Ime-Adulth Health (Chapter 6-Care Of The Patient With A Gallbladder, Liver, Biliary Tract, Or Exocrine Pancreatic Disorder)

Front 1

An accumulation of fluid and albumin in the peritoneal cavity.

Back 1

Ascites

Front 2

Is a hand-flapping tremor in which the patient stretches out an arm and hyperextends the wrist with the fingers separted, relaxex, and extended.

Back 2

Asterixis

Front 3

A complex of longitudinal, tortuous veins at the lower end of the esophagus.

Back 3

Esophageal varices

Front 4

Excess formation of gases in the stomach or intestine.

Back 4

Flatulence

Front 5

Is a type of brain damage caused by liver disease and consequent ammonia intoxication.

Back 5

Hepatic encepalopathy

Front 6

Is an inflammation of the liver resulting from several types of viral agents or exposure to toxic substances

Back 6

Hepatitis

Front 7

Yellow discolaration of the skin, mucous membranes, and sclerae of the eyes, caused by greater than normal amounts of bilirubin in the blood.

Back 7

Jaundice

Front 8

An obstruction of closing off in a canal, vessel, or passage of the body.

Back 8

Occlusion

Front 9

A procedure in which fluid is withdrawn from the abdominal cavity.

Back 9

Paracentesis

Front 10

Tissue of an organ as distinguished from supporting or connective tissue.

Back 10

Parenchyma

Front 11

Dilated superficial arterioles.

Back 11

Spider telangiectases

Front 12

Excessive fat in the feces.

Back 12

Steatorrhea

Front 13

Nursing interventions for Cholecystography

Back 13

-Make certain that patient is not allergic to iodine.
-Administer 6 iopanoic acid (e.g., Telepaque, Priodax, Oragrafin) tablets orally, one q 5 mins.
-Patient on NPO status from midnight.
-Patient may be given a high-fat meal or beverage to stimulate emptying of the gallbladder after the test has begun.

Front 14

Nursing interventions for CT Scan of the abdomen

Back 14

-Fluids & food are witheld from midnight until examination is complete.
-Show the patient picture of the machine & encourage the patient to verbalize fears.

Front 15

Nursing interventions for Endoscopic retrograde cholangiopancreatography

Back 15

-Food & fluids are witheld for 8 hours before examination.
-Patient's signature on a consent form obtained.
-Tell patients that test takes approximately 1-2 hours.
-Patient must lie completely motionless on hard x-ray table.
-Keep patient NPO until gag reflex returns.
-Assess for abdominal pain, tenderness, and guarding.
-Assess for s/s of pancreatitis (abdominal pain, nausea, vomiting, diminished or absent bowel sounds).

Front 16

Nursing interventions for Gallbladder scanning.

Back 16

-Assure the patient that exposure to radioactivity is minimal because only a trace dose of the radiosotope is used.
-Patient is NPO from midnight until examination is complete.

Front 17

Nursing interventions for Hepatitis virus studies.

Back 17

-Use standard precautions.
-Don gloves when handling any blood or body fluids.
-Wash hands after handling all equipment.

Front 18

Nursing interventions for Liver biopsy.

Back 18

Before the procedure:
-Explain procedure and obtain patient's signature on a consent form.
-Ensures that platelet, clotting, or bleeding time, and prothrombin time and International Normalized Ratio (INR) have been ordered and any abnormal values are reported to the physician.

After the procedure:
-Observe patient for symptoms of bleeding.
-V/S are monitored q 15 mins (two times), then q 30 mins (four times), and then every hour (four times).
-Assessed for pneumothorax (collapsed lung).
-Keep patient lying on the right side for minimun of 2 hrs to splint the puncture site.

Front 19

Nursing interventions for Liver enzyme test.

Back 19

Nurse should assess the venipuncture site for bleeding.

Front 20

Nursing interventions for Radioisotope liver scanning.

Back 20

-Patient should be NPO from midnight.
-Assure patients that they will not be exposed to a large amount of radioactivity, because only trace doses of isotopes are used.

