Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
44 Cards in this Set
- Front
- Back
|
What is hepatitis?
|
an inflammation of the liver?
|
|
|
What is the most common type of hepatitis?
|
viral hepatitis
|
|
|
What types of viral hepatitis have been recognized by the CDC?
|
A, B, C, D, E and G
|
|
|
What are the three most common types of viral hepatitis?
|
A, B, C
|
|
|
What methods are used in the prevention of viral hepatitis?
|
vaccinations for A & B, no current therapy for Hep C
|
|
|
What are the signs and symptoms of hep A, B, C?
|
malaise, anorexia, fatigue, nausea, occasional vomiting, abd (RUQ) discomfort, decreased sense of smell, headache lowgrade fever, arthralgais, skin rashes, heptomegaly, lymphadenopathy, splenomegaly, jaundice
|
|
|
How is Hep A transmitted from person to person?
|
Fecal - oral, through food when the preparer has hep A and does not know and demonstrates poor sanitary conditions
|
|
|
How is Hep B transmitted from person to person?
|
blood and body fluids, sexual contact, perinatal transmission
|
|
|
How is Hep C transmitted from person to person?
|
blood and body fluids, sexual contact, perinatal transmission
|
|
|
What nursing interventions are implemented when a person has viral Hepatitis?
|
A-good personal and environmental hygiene (teach to wash hands after bathroom and before eating)
B- promote good hygiene, wear gloves when handling blood, advise not to share personal items C-same as B |
|
|
Nursing interventions for all acute Hepatitis patients
|
Assess degree of jaundice, insure adequate nutrition (breakfast is usually easier for them to eat more than dinner), mouth care antiemetics, 2/3L of fluid a day, if on bed rest assess skin, resp., and circulatory complications
|
|
|
What is the essential factor for promoting liver cell regeneration in the client with viral hepatitis?
|
REST
|
|
|
What medication regimen is used for Hep A, B, & C?
|
A- antiemetics (dramamine or tigan), sedative (benadryl) do not use phenothiazines
B- alpha- interferonnucleoside analogs (epivir, hepsera, baraclude, tyzeka) C- pegylate alpha-interferon(injected once a week) given with ribavirin(taken orally twice a week) |
|
|
Which type of viral hep. can result in the infected person being a chronic carrier of the virus?
|
Hep C
|
|
|
How does a person get infected with Hep D?
|
through blood or bodily fluids, perinatal transmission, infection can only occur when HBV is present
|
|
|
What is the relationship between Hep B and Hep D?
|
Hep D cannot survive on its own, it requires the helper function of HBV to replicate
|
|
|
What is cholecystitis?
|
inflammation of the gallbladder
|
|
|
What is cholelithiasis?
|
stones in the gallbladder
|
|
|
What is the etiology of cholecystitis?
|
inflammation can be confined to the mucous lining or involve the entire lining of the gallbladder, this is most common with an obstruction caused by gallstones or biliary sludge, and sometimes can occur in the absence of an obstruction
|
|
|
What is the etiology of cholelithiasis?
|
This occurs when the balance that keeps cholesterol, bile salts, and calcium in solution is altered so that the precipitation of these substances occur. this upset can be caused by infection and disturbances in the metabolism of cholesterol.
|
|
|
What are the clinical manifestations of cholecystitis?
|
fever, jaundice, indigestion, pain in RUQ, abdominal rigidity; chronic symptoms include fat intolerance, dyspepsia, heartburn and flatulence
|
|
|
What type of pain is common with cholelithiasis?
|
sever pain is known as biliary colic (more steady than colicky) attacks may last an hour and can occur 3 to 6 hours after eating a heavy meal or when patient lies down, this can be accompanied by tachycardia, diaphoresis, and prostration
|
|
|
What are the clinical manifestations of cholelithiasis?
|
symptoms can be severe or silent
|
|
|
What type of pain is associated with cholecystitis?
|
pain can range from severe pain to moderate ingestion, pain will start in the RUQ and may be refered to right shoulder and scapula, this pain can be accompanied by nausea, vomiting, restlessness and diaphoresis
|
|
|
What are some clinical manifestations of obstructed bile flow?
