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GIGU Test 2 Accessory Organs
Terms in this set (67)
What are the 3 types of Hepatitis we need to know
A, B, and C.
How is Hep A transmitted
Through the fecal-oral route.
What is the incubation period for Hep A
Where is the Hep A virus found
In the stool.
What is the name of the vaccine for Hep A
How is Hep B transmitted
Blood, semen, vaginal secretions, saliva, and perinatal.
Where is Hep B not found
Urine, feces, milk, tears, or sweat.
What is the incubation period for Hep B
How long is a Hep B carrier infectious for
4-6 months and 6-10% for their lifetime.
What are risk factors that lead to Hep C infection
IV drug use, transfusions, hemodialysis and occupational exposure.
What is the incubation period of Hep C
How long is a Hep C carrier infectious for
What are kupffer cells
kupffer cells line the liver and are responsible for filtering bacteria and other foreign proteins out of the blood.
What is another term for jaundice
What are the 3 phases of hepatitis
Preicteric, Icteric, and Posticteric.
Define the preicteric phase
Last 1-21 days and precedes jaundice.
How will a patient in the preicteric phase present
Anorexic and state that they find food repugnant, weight loss, RUQ pain, hepatomegaly, urticaria.
Define the icteric phase
Lasts 2-4 weeks and characterized by jaundice.
How will a patient in the icteric phase present
The patient may have dark colored urine, light colored stools, hepatomegaly, and be itchy.
Why do pt's in the icteric phase itch
Because of the accumulation of bile salts under the skin.
Define the post-icteric phase
Lasts 2-4 weeks and coincides with the disappearance of jaundice.
How will pt's in the posticteric phase present
Very fatigued, hepatomegaly, and LFT (liver function test) will be elevated.
What is the primary cause of liver cirrhosis
What are the 2 types of skin lesions cause by liver cirrhosis
Spider angiomas and palmar erythema.
What are the 3 biggest complications of liver cirrhosis
Varices, Ascites, and Hepatic encephalopathy.
What is Hepatic encephalopathy
When blood is shunted past liver via collateral circulation and prevents liver from converting ammonia to urea. Large amounts of NH3 (nitrous ammonia) circulates in the blood stream and crosses the blood-brain barrier producing toxic manifestations.
How is hepatic encephalopathy managed
Reduction of ammonia formation by restricting proteins, sterilization of the intestines with antibiotics [neomycin], and lactulose therapy.
What is a Sengstaken-Blakemoore tube used for
As a balloon tampanode for esophageal varicies.
Where is the Sengstaken-Blakemoore tube inserted
Through the nose and ends in the stomach.
What is the purpose of the gastric balloon in the Sengstaken-Blakemoore tube
To anchor the device and apply pressure to the varices.
What would happen if the gastric tube is deflated unintentionally
The esophageal balloon will migrate upward and occlude the airway.
Why should the esophageal balloon be deflated and how often
To prevent necrosis and it should be deflated every 8-12 hours.
What specific tool should alway be at bedside when using a Sengstaken-Blakemoore tube and why
Scissors. In case emergency deflation is needed, the balloons can be cut.
What are the 3 causes of ascites
Increased pressure that causes proteins and water to leak into the peritoneal cavity, hypoalbuminemia, hyperaldosteronism.
What is primary liver cancer
Liver cancer that originates in the liver's parenchymal cells or intrahepatic bile ducts.
What is metastatic liver cancer
Cancer that spreads to the liver usually originating in the GI tract, lungs, or breasts.
What is the most common type of liver cancer
What are the signs and symptoms of liver cancer
Pretty much the same as liver cirrhosis. Anorexia, hepatomegaly, orthopnea or dsypnea r/t ascites, anorexia, weight loss, fever, jaundice, etc.....
What test confirms liver cancer
What are the 2 types of pancreatitis
Acute and Chronic.
What are the 2 subtypes of chronic pancreatitis
chronic obstructive pancreatitis and chronic calcifying pancreatitis.
Define acute pancreatitis
An inflammatory process of the pancreas associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissue causing necrosis and hemorrhage.
What are the 2 main causes of acute pancreatitis
Alcoholism and gallbladder disease.
In a normally functioning pancreas, when do the digestive enzymes begin to work
When the digestive enzymes reach the duodenum.
Why would the digestive enzymes in acute pancreatitis begin to harm the pancreas
Due to reflux of bile from the duodenum or an obstruction of the pancreatic duct from gallstones, the digestive enzymes become activates while still in the pancreas.
Where in the pancreas in acute pancreatitis may the digestive enzymes become activated
In the ampule of vater.
How does alcoholism cause acute pancreatitis
Ingestion of alcohol causes excess HCL which causes spasms of the sphincter of Oddi and ampulla of vater, thus obstructing pancreatic flow.
Name some major signs and symptoms of acute pancreatitis
LUQ or mid-epigastric pain that can radiate to the retroperitoneal, Grey Turner's sign and Cullen's sign.
What are the major diagnostic tests to diagnose pancreatitis
Serum amylase and lipase.
How to manage pancreatitis
NPO, bedrest, HOB 45 degrees/sitting up/or fetal position, any meds to calm HCL secretion (H2 antagonists, antacids, etc...), pain meds.
Diet for pancreatitis
High carb and protein, low fat.
Define chronic pancreatitis
a progressive destruction of the pancreas with fibrotic replacement of pancreatic tissue.
Is Chronic pancreatitis reversible
How does Chronic Calcifying Pancreatitis occur
It is alcohol induced.
What are some signs and symptoms of Chronic pancreatitis
The same as acute with a few different ones: Steatorrhea (fatty stools), Greasy stools/oil droplets, Dark colored urine, Glucose intolerance (islet cell destruction decreases insulin secretion), Weight loss.
What are the main types of medications used to treat chronic pancreatitis
Pancreatic enzymes - give with meals and snacks, Bile salts - to facilitate absorption of fat-soluble vitamins, Insulin or oral hypoglycemic drugs - if diabetes develops.
How will the Doctor decide whether to give oral hypoglycemic drugs or insulin to a patient with pancreatitis
If the patient still has functioning Islet cells, then the patient will produce some insulin of their own and need oral hypoglycemic agents to help out. However is all of the Islet cells are destroyed, then the pt will produce no insulin and need insulin injections for the rest of his/her life.
What is a pseudocyst
When the cavity that surrounds the pancreas is filled with necrotic product.
What is the HALLMARK of pancreatitis
An abnormal rise in serum amylase >200u/liters within 12 hours of onset of the disease.
Why would a patient with pancreatitis not be given Morphine
Because is will cause spasms of the Sphincter of Oddi.
How should the administration of Demerol be managed
It should be ordered for acute pain management only. It is not used for long term pain management because it causes a build up of a toxic metabolite normeperidine. Normeperidine is a CNS irritant and can cause seizures.
What types of people are most prone to getting gallstones
Fat, Female, Fertile, Fair, and Forty.
What are the signs and symptoms of gallstones
right-sided abdominal pain, n/v, intolerance to fatty foods, steatorrha,jaundice, clay-colored stools, dark foamy urine.
What are the signs and symptoms of Cholecystitis
Fever, elevated WBC count, elevated serum bilirubin, elevated alkaline phosphatase, abdominal muscle guarding w/ rebound tenderness and rigidity [seen in chronic cholecystitis due to perforation that results in peritonitis].
What are common diagnostic tests for cholecystitis
Ultrasound, serum amylase and lipase, serum biliruben, percutaneous transhepatic cholangiography.
What should a nurse be cautious with percutaneous transhepatic cholangiography
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