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GI Finals

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Question
Answer
JAUNDICE   yellow tinge to the skin that may indicate obstruction flow of bile.  
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TYPES & CAUSES OF JAUNDICE   hemolytic, hematocellular, obstructive  
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HEMOLYTIC (JAUNDICE)   overabundance of breakdown products of blood  
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HEMATOCELLULAR (JAUNDICE)   internal liver disease, prevents normal transformation of bile by liver cells  
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OBSTRUCTIVE (JAUNDICE)   inability of normally formed liver bile to be passed into the intestine because of blockage in bile ducts  
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CIRRHOSIS   liver damage followed by development of excessive fibrous connective tissue  
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TYPES & CAUSES OF CIRRHOSIS   laennec's, post necrotic, billiary  
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LAENNEC'S (CIRRHOSIS)   alcoholic, toxic chronic poisoning  
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POST NECROTIC (CIRRHOSIS)   follows types of hepatitis  
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BILLIARY (CIRRHOSIS)   unknown cause, or result of chronic obstruction or infection of bile ducts  
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CIRRHOSIS S/S   some jaundice and disorders of metabolism (protein, fats, carbs, and vitamins)  
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ASCITES   fluid in abdomen  
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ECCHYMOSIS   easy bruising, superficial bleeding under skin  
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People with liver disease   assess daily weight and measure abdominal girth  
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CIRRHOSIS - diagnosis   history & physical, liver biopsy.  
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LIVER BIOPSY post op   have pt lie on right side to splint the liver dressing for 1 hour.  
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LIVER BIOPSY complications   internal bleeding (due to liver is very vascular!); monitor dressing, decrease blood pressure, increase heart rate, increase respiratory rate  
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CIRRHOSIS (LIVER DISEASE) treatment   only treatment for nth stage is liver transplant  
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CIRRHOSIS complications   reasons for development are complicated and not clear  
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CIRRHOSIS treatment   paracentesis to removal of fluid from the abdomen  
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CIRRHOSIS fyi   can cause a drastic shift between vascular and extravascular compartments causing circulatory collapse  
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LAVEEN SHUNT (cirrhosis)   redirects fluid from the peritoneal cavity to the systemic circulation. THEY OFTEN HAVE LAVEEN SHUNT IN PLACE OF PARACENTHESIS TO PREVENT LOSE OF PROTEIN  
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ESOPHAGEAL VARICES   life threatening complication associated with liver disease and aggravated by clotting disorders (possible hemorrhaging)  
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SENGSTAKE - BLAKEMORE   this type of tube has a balloon that when it is inflated, it puts pressure on bleeding vessels. it applies pressure on bleeding site.  
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HEPATIC ENCEPHALOPATHY   liver detoxifies ammonia by converting into urea which kidneys excrete.  
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increased level of ammonia diet   to restrict protein because it is harder for liver to digest  
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S/S HEPATIC ENCEPHALOPATHY   twitching, confusion, stupor, death, SEIZURE PRECAUTIONS  
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HEPATIC ENCEPHALOPATHY nursing diagnosis   check gums for bleedikng, check skin for itching, stool for GI bleeding. HAVE PT WRITE THEIR NAME, IF THEY CAN'T IT MEANS THEY ARE GOING INTO HEPATIC ENCEPHALOPATHY. NO ASA AND STEROIDS  
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HEP A   it is infectious. spread by feces and contaminated food and water. avoid sharing food because it can spread through saliva  
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HEP A drug treatment   GAMMAGLOBULIN  
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HEP B   pt will always be a carrier. it is also called serum hepatitis (blood); transmitted by transfusions, plasma, needles, syringe, dental equipment.  
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HEP C   transmitted by blood. maybe asymptomatic for years but can result to a higher risk of cancer of the liver.  
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HEP D   only people who can contract HEP D are people with HEP B  
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HEP E   from oral, fecal, contaminated water; miniminal symptoms with hep c  
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PRURITIS   may be related to an accumulation of BILE SALTS under the skin  
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Hepatitis treatment   remove causative agent; bedrest (complication: pneumonia, need to turn, cough and deep breath), small frequent meal and increase fluids  
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ALL CASES OF HEPATITIS   have to report to health care officials so they can get hep meds  
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CHOLELITHIASIS   gall bladder stones ( Fourty year old woman, Overweight and 4-5 kids). It blocks the common bile duct; MIGHT HAVE CLAY COVERED STOOLS  
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CHOLELITHIASIS   most common abnormality of biliary system: incidence increases with age/obesity. Between 20-50 age, six times more common in women, after age 50-equal wit men  
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CHOLELITHIASIS S/S   severe mid-epigastric RUQ pain, radiates to back, right scapula, frequently following a meal high in fat, flatulence, indigestion, nausea, jaundice  
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CHOLELITHIASIS Treatment   low fat diet, put NG tube, IV fluid, might do surgery  
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CHOLECYSTECTOMY   most commonly attempted by LAPAROSCOPY  
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ACUTE CHOLECYSTITIS   cause is gall bladder stones completely blocks the flow of bile from the gall bladder  
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ACUTE CHOLECYSTITIS S/S   patient is very ill. Fever, vomiting, severe abdominal pain, biliary colic, WBC elevated, jaundice  
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ACUTE CHOLECYSTITIS treatment   medical management, IV fluids, antibiotics, N/G tube if medical management works, remove GB after healing  
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PANCREATITIS   inflammatory disease of pancreas characterized by inflammation of pancreatic tissue  
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PANCREATITIS S/S   severe epigastric pain centered close to umbilicus. Pain may radiate to sides and straight through to back. Classic position = knees drawn up, clutching abdomen  
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PANCREATITIS diagnosis   dramatically elevated amylase: 500/somogyi units/dl returns to normal within 24 hours (normal 60-160 U/dl)  
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PANCREATITIS treatment   to relieve pain : DEMEROL. NPO, N/G tube, rest GI tract (to rest pancreas), ATROPINE  
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PANCREATITIS nursing care   almost initially put pt into ICU. Observe for calcium deficiency, tetany (rigidity of muscle)  
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CHRONIC PANCREASTITIS   usually associated with alcoholism. It might cause diabetes. Inflammation and fibrosis cause progressive pancreatic insufficiency and eventually destroy pancreas  
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CHRONIC PANCREASTITIS nursing care   address pain immediately. Severe chronic pain makes addiction a great risk  
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CHRONIC PANCREASTITIS treatment   pancrease = mix with juice!  
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