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34 Cards in this Set
- Front
- Back
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What is the purpose of a Liver Biopsy?
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TO obtain hepatic tissue for establishing diagnosis such as fibrosis, cirrhosis, and neoplasms. Also used to monitor progression of Liver disease such as chronic hepatitis
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Describe the procedure of a Liver Biopsy
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Percutaneous Procedure where the needle is inserted between the 6th and 7th intercostal space or the 8th and 9th on the Right side. Often a CT scan or a ultrasound is used.
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A liver biopsy can either be done during a surgery where an incision is made and a peice of the liver is cut off or it can be done through the insertion of a needle. These two types are labled open and closed. When the needle is used for aspiration is it open or closed?
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Closed
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How many consents must be collected for a biopsy and why?
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2, one for the procedure and the other for the sedation.
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Prior to the surgery what prior test should be done and why?
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Coagulation labs should be checked to make sure the patient will be able to stop themselves from bleeding. If these labs are abnormal the surgery should be put on hold until corrected.
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Other than labs and consents what other responsibilities does the nurse have prior to the liver biopsy?
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Verify rders, Take baseline vitals, Explain to the client what to expect and how to breath, type patient's blood and cross match.
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During the procedure of a liver biopsy, how is the patient posisitioned?
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Supine with Right arm behind head.
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What is something that the client must do just prior to the insertion of the needle in a liver biop?
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Exhale all air and hold.
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When inserting the needle during a liver biopsy what is the technique used?
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The needle is inserted through the intercostal space and the normal saline pushed out to clear needle of blood. The needle should be inserted a little further and then the sample should be aspirated.
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Post op Liver biopsy what posistion should the client be placed in?
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On right side for 2 hours to splint the site.
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How often should vital signs be taken after a liver biopsy?
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Q 15 min x 2, Q 30 min x 4, Q hour x4.
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After the 2 hours of side lying post liver biopsy, what posisition should the client take and for how long?
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Flat on back for 12-14 hours.
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What are possible complications to be on look out for after biopsy?
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Shock, pneumothorax, and bile peritonitis.
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Describe the ultrasonography (Hepatobiliary)
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Ultrasound waves passed into body and reflected to record. Conductive Jel applied (jelly lubricant) and transducer placed on site.
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Nursing Responsibility for pre - ultrasonography
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Instruct Patient NPO for 8-12 hours prior. Explain procedure, verify orders.
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The purpose of an ultrasonography is?
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Detects subphrenic abcesses, cysts, tumors, cirrhosis, and to visualize biliary ducts.
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An MRI is...
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Radiofrequency waves passed through patient in a magnetic field.
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The purpose of the MRI is to...
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Detect Hepatic Metastases and sources of GI bleed
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Prior to the MRI procedure the nurse needs to...
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Verify Orders, Check NPO status, Complete questionairre, Explain procedure.
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What is a CT scan?
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Non invasive X-ray, shows exposures at different depths.
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The purpose of a CT scan?
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Show biliary tract, liver and pancreatic disorders.
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What does the use of contrast medium do if used in a CT scan?
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Accentuates density differences
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Responsibility of nurse prior to CT scan?
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Check for allergies to iodine if contrast used.
Explain procedure Verify Orders Check NPO status |
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Prior to an arteriography or angiography the nurse's role includes:
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Verifying orders and consents, Checking NPO status, Check V.S, Explain Procedure
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Post angiography or anteriography the nurse ...
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Checks frequent VS, checks puncture site and assess the extremity pulses.
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What is a Laparscopy?
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Periotneal cavity and contents are visualized with laparoscope. Performed in operating room under general anestesia.
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What is the Laparscopy used for?
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Biopsy sample may be taken.
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Responsibilities of a nurse pre op for laparoscopy?
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NPO 4 8 hours.
Admin pre-op sedative med Ensure bowel/bladder emptied Teach client about procedure |
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Post Op Responsibilities for laparoscopy?
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Watch for complications: Bleeding/ Bowel perforation.
Monitor frequent VS |
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What does ERCP stand for?
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Endoscopic Retrograde Cholangio ancreatography
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Explain the procedure of an ERCP?
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Feberoptic endoscope (using fluroscopy) inserted through oral cavity down into duodenum and common bile duct/pancreatic duct cannulated...Contrast medium injected into ducts.
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What is the purpose of an ERCP?
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DIrect visual of strutures, retrieve gall stone from distal common bile duct, dilate strictures, obtain biopsy of tumors and diagnosis of psuedocysts.
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What are the responsibilities of the nurse pre op for ERCP?
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NPO for 8 hours
2 consents signed Admin sedative med b/f Sx and during Sx. Admin Antibiotics if ordered Check VItal SIgns Check Orders |
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Post Op Responsibilities for ERCP iclude:
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Check VS
Check complications: Perforation or infection Reactions to meds Check for return of gag reflex. |
