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18 Cards in this Set
- Front
- Back
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open/lap cholecystectomy and expectations after surgery with each
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Traditional done through long, transverse incision, t-tube for several days following, incision pain creates difficulty with coughing and deep breathing, hospitilzed for 2-3 days vs. 24 hours
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• Oral Dissolution of gall stones
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Chenodiol (Chenix) or ursodiol (Actigall)
May increase serum cholesterol, abnormal liver function/diahhrea = side effects, may take 4 months to 2 years |
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• Pruritis
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Result of dermatitis: inflammation of the skin, caused by exposure to irritants/allergens, hereditary, emotional stress
Itching Antihistamines, analgesics, antipruritic medications, oatmeal |
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• Diarrhea- priorities
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Replace fluid and electrolytes – increase oral fluid intake
May need IV fluid replacement |
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Histamine blockers
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H2 receptor blocking agents; inhibits gastric acid secretion by blocking H2 receptors on gastric parietal cells; cimetidine (Tagement), may cause confusion
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Proton pump inhibitors
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binds to enzymes to prevent gastric acid secretion, omeprazole (Prilosec), Lansoprazole (Prevacid), can cause bleeding, prevacid can be taken with applesauce
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Antacids
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strengthen gastric muscous and tightens esophageal spinchter, Tums, Maalox, monitor for constipation, hypermagnesia, hypercalcemia
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Upper GI bleed S&S
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severe blood loss = hypovolemic shock (hypotension, weak/thread pulse, chills, palpitations, diaphoresis)
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Upper GI bleed Care
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severe blood loss = hypovolemic shock (hypotension, weak/thread pulse, chills, palpitations, diaphoresis)
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Lower GI bleed S&S
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melena (black/tarry stools) = in or above small bowel; red = colon/rectum (hematochezia), may have hypovolemic shock
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Lower GI bleed Care
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correct cause of bleeding; check stools for amount/presence of blood, vitals to assess for shock
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GERD S&S
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a. Heartburn, regurgitation, dysphagia, bleeding
b. Aspiration is concern c. Scar tissue may develop |
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GERD diagnosis/complications
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barium swallow, esophaogoscopy, pH monitoring of esophagus
barretts esophagus = precancerous lesion |
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GERD care
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a. Lose weight
b. Low fat, high protein diet (fat decreases functioning of lower esophageal spinchter c. Avoid caffine, milk, spicy foods d. Meds: antacids, histamine blockers, proton pump inhibitors |
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S&S PAD
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a. intermittent claudication = pain in the calves, cramping, stops with rest
b. decreased blood flow = skin color changes, hair loss, dry/flaky/scaly/pale/mottled skin, thick toenails |
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PAD
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1. Disorder of arterial circulation caused by narrowing of arterial vessels = obstruction/occlusion
2. Lower extremities 3. Atherosclerosis = leading cause 4. decreased nutrition, cellular waste accumulation, development of ischemia @ obstruction |
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PAD Diagnostic tests
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ankle-brachial blood pressure index (lower in lower indicated PAD), Doppler to measure blood flow, MRI, angiography
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PAD care
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a. Meds: vasodilators, also Pentoxyfylline (Trental)/cilostazol (Pletal) for IC, thrombyltic therapy sometimes
b. Diet: low fat, low cholesterol, low calories; avoid red meats, fried foods, whole milk, chees c. Endarterectomy to remove atherosclerotic lesions, grafting to bypass area, Percutaneous transluminal angioplasty to dilate vessels, peripheral atherotomy to remove plaque, stents |