|
obstructive jaundice, dark amber urine which foams when shaken, no urobilinogen in the urine, clay-colored stools, pruritus, Intolerance for fatty foods (nausea, sensation of fullness, anorexia), bleeding tendencies, steatorrhea
|
|
|
What can occur when the gallbladder becomes so inflamed or infected that it bursts?
|
it can produce bile peritonitis
|
|
|
What is the relationship between biliary obstruction and jaundice?
|
bile duct obstruction from a stone, biliary strictures, and sclerosing cholangitis obstructs flow of bile through the liver or biliary duct system causing jaundice
|
|
|
What type of lab values would the nurse expect to see with this type of obstructive jaundice?
|
lab values would show an elevation in both conjugates and unconjugated bilirubin levels and urine bilirubin will also be elevated, urobilinogen of stool and urine are decreased or absent
|
|
|
What is the origin of unconjugated (indirect) bilirubin?
|
it is released into the circulation bound with albumin and is not water soluble, it is not excreted in the urine
|
|
|
What is the origin of conjugated (direct) bilirubin?
|
In the liver the unconjugated bilirubin is is conjugated with glucuronic acid to form conjugated bilirubin, then secreted into the bile where it flows through the hepatic and biliary duct systems the to the small intestine
|
|
|
What are the two most common etiologic factors for acute pancreatitis?
|
biliary tract disease (most common in women) and alcoholism (most common in men)
|
|
|
What is the most common pathogenic mechanism for acute pancreatitis?
|
autodigestion of the pancreas, this is injury to pancreatic cells or activation of the pancreatic enzymes in the pancreas rather than in the small intestine
|
|
|
What is the predominant symptom of acute pancreatitis?
|
Abd pain that usually occurs in the LUQ but may be midepigastrium, it can radiate to the back
|
|
|
How is acute pancreatitis pain described by the patient?
|
a sudden onset of severe pain described as deep, piercing, and continious or steady, aggrivated by food and not relieved by vomiting
|
|
|
What are some other manifestations of acute pancreatits?
|
n/v, low-grade fever, leukocytosis, hypotension, tachycardia, jaundice, abd tenderness and guarding, decreased or absent bowel sounds, ileus marked by abd distension, crackles in lungs, gray turners sign and culens sign, cyanosis or yellowish green color on abd. shock
|
|
|
What is the pathology of pancreatitis?
|
autodigestion of the pancreas caused by trypsin, proteolytic and phospholipase enzymes that are inadvertently activated in the pancreas instead of the small intestine commonly caused by reflux of bile acids into the pancreas, obstruction of pancreatic ducts, and blockage caused by gallstones
|
|
|
What are some complications of acute pancreatitis?
|
Pseudocyst and abscess
|
|
|
What is a Pseudocyst?
|
a cavity continuous with or surrounding the outside of the pancreas containing necrotic substances that when released cause the pancreas to become inflammed
|
|
|
Besides pain management, what is the principal focus of supportive care for a client with acute pancreatitis?
|
prevention and alleviation of shock
|
|
|
What signs and symptom would alert the nurse of hypocalcemia in a patient with acute pancreatitis?
|
signs of tetany such as jerking, irritability, and muscular twitching, numbness and tingling around the lips and fingers
|
|
|
What physical assessment techniques are good for detecting hypocalcemia?
|
chvostek or trousseau's sign
|
|
|
explain the meaning of the serology test associated with hep A
|
Anti-HAV IgM -acute infection
Anti-HAV IgG- previous infection and longterm immunity |
|
|
explain the meaning of the serology test associated with hep B
|
HBsAg - current infection, positive in chronic carriers
Anti-HBs- indicates previous infection, marker of response to vaccine HBeAg- indicates high infectivity Anti-HBe- indicates previous infection Anti- HBc IgM- ongoing infection Anti- HBc IgG- indicates previous infection, not appearing after vaccine, HBV DNA- indicates active ongoing viral replication HBV genotyping- indicates the genotype of HBV virus |
|
|
Explain the meaning of the serology tests associated with hep C
|
Anti- HCV- marker for acute or chronic infection
enzyme immunoassay- used in initial screening RIBA- more sensitive antibody test HCV RNA- indicates active ongoing viral replication HCV genotyping- indicates the genotype of HCV |
