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Liver, Gall, & Panc

Ch 41, Med-Surg

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