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45 Cards in this Set

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Ulcrer treatment Medical
Medical
Triple Therapy – antimicrobials, antacids , H2 blockers
Ulcrer treatment Surgery
Surgery
Pyloroplasty
Vagotomy
Gastrectomy
Betroth 1
Bilroth II
Total
Dumping Syndrome ?
when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. Symptoms of early dumping include nausea, vomiting, bloating, diarrhea, and shortness of breath
Nursing Diagnosis -GI Disorders
Fluid volume defecient
Nutrition less than body requirements
Breathing pattern , ineffective
Skin integrity
Pain , acute or chronic
Body image disturbance
Knowledge defecient
Hepatitis A
Caused by an RNA virus
Hepatitis A
Hepatitis A Clinical Manifestations
• Many patients are anicteric and symptom less
• When symptoms appear they are mild
• Flu like
• Upper respiratory infection
• Low grade fever
• Anorexia is an early symptom
• Often severe
• Later jaundice and dark urine may be present
Hepatitis A
Diagnostics
• Stool for hepatitis A antigen
• Serum hepatitis A virus antibodies
Hepatitis A
Prevention
• Vaccine recommended for high risk groups
• Harvix
• Immune globulin to prevent hepatitis A if given within 2 weeks of exposure
Hepatitis B
Caused by a DNA virus
Hepatitis B
• May be insidious and variable
• Loss of appetite
• Dyspepsia
• Abdominal pain
• General aching
• Malaise and weakness
• Jaundice may or not be evident
• Liver may be tender and enlarged
• Spleen may be enlarged
• Posterior cervical lymph nodes may also be enlarged
Hepatitis B
• Alpha interferon is promising
• Bed rest and restriction of activities while
• Liver enlarged
• Bilirubin elevated
• Liver enzymes increased
• Maintain adequate nutrition
• Restrict proteins when liver is impaired
• Antacids/antiemetics for dyspepsia
• Convalescence may be prolonged
• Encourage gradual activity after complete clearing of jaundice
• Include family in planning patients care
Hepatitis C
Cirrhosis
• Diffuse inflammation and fibrosis
• Structural changes due to fibrosis
• Loss of liver function
• Liver cell death
• Scar tissue formation
• Changes in circulation through the liver
Pathophysiology of The Cirrhotic Liver
Cirrhotic Liver Clinical Manifestations
Cirrhotic Liver Clinical Manifestations
• Liver enlargement.
• Portal obstruction.
• Constipation/Diarrhea.
• Spider telangiectases on face and trunk.
• Vitamin deficiency (A,C, and K).
• Varices in esophagus, stomach, rectum.
• Decreased plasma proteins resulting in edema.
Cirrhotic Liver Clinical Manifestations
• Increased aldosterone production
• Anemia from poor diet and decreased G.I. function
• Renal failure
• Infections
• Deterioration of mental function
• Pruritis
Cirrhotic Liver Lab Tests
Cirrhosis – Nursing Assessment
Cirrhosis – Nursing Implementation
Cirrhosis – Nursing Implementation
Cirrhosis – Nursing Implementation
Cirrhosis Complications.
• Observe for melena, blood in stools.
• Avoid straining at stool.
• Keep equipment ready for bleeding varices.
Portal Hypertension
Manifestations of P.H.
Ascites
Ascites
Ascites – Nursing Assessment
Ascites - Nursing Intervention
Ascites - Nursing Intervention
Paracentesis
Bleeding Esophageal Varices
Medical Management of Varices
Medical Management of Varices
Ascites - Nursing Intervention
Paracentesis
Bleeding Esophageal Varices
Medical Management of Varices
Medical Management of Varices
Balloon Tamponade
Balloon Tamponade Nursing interventions
• Deflate balloon to decrease erosion and necrosis
• Teach how to decrease risk of varices rupture
• No straining
Balloon Tamponade
Bleeding Esophageal Varices – Nursing Assessment
Bleeding Esophageal Varices – Nursing Interventions