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47 Cards in this Set
- Front
- Back
hepatitis
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inflammation of cells of liver
usually caused by virus but may also be caused by drugs or bacteria S/S: malaise - headache - anorexia - fever - RUQ pain - fatigue - vomiting - jaundice |
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hepatotoxic
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substance that is damaging to the liver
includes: Tylenol - aspirin - oral contraceptives - industrial chemicals |
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fulminant liver failure
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AKA acute liver failure
uncommon but serious complication of liver disease up to 50% mortality rate S/S: CNS dysfunction - rapid reduction in liver size - marked elevation in prothrombin time |
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encephalopathy
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central nervous system dysfunction
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cirrhosis
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chronic dx of liver associated w/fat infiltration & fibrotic tissue
S/S: malaise - anorexia - diarrhea - RUQ pain - icterus - jaundice |
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hepatorenal syndrome
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complication of liver failure
S/S: oliguria w/o detectable kidney damage - reduced GFR - urine output 200 mL or less daily - nearly total sodium retention |
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postnecrotic liver failure
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results from massive exposure to hepatotoxins or viral hepatitis
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biliary liver failure
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caused by chronic inflammation & obstruction of the gallbladder & bile ducts
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cardiac liver failure
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caused by chronic severe congestion of liver from heart failure
liver congestion causes death of liver cells from lack of nutrients & oxygen |
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ascites
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accumulation of serous fluid in abdominal cavity
accumulates primarily due to low production of albumin by failing liver |
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portal hypertension
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persistent BP elevation in portal circulation of abd
most serious result is bleeding esophageal varices (dilated veins) |
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varices
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dilated veins that tear easily from excessive pressure (coughing, lifting, etc)
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hepatic encephalopathy
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caused by accumulation of noxious substances in circulation
failing liver unable to make toxic substances water soluble for excretion S/S: progressive confusion - asterixis - fetor hepaticus - fatigue - handwriting changes |
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asterixis
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flapping tremors in hands caused by toxins at peripheral nerves
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fetor hepaticus
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foul breath caused by metabolic end products related to sulfur
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transjugular intrahepatic portosystemic shunt (TIPS)
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shunt placed between portal and systemic venous systems
diverts venous blood around liver to vena cava |
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What are the medical goals for managing bleeding from esophageal varices? (four listed)
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1 Stop bleeding
2 Treat fluid volume deficit caused by bleeding 3 Prevent further fluid loss 4 Maintain fluid & electrolyte balance |
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What types of drugs are used to treat bleeding varices?
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vasoconstrictors
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List some dietary considerations for a pt w/liver failure.
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1 restrict protein intake
2 homogenized milk & eggs recommended 3 adequate carb intake necessary 4 fluid & sodium restricted if ascites present |
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The pt w/chronic liver failure is at risk for 1_____ from bleeding esophageal varices, gastrointestinal bleeding, & lack of 2_____ 2_____ 2_____.
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1 hemorrhage
2 blood clotting factors |
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Signs of possible organ transplant rejection include: (five)
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1 pulse greater than 100 bpm
2 temp greater than 101F 3 c/o of RUQ pain 4 increased jaundice 5 decrease in bile from T-tube or change in bile color |
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Symptoms of acute tissue rejection usually develop between the 1_____ and 2_____ postoperative days.
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1 fourth
2 tenth |
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cancer of the liver
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usually result of metastasis from primary cancer at distant location
increased risk for pts w/hx of chronic HBV, nutrional deficiencies, or exposure to hepatotoxins S/S: encphalopathy - abnormal bleeding - jaundice - ascites - elevated serum alkaline phosphatase |
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pancreatitis
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inflammation of the pancreas
may be mild or severe - acute or chronic |
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acute pancreatitis
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caused by autodigestion
most commonly associated w/excessive alcohol consumption S/S: dull abd pain - rigid abd - hypotension - respiratory distress - fever - dry mucous membranes - tachycardia |
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chronic pancreatitis
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chronic dx that replaces functioning pancreatic tissue w/fibrotic tissue due to inflammation
S/S: pattern of remissions /exacerbations over years - epigastric or LUQ pain - weight loss - anorexia |
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Dry, scaly skin or changes in skin pigment may indicate a deficiency in:
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vitamin A
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A pt complaining of bone pain may have a _____ _____ deficiency.
