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112 Cards in this Set
- Front
- Back
nausea is usually accompanied by |
anorexia |
|
vomiting - loss of gastric HCl causes |
metabolic alkalosis |
|
if vomit bicarb from sm intestine then you get |
metabolic acidosis |
|
persisting emesis can eventually lead to |
circulatory failure (loss of ECF) |
|
obesity d/t production of |
adipokines |
|
only sustained wt loss for severly obese |
bariatric sx |
|
3 bariatric sx categories |
malabsorptive, restrictive, combo of both |
|
most common bariatric sx |
adjustable gastric banding (agb) |
|
agb cuts off |
30ml - one h2o fountain sip |
|
vertical sleeve gastrectomy - % removed |
85 |
|
vertical sleeve gastrectomy - stomach does not |
grow back but stretches |
|
verti sleeve gastrectomy tx what |
hunger, but hunger is not normally the issue |
|
RYGB stands for |
roux-en-Y |
|
RYGB |
30ml pouch at top of stomach |
|
2 complications of RYGB |
dumping syndrome, malnutrition |
|
5 post op obese risks |
DVT, infection, dehiscence, delayed healing, evisceration |
|
dehiscence |
sutures coming out |
|
evisceration |
intestines coming out |
|
what returns in women after wt loss |
fertility |
|
1/3 liver blood |
hepatic artery |
|
2/3 liver blood |
portal vein |
|
3 GI tract organs |
liver, pancreas, gallbladder |
|
liver metabolizes |
protein (albumin, clotting factors) |
|
liver detoxifies |
ammonia to urea |
|
destroyed liver cells and scar tissue cuases |
inc in GI system BP |
|
3 causes of hepatitis |
virus, autoimmune, drugs |
|
viral hep |
a b c d e g |
|
toxic hep |
acetaminophen, ETOH |
|
autoimmune hep |
wilsons disease, PBC |
|
NAFLD |
non alcoholic fatty liver disease |
|
type a |
fecal oral |
|
type a vac |
ppl traveling outside US |
|
type b |
blood, body fluid |
|
type b vac |
everyone in US |
|
type c |
drug user, tatoos, piercings |
|
20% type c will |
progress to cirrhosis |
|
type c liver damage |
15-20 years post infection |
|
wilsons disease |
liver flap (hand flaps) |
|
PBC |
primary biliary cirrhosis |
|
hemochromotosis |
iron storage disorder |
|
NAFLD linked to |
obesity, steroids |
|
NAFLD elevated |
ALT |
|
asymptomatic hepatitis |
30% acute HBV, 80% acute HCV |
|
phases of hep infection |
incubation/prodromal, icteric, convalesvent |
|
incubation |
asymptomatic |
|
icteric |
jaundice, dark urine, clay stool, RUQ pain |
|
convalescent |
jaundice resolve, LFT normal |
|
hep labs |
prolonged PT & PTT |
|
hep a dx |
one test |
|
hep b dx |
many tests |
|
hep c tx |
genotyping |
|
hep tx |
rest rest rest |
|
hep diet |
low fat, high carb |
|
hep follow up |
1 yr post dx |
|
hep supportive therapy |
milk thistle, vit, antiemetics |
|
chronic hep b and c drug |
antiviral (interferon) |
|
interferon dