Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Med Surg Ch 35

Nursing Care of Patients with Liver, Pancreatic, and Gallbladder Disorders

QuestionAnswer
Hepatitis G was just discovered in 1915. Not much is known about it. It is thought to cause a mild illness; it is unknown if it causes longterm liver damage
Hepatitis G transmission It is bloodborne and transmission may occur with transfusions, hemodialysis, IV drug use, sexual contact and mother to newborn
Who are co-infected with Hepatitis G HBV and HCV
HIV and Hepatitis G relationship those with HIV who are infected with HGV seem to have increased survival rate
Prevention of Hepatitis vaccinations available for HAV and HBV provide permanent active immunity
Diagnostic tests for hepatitis Liver enzymes elevated; serum bilirubin elevated; prothrombin time prolonged
Liver toxic drugs acetaminophen; opioids; tranquilizers; sedatives; many drugs are metabolized by the liver and may need to be discontinued or dosage adjusted
Nursing care with liver failure do not use acetaminophen or products with acetaminophen; position patient upright or sitting position
Acute liver failure therapeutic interventions high-calorie, low-sodium, and low-protein diet
Meds to decrease ammonia level lactulose, neomycin, sorbitol, magnesium citrate
Clotting defects and cirrhosis impaired prothrombin and fibrinogen production; absence of bile salts prevents absorption of fat-soluble vitamin K; hemorrhage can develop
Therapeutic interventions for esophageal varices vasoconstrictors (octreotide, vasopressin)
Encephalopathy and lactulose makes colon more acidic which creates an insoluble form of ammonia that is excreted in the stool
Encephalopathy and Neomycin to reduce colonic bacteria that change ammonium to ammonia
Reason to restrict dietary protein with encephalopathy reduces ammonia production
Diet with acute liver failure and cirrhosis low-sodium diet with fluid restriction; protein restriction and frequent mouth care may help imbalanced nutrition
Assessing neuromuscular status ask patient to stand with his arms and hands out straight in front of him, if asterixis is present, his hands will unwillingly dip and return to horizontal position in a flapping motion
Med administration and acute liver failure and cirrhosis give lactulose, neomycin, Mg citrate, sorbitol as scheduled; do not withhold lactulose for loose stools, this indicates the med. is working; question giving meds. such as sedatives, opioids, tranquilizers
Risk for deficient fluid volume/bleeding with acute liver failure and cirrhosis monitor gastric secretions, stool, and urine for bleeding; advise use of soft bristle toothbrush and electric razor; avoid forceful coughing, nose blowing, straining, vomiting, or gagging
Signs of rejection for liver transplant Pulse >100 bpm; temperature >101°F; RUQ Pain; increase in jaundice; decrease in bile from T-tube or change in bile color; elevated liver enzymes
Signs and symptoms of acute pancreatitis abd pain; guarding; rigid and distended abd; hypotension; shock; jaundice; dry mucous membranes; tachycardia; respiratory distress; midline pain under sternum with radiation to spine, back, flanks; low fever; nausea and vomiting; eating worsens pain
Diagnostic test for acute pancreatitis serum amylase and lipase elevation; elevated glucose , bilirubin, alkaline phosphatase, lactic dehydrogenase, ALT, AST, cholesterol and potassium; decreased albumin, calicium, sodium and magnesium
Acute pancreatitits therapeutic interventions with foley catheter strict I and O
Acute and chronic pancreatitis interventions for pain position in high Fowler’s, leaning forward to keep abdomen organs from pressing against inflamed pancreas
Acute and chronic pancreatitis interventions for imbalanced nutrition effective treatment if weight loss is < 5% of baseline and patient’s albumin level is above 3.5 g/dl
Acute and chronic pancreatitis patient teaching s/s of diabetes mellitus; teach self-monitor for malabsorption syndrome; vital signs are stable; urinary output > 30 ml/hr
Malabsorption syndrome s/s fatty stools, weight loss, dry skin, bleeding
Signs and symptoms of cancer of the pancreas with obstruction of bile duct jaundice; dark urine; light colored, clay colored stools; pruritus
Patient education for cancer of the pancreas management of hyperglycemia; pancreatic enzyme replacement; s/s of hemorrhage, gastric ulceration, infection, fistula formation; dressing/drain care; complications to report
 Fasting: less active GB, bile will concentrate-can lead to cholelithiasis
Signs and symptoms of cholelithiasis jaundice and clay-colored stools due to common bile duct blockage
T-tube and nursing care placed in common bile duct during open cholecystectomy; drains 500-1000 ml the 1st post op day; decreases to 200 ml by 3rd post op day
Gallbladder disorders and acute pain Incisional pain causes hesitancy to coughand deep breath; administer analgesics, have pt. splint the incision, perform C & DB or use of incentive spirometry
Gallbladder disorders and risk for deficient fluid volume monitor I & O; give antiemetics
Gallbladder disorders and risk for ineffective breathing pattern encourage C & DB; use incentive spirometry; control the pain; splint the incision; encourage early ambulation
Created by: laotracuata