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35 Cards in this Set

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Cirrhosis
Etio
~liver cells destroyed and replaced by scar tissue
~cause not clear
~seen in alcoholics
~assoc w/nutritional deficiency w/decr protein intake
Cirrhosis
S/S - early stg
~enlarged liver w/fatty infiltration
~jaundice
~GI disturbances
~abd discomfort
~palpate lg liver
Cirrhosis
S/S - late stg
~liver shrinks
~becomes nodular
~spleen enlarges
~ascities
~distended abd veins
~bleeding tendency
~esophageal varices
~dyspnea (b/c ascities)
~pruritis (b/c bilirubin)
~clay colored stools
Cirrhosis
S/S - end stg
~hepatoencephalopathy (prodromal, impending, stupor, coma, convulsion, death)
Cirrhosis
NI
~protein restriction during stg I & II
~no protein stg III & IV
~rest
~no drugs/alcohol damaging 2 liver
~high cal, mod protein, low fat, low Na (early stg)
~albumin
~daily wts
~measure abd girth
~skin care
~I&O
~meds (lactulose)
bleeding esophageal varices
etio
~blood vessels enlarging b/c liver doesnt filter; excess goes 2 blood vessel & expand
~dilated veins found in L esophagus 2nd 2 portal hypertension
~bleeding may result b/c of coughing, trauma, or vomiting
~medical emergency
bleeding esophageal varices
NI
~maintain airway
~assist MD w/sangstake-blakemore tube
~meds (vit K)
~semi-fowlers
~suction @ bedside
bleeding esophageal varices
surg interv
~portocaval shunt
gallbladder disease
etio
~cholecystitis
~cholelithiasis
gallbladder disease
S/S
~RUQ/epigastric pain
~NV
~fat intolerance
~Murphy's sign
gallbladder disease
NI
~relieve pain
~meds (Demerol)
~administer antibiotics
~antiemetics
~low fat
choleycystectomy
~removal of gallbladder
~POST:check 4 bleeding
~check 4 drainage
~diet: low fat, high carbs, high protein
pancreatitis
etio
~inflam brought about by digestion of pancreas by enzyme it produces
~endo/exo
pancreatitis
S/S
~extreme upper abd pain radiating 2 back
~persistent vomiting
~abd distension
~wt loss
~steatorrhea
pancreatitis
NI
~w/hold oral intake
~prov IV
~relieve pain (Demerol)
~low fat
~no alcohol
~no caffeine
~anticholinergics
~antacids
~pancreatic enzyme (Viokase, Pancreatin)
hiatal hernia
etio
~portion of stomach is herniated through the esophageal hiatus of the diaphragm
hiatal hernia
S/S
~heartburn
~dysphagia
hiatal hernia
NI
~small freq meals
~upright pos w/meds
~HOB elev
~antacid 4 heartburn
~no coughing
~no anticholinergics
gastric resection
bilroth I
~gastroduodenostomy
~gastro 2 sm intestine
gastric resection
bilroth II
~gastrojejunostomy
~gastro 2 jejunum
~CA on sm intes
~90% digestion on sm intes
gastric resection
complications
~hemorrhage
~pulmonary
~dumping syndrome
gastric resection
NI
~early 5-20 mins after meals:vertigo, sweating, diarrhea, nausea d/t fluid shifts
~late 2-3hrs: hypoglycemia occurs d/t excess insulin secretion
~no salty, high chol meals
~sm freq meals
~no liquids w/meals
~lie down after meals
~antispasmodics
~high protein, high fat, low chol
chronic duodenal ulcers
etio
~25-50yrs
~M:F 3:1
~executives, leaders
chronic duodenal ulcers
S/S
~2-3hrs after meals: night, early morning pain
~ingestion of food relieves pain
~pain is gnawing sensation sharply localized in midepigastrium/back
chronic gastric ulcers
etio
~50yrs+
~M:F 2:1
~laborers
chronic duodenal ulcers
S/S
~0.5-1hr after meals: pain rarely @ night
~relieved by vomiting
~ingestion of food doesnt help; sometimes causes pain
colostomy
~portion of colon brought thru abd wall, creating temp/perm opening 4 exit of waste prods
~large bowel
~indic 4 inflam/obstruc process of lower intes tract
~indic 4 trauma 2 intes tract, CA of rectum/sigmoid
~stool: semiformed-formed
~no vol control; only by diet/irrigation
ileostomy
~portion of ileum brought thru abd wall creating perm opening 4 exit of waste prods
~small bowel
~indic 4 crohn's dz, ulcerative colitis
~stool: liquid
~no control, wear appliance @ all times
crohn's dz
~ileum/R colon
~20-30, 40-50
~S/S: light bleeding, slight diarrhea, abd pain after meals, wt loss
~TX: steroids, hyperalimentation, part/comp colostomy/ileostomy, anastomosis
~Complications: scarring, obstruction
ulcerative colitis
~mucosal ulceration of lower colon/rectum
~20-40
~S/S severe bleeding, severe diarrhea (10-20xDay), abd pain after meals, wt loss
~TX: steroids, part/comp colostomy/proctocolectomy/ileostomy
~Complications:perforation, susceptible 2 CA, toxic megacolon
ileal loop
~urinary conduit
~pouch is made 4m loop of ileum where ureters are transplanted 4 urine drainage
~excrete urine only
~open-ended pouch
blakemore
~balloon on tube
pen-rose drainage
~allows bile to drain from wounds/ducts
gastrostomy tube
~check residual 2 see if pt is digesting
~if residual is 100, discard, hold feeding
~max residual is 50
~sutured by MD
total parenteral nutrition
~3000-4000cal/day