Front 21

Nursing interventions for Serum ammonia.

Back 21

Nurse should list on the laboratory requisition any antibiotics the patient is currently taking.
Some antibiotics can caused decreased ammonia level.

Front 22

Nursing interventions for Serum amylase test.

Back 22

Nurse should note on the lab requisition whether the patient is receiving IV dextrose of any medications, because these can cuase a false-negative result.

Front 23

Nursing interventions for Serum bilirubin test

Back 23

-Keep the patient on NPO status until after the blood speicemn is drawn.

Front 24

Nursing interventions for Serum lipase test.

Back 24

Instruct patient to remain NPO after midnight except for water.

Front 25

Nursing interventions for Serum protein test.

Back 25

Nurse should assess the venipuncture site for bleeding.

Front 26

Nursing interventions for T-tube cholangiography.

Back 26

-Nurse should protect the patient from sepsis by connecting the T-tube (if left in place) to a sterile closed-drainage system.
-If the tube is removed, the T-tube tract site should be kept covered with a sterile dressin to prevent bacteria from entering the ductal system.
-Ensure patient is not allergic to iodine.
-Patient is on NPO after midnight and until the examination is completed.
-Administer a cleansing enema on the morning of the examination, if ordered.

Front 27

Nursing interventions for Ultrasonography (echogram).

Back 27

-Patient is on NPO from midnight.
-If the patient has had recent barium contrast studies, the nurse should request for cathartics. Ultrasound cannot penetrate barium.

Front 28

Nursing interventions for Ultrasonography of pancreas.

Back 28

-Fluids and foods are withheld for 8 hrs before the examination, but fasting is not mandatory.
-The study is postponed if the patient's abdomen is distended with gas or if the patient has had a recent barium examination.

Front 29

Nursing interventions for Urine amylase test.

Back 29

-Nurse should record the exact times of the beginning and end of the collection period.
-Collection begins after the patient empties the bladder and discards that specimen.
-All subsequent urine is collected, including the voiding at the end of collection period.
-Specimen should be kept on ice or refrigerated until it is sent to the lab.

Front 30

Signs and Symptoms of Hepatitis

Back 30

-General malaise
-Aching muscles
-Photophobia
-Headaches
-Chills
-Abdominal pain
-Dyspepsia
-Nausea
-Diarrhea/constipation
-Pruritus
-Hepatomegaly
-Enlarged lymph nodes
-Weight loss
-Jaundice (Appears because of the damages liver's inability to metabolize bilirubin.
-Dark amber urine
-Clay-colored stools

Front 31

Mode of trasmission for Hepatitis A

Back 31

-Oral-fecal transmission
-Most common

Front 32

Mode of trasmission for Hepatitis B

Back 32

Transmission by:
-Contaminated serum
-Blood transfusion
-Contaminated needles
-Dialysis
-Direct contact with infected body fluids

Front 33

Mode of trasmission for Hepatitis C

Back 33

-Transmitted through contaminated needles and blood transfusions.

Front 34

Mode of transmission for Hepatitis D

Back 34

-Co-infection with hepatitis B
-Transmitted same way as Hepatitis B
-Transmission by contaminated serum; blood transfusion, contaminated needles, dialysis, or direct contact with infected body fluids

Front 35

Mode of transmission for Hepatits E

Back 35

-Fecal contamination of water
-Rare in the U.S.; usually in developing countries

Front 36

Mode of transmission for Hepatitis G

Back 36

-Co-infection with Hepatitis C
-Transmission by contaminated injectable drugs, contaminated blood organs or tissues are received, hemodialysis, unsafe methods of tattoing or body piercing

Front 37

Identify three causes of Hepatitis

Back 37

Caused by bacteria, such as:
-Streptococci
-Salmonellae
-E. coli

Front 38

Discuss the basic shared pathophysiology of the six forms of hepatitis.

Back 38

-A diffuse inflammatory reaction occurs.
-Liver cells begin to degenerate and die.
-As the liver cells degenerate, the normal functions of the liver slow down.