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Liver, Gall, & Panc
Ch 41, Med-Surg
| Question | Answer |
|---|---|
| Chronic, progressive liver disease | Cirrhosis |
| Accumulation of excess fluid in the peritoneal cavity | Ascites |
| Removal of ascetic fluid from the peritoneal cavity | Paracentesis |
| enlargement of the liver | Hepatomegaly |
| removal of the gallbladder | cholecystectomy |
| presence of gallstones in the gallbladder | cholelithiasis |
| obstruction in common bile duct | choledocholithiasis |
| excess fat in stool | steatorrhea |
| enlargement of breast tissue in males | gynecomastia |
| organ where bile is produced | liver |
| specialized reticuloendothelial cells in the liver that ingest old red blood cells and bacteria | Kupffer cells |
| passage that delivers bile to the small intestine from the gallbladder | common bile duct |
| a product of the normal breakdown of old red blood cells in the liver | bilirubin |
| the vessel that delivers blood from the aorta to the liver | hepatic artery |
| the vessel that delivers blood from the intestine to the liver | portal vein |
| passage that delivers bile into the gallbladder for storage | cystic duct |
| organ where bile is stored | gallbladder |
| a procedure in which a radioactive substance is injected into a vein and visualized in a radiograph to reveal tumors and abscesses | liver scan |
| the use of sound waves to create an image of the liver, spleen, pancreas, gallbladder, and biliary system that is noninvasive and painless | ultrasonography |
| a procedure that involves removal of a small specimen of liver tissue for examination | liver biopsy |
| a primary complication of liver biopsy that occurs because of the liver's rich blood supply and potential for impaired coagulation | hemorrhage |
| a primary complication of liver biopsy that occurs if the lung is accidently punctured during the biopsy | pneumothorax |
| five body systems where clinical manifestations of cirrhosis occur | integumentary hematologic gastrointestinal neurologic |
| manifestations of cirrhosis in the integumentary system | jaundice spider angioma palmar erythema purpura petechiae caput medusae |
| manifestations of cirrhosis in the hematologic system | anemia thrombocytopenia leukopenia coagulation disorders spenomegaly |
| manifestations of cirrhosis in the reproductive system | amenorrhea testicular atrophy gynecomastia (male) impotence |
| manifestations of cirrhosis in the gastrointestinal system | anorexia dyspepsia nausea & vomiting change in bowel habits dull abdominal pain fetor hepaticus esophageal and gastric varices hematemesis hemorrhoidal varices congestive gastritis |
| manifestations of cirrhosis in the neurologic system | hepatic encephalopathy peripheral neuropathy asterixis |
| liver enlarges, becomes "knobby" and shrinks later | alcoholic cirrhosis (Laennec's disease) |
| obstructive cirrhosis that develops as a result of obstruction of bile flow | biliary cirrhosis |
| results from venous congestion and hypoxia | cardiac cirrhosis |
| results in leaking of lymph fluid and albumin-rich fluid from the diseased liver (fluid accumulated in the peritoneal cavity) | Ascites |
| renal failure following diuretic therapy, paracentesis, or GI hemorrhage | hepatorenal syndrome |
| caused by excessive ammonia in the blood resulting in cognitive disturbances | hepatic encephalopathy |
| may cause fatal hemorrhage | esophageal varices |
| development of collateral vessels | portal hypertension |
| if the lung is accidently punctured and air escapes into the pleural cavity and into the lung on the affected side collapses | pneumothorax |
| three phases of hepatitis progression | 1. preicteric 2. icteric 3. posticteric |
| common findings in the preicteric phase | malaise, severe headache, right upper quadrant abdominal pain, anorexia, nausea, vomiting, fever, arthralgia, rash, enlarged lymph nodes, urticaria, and enlargement and tenderness of the liver last 1-21 days |
| common findings in the icteric phase | jaundice, light-clay colored stools, dark urine, puritus, GI symptoms are preictric phase are persistent increased in blood levels of bilirubin last 2-4 weeks |
| common findings in the posticteric phase | fatigue, malaise and liver enlargement persist for several months |
| two elements for coagulation synthesized by the liver | prothrombin and fibrinogen |
| after liver biopsy what are important nursing assessments | assess site for bleeding, watch for systemic bleeding. have patient remain on right side for 2 hours to maintain pressure |
| treatment for hepatic encephalopathy | lactulose and neomycin laxative decreased absorption of ammonia from injected protine and antibiotic reduces bacteria in bowel needed for ammonia production |
| what caused hepatic encephalopathy | high ammonia levels; damaged liver stops converting ammonia from proteins into urea, also digested blood produces ammonia |
| treatment only completed by a dr to treat bleeding varices | Sengsaken-Blakemore esophageal-gastric balloon tube (3 lumen NGT) inserted to apply direct compression of vessels |
| predisposing factors of cholelithiasis (AKA gallstones) | 5 Fs fat forty female fertile fair skin |
| gallbladder inflammation | cholecystitis |
| gallstones | cholelithiasis |
| Pancreatitis nursing interventions | Pain morphine or Dilaudid antispasmodic drugs decrease motility NPO/NGT suction-pancreas to rest, TPN Calcium, replace Ca Replace fluid & electrolytes Endocrine & Enzymes antibiotics - with fever steroids corticosteroids during acute attacks |
Created by:
arogers74
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