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vitamin D
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_____ _____ deficiency may be associated with anemia.
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Vitamin E
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Abnormal bruising or bleeding & prolonged clotting time indicate a deficiency of _____ _____.
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vitamin K
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cancer of the pancreas
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spread rapidly by direct extension to stomach, gallbladder, & duodenum
associated w/hi-fat diets, cigarettes, diabetes, alcohol, & chronic pancreatitis S/S: weight loss - abdominal pain (worse at night) - anorexia - vomiting - weakness - feeling bloated after eating |
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pancreatectomy
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surgical removal of all or part of pancreas
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Relief of biliary obstruction can sometimes be accomplished by implanting a _____ or plastic tube in the common bile duct.
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stent
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cholecystitis
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inflammation of the gallbladder
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cholelithiasis
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gallstones
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cholangitis
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inflammation of the bile ducts
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choledocholithiasis
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gallstones in the common bile duct
S/S: sudden biliary colic onset - lasts 1 to 3 hrs - fever - nausea/vomiting |
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Medical management for an acute episode of cholecystitis centers on 1____ 1_____, prevention of 2_____, and maintenance of fluid and electrolyte balance. The analgesic agent most often ordered is meperidine hydrochloride because 3_____ 3_____ is believed to cause spasms of the gallbladder, biliary ducts, and the sphincter of Oddi.
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1 pain control
2 infection 3 morphine sulfate |
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choledochoscopy
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use of endoscope to explore common bile duct & possibly remove stones found
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extracorporeal shock-wave lithotripsy (ESWL)
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use of shock waves as a noninvasive method to destroy stones in gallbladder or biliary ducts
usually used w/pts considered poor surgical candidates |
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The pt w/altered thought processes r/t liver failure most likely has which of the following laboratory findings?
a. Low bilirubin b. Low amylase c. High hematocrit d. High ammonia |
d. High ammonia
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Jack, a pt w/chronic liver failure, has an episode of bleeding. Which of the following conditions placed Jack at risk for bleeding?
a. Portal hypertension b. Low vitamin K c. Elevated liver enzymes d. High-fiber diet |
b. Low vitamin K
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Most gallstones are composed of which of the following?
a. Lipase b. Cholesterol c. Sodium d. Potassium |
b. Cholesterol
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John develops jaundice & dark, amber-colored urine. Which of the following is the most likely cause?
a. Encephalopathy b. Pancreatitis c. Bile duct obstruction d. Cholecystitis |
c. Bile duct obstruction
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Jeff is a 26-yr-old health care worker who is diagnosed w/HCV. Which of the following questionis is most important to ask Jeff?
a. "Have you eaten any raw seafood recently?" b. "Have you experienced a needle stick?" c. "Have you made beds or handled clothing such as slippers w/o gloving?" d. Has anyone coughed into your face whe you weren't wearing a mask?" |
b. "Have you experienced a needle stick?"
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Jim, age 43, is admitted to your unit w/chronic pancreatitis. You recognize that an elevation in which diagnostic test indicates chronic pancreatitis?
a. Serum bilirubin b. Serum calcium c. Serum albumin d. Serum amylase |
d. Serum amylase
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In planning care for the newly admitted pt w/acute pancreatitis, you assign the highest priority to which pt outcome?
a. Pt expresses satisfaction w/pain control b. Pt verbalizes understanding of meds for home c. Pt increases activity tolerance d. Pt maintains normal bowel functions |
a. Pt expresses satisfaction w/pain control
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