pancreatic cancer

Can be primary or metastasis cancer

Difficult to diagnosis early

Etiology: Unclear

Risk Factors: People in 50s-80s, Smokers, Diabetics, Chronic Pancreatitis

Diagnosed: CT will biopsy it to stage it, then treat. Will generally start at the head of the pancreas.

Non-Surgical: Chemo, Radiation, Medications

***Surgical: Partial Pancreatectomy for tumors <3cm, Whipple Procedure for larger tumors

31

What is a Whipple Procedure,

Removal of head of pancreas, duodenum, portion of jejunum and stomach, gallbladder with anastomosis of pancreatic duct, common bile duct and stomach to jejunum. Possibly a splenectomy.

32

***What are the post-op considerations for a whipple- proceedure?

Post-operative: Monitor for Complications; some of these patients will start to have chest pain. May have MI so will start to have those symptoms. Respiratory symptoms such as SOB. Monitor for bowel sounds must monitor for 5 min per quadrant before charting that they are absent. . Urine output may decrease due to blood loss from the surgery.