accessory organ disorders
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What is a whipple procedure? | Remove head of pancreas, remove first part of the small intestine (duodenum), the gallbladder, the end of the common bile duct, and sometimes a portion of the stomach. The intestine, bile duct, and remaining portion of pancreas are reconnected.
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Why are we concerned about respiratory complications in the post op pancreatic surgical patient? | In pancreatic surgeries, the incision is made near the diaphragm so we need to moniter respirations.
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What is a common cause of pancreatitis? | Alcoholism, bilary tract disease
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What are s/s of severe pancreatitis? | Abdominal pain that radiates to the back
Pain worse after eating
N/V
Tenderness
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A decrease in urine output is an indication of what in a post op patient? | This can be caused by anything ranging from dehydration to renal failure.
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What is jaundice an indication of? | Liver disease such as cirrhosis or hepatitis.
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What does a patient look like? | Their skin and sclera will turn yellow.
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Bruising in the flank area and around the umbilicus is related to what GI problem? | Pancreatitis
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What are the signs and symptoms of chronic pancreatitis related to alcoholism? | Similar to acute pancreatitis
Weight loss caused by malabsorption of food
Diabetes
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What is colicky pain? | Comes in waves
Starts and stops abruptly
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What is peritonitis? | Inflammation or irritation of the peritoneum
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Peritoneum | the tissue that lines the inner wall of the abdomen and covers most of the abdominal organs
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What are s/s of peritonitis? | Abdominal pain and tenderness
Pain becomes worse when patient is touched or when patient moves
Distention
Fever
N/V
Inability to pass stool or gas
Decreased urine output
Fatigue
Diarrhea
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What are the possible causes of peritonitis? | Ruptured appendix, stomach ulcer, or perforated colon
Pancreatitis
Diverticulitis
Trauma
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What is thrombocytopenia? | Lower than normal platelets in blood
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What is portal hypertension? | Increase in blood pressure within a system of veins called the portal venous system.
Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver.
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Bloody, foul smelling stools are related to what highly contagious complication? | C. Diff
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A positive fluid wave test on the abdomen is related to which disease? | Ascites which can be indicative of cirrhosis.
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Fatty stools is related to what digestive disorder related to alcoholism? | Chronic pancreatitis
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What position would you place a client in for comfort who has acute pancreatitis? | Fetal, side lying, HOB elevated, sitting up, or leaning forward
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What are s/s of pancreatic cancer? | Anorexia and weight loss
Pain radiating to back, more severe at night
Fatigue
Flatulence
Pruritis
Palpable abdominal mass
Hepatomegaly
Jaundice
Clay colored stool
Dark urine
Ascites
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What is cholecysitis? | Inflammation of the gallbladder wall
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What is a common cause of cholecysitis? | Gallstones
Tumor
Bile Duct Blockage
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What are s/s of cholecysitis? | Abrupt onset pain in RUQ that radiates to right shoulder.
Pain with deep inspiration during right subcoastal palpation (positive Murphy's sign)
Intense pain, high rate rate, pallor, diaphoresis with nausea and vomiting after ingestion of high fat foods
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What is a gallbladder's function? | A small sac that stores bile.
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What are causes of gallstones? | Bile that contains too much cholestrol or bilirubin.
Gallbladder doesn't empty correctly.
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What does clay colored stool have to do with gallstones? | When not enough bile gets to the duodenum to help with digestion, the result will be undigested fats that cause light colored stools.
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Black tarry stools are caused by? | Upper GI bleeds
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What is the t-tube used for? | Used after cholecystectomy.
Allows bile to drain out into small pouch.
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When do clamp a t-tube? | 1-2 before and after meals to prepare for removal.
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What does the drainage from a post op cholecystectomy look like the next post op day? | Initially bloody then green brown bile.
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What is a laparoscopic cholecystectomy? | Removes the gallbladder through several small incisions in the abdomen.
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What does elevated cholesterol have to do with gallbladder problems? | People with high cholesterol makes it more difficult for the gallbladder to empty which can cause things such as gallstones.
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