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35 Cards in this Set
- Front
- Back
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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 |
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Cirrhosis
S/S - early stg |
~enlarged liver w/fatty infiltration
~jaundice ~GI disturbances ~abd discomfort ~palpate lg liver |
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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 |
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Cirrhosis
S/S - end stg |
~hepatoencephalopathy (prodromal, impending, stupor, coma, convulsion, death)
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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) |
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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 |
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bleeding esophageal varices
NI |
~maintain airway
~assist MD w/sangstake-blakemore tube ~meds (vit K) ~semi-fowlers ~suction @ bedside |
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bleeding esophageal varices
surg interv |
~portocaval shunt
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gallbladder disease
etio |
~cholecystitis
~cholelithiasis |
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gallbladder disease
S/S |
~RUQ/epigastric pain
~NV ~fat intolerance ~Murphy's sign |
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gallbladder disease
NI |
~relieve pain
~meds (Demerol) ~administer antibiotics ~antiemetics ~low fat |
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choleycystectomy
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~removal of gallbladder
~POST:check 4 bleeding ~check 4 drainage ~diet: low fat, high carbs, high protein |
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pancreatitis
etio |
~inflam brought about by digestion of pancreas by enzyme it produces
~endo/exo |
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pancreatitis
S/S |
~extreme upper abd pain radiating 2 back
~persistent vomiting ~abd distension ~wt loss ~steatorrhea |
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pancreatitis
NI |
~w/hold oral intake
~prov IV ~relieve pain (Demerol) ~low fat ~no alcohol ~no caffeine ~anticholinergics ~antacids ~pancreatic enzyme (Viokase, Pancreatin) |
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hiatal hernia
etio |
~portion of stomach is herniated through the esophageal hiatus of the diaphragm
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hiatal hernia
S/S |
~heartburn
~dysphagia |
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hiatal hernia
NI |
~small freq meals
~upright pos w/meds ~HOB elev ~antacid 4 heartburn ~no coughing ~no anticholinergics |
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gastric resection
bilroth I |
~gastroduodenostomy
~gastro 2 sm intestine |
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gastric resection
bilroth II |
~gastrojejunostomy
~gastro 2 jejunum ~CA on sm intes ~90% digestion on sm intes |
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gastric resection
complications |
~hemorrhage
~pulmonary ~dumping syndrome |
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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 |
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chronic duodenal ulcers
etio |
~25-50yrs
~M:F 3:1 ~executives, leaders |
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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 |
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chronic gastric ulcers
etio |
~50yrs+
~M:F 2:1 ~laborers |
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chronic duodenal ulcers
S/S |
~0.5-1hr after meals: pain rarely @ night
~relieved by vomiting ~ingestion of food doesnt help; sometimes causes pain |
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colostomy
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~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 |
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ileostomy
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~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 |
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crohn's dz
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~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 |
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ulcerative colitis
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~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 |
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ileal loop
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~urinary conduit
~pouch is made 4m loop of ileum where ureters are transplanted 4 urine drainage ~excrete urine only ~open-ended pouch |
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blakemore
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~balloon on tube
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pen-rose drainage
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~allows bile to drain from wounds/ducts
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gastrostomy tube
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~check residual 2 see if pt is digesting
~if residual is 100, discard, hold feeding ~max residual is 50 ~sutured by MD |
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total parenteral nutrition
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~3000-4000cal/day
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