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26 Cards in this Set
- Front
- Back
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hepatitis A. transmissio, incubation, manifestations
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- spread thru fecal oral route
- incubation 15-50 days - illness may last 4-8 weeks manifestations - mild flu like symp, low grade fever - anorexia early symp - later jaundice, dark urine - indigestion - enlarged liver/spleen |
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medical trtment for hepatitis A
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- supportive
- bed rest during acute stage - small frequent meals - 2000 to 3000 kcal/day during acute illness - no alcohol |
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hep B transmission
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- blood, saliva, semen, vaginal secretions
- sexually transmitted, vertical transmission during birthing, open cuts |
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hepC
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- most common blood-borne infection
- causes 1/3 cases of liver cancer - most common reason for liver transplant - clinical course similar to hepB, but chronic carrier state occurs frequently - inc risk for cirrhosis and liver cancer |
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at what conc does jaundice occur
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- bilirubin level greater than 2.5 mg/dl
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types of jaundice and patho
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- hemolytic - due to destruction of RBC
- hepatocellular - due to damage of liver cells - obstructive - due to blockage of hepatic duct. body absorbs bile. - hereditary - ie gilber's syndrome, dubin-johnson synrome |
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gilbert's syndrome
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- a hereditray hyperbilirubinemia
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dubin johnson syndrome
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- a hereditray hyperbilirubinemia
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SS of hepatocellular vs obstructive jaundice vs hemolytic
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hepatocellular
- necrotic/ damaged liver cells, ie cirrhosis - serum bilirubin, urine bilinogen rises - ALT AST inc, indicating necrosis - nausease, malise, fatigue, weakness, weight loss Obstructive - bile absorbed into blood - urine deep orange and foamy - stools pale b/c dec bile in GI - dyspepsia and fat intol for same reason - moderate rise in ALT, AST, GGT - rise in serum bilirubin and alkaline phosphatase hemolytic - fecal and urine urobilinogen inc - however, since there is inc of non water soluble uncojugated biliruben, urine is free of it (not orange) |
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AST, ALT
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- enzyme lab values that indicate liver damage
- for both, above 40mg/dl indicates damage |
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portal hypertension
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- obstructed blood flow through liver results in htn in portal venous system
- associated with cirrhosis and splenomealy |
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effects of portal hypertension
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- ascites, and esoph varices
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pt with painful abdominal distension and hemorrhoids
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usually portal hypertension
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varices
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dilated tortuous veins - varicosities
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cause of esoph varices
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- usually portal htn
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patho of esoph varices
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- liver damage (cirrhosis) --> portal htn --> varices
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manifestations of bleeding esoph varices
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- hematemesis
- melena (tarry feces) - shock symptoms |
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patho of cirrhosis
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- scarring of liver tissue ( replacing with fibrotic tissue) affecting structure and function of liver
- mostly due to alchol intake liver enlargement portal obstruction --> ascites and esoph varices, edema - infection - edema - mental deterioation |
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patho of cholelithiasis
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= gall stones
pigment stones - unconjugated pigments preciptate from bile - must be removed surgically since can't be dissolved with meds cholesterol stones - dec bile acid synth inc cholesterol synth by liver - may be able to dissolve |
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cholelithiasis aka
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gallstones
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signs of cholilithiasis
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vague upper right quardrant pain, distress after fatty meal
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patho acute pancreatities
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- pancreatic duct obstruct
- enzymes back up into duct --> autodigestion and inflamm of pancreas - assoc with ETOH |
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what drugs predispose a person for cholelithiasis
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- estrogen
- oral contraceptives - clofibrate - these drugs increase biliary cholesteral saturation |
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clinical manifestations of choleliithiasis
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biliary colic
- gall stones obstruct duct, causing distention, inflammation, and infection - RUQ pain, radiates to back or right shoulder - caused by contraction of gallbladder - usually after eavy meal jaundice urine dark, feces pale malabsorption of ADEK |
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what pain med should be used for cholelithiasis
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- demeral preferred over morphine
- morphine causes contraction (sphincter of oddi) |
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nursing management for pancreatitis
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pain
- frequenly assess pain and the effect of meds - inc sever pain must be reported - may be hemorrhage of pancras or inadequate dose of analgesics - oral feedings ceased to decrease secrtion of secretin - bed rest to dec met rate and reduce secretion of pancreatic enzymes - skin integrity at risk due to bed rist and poor nutrtional stats - assess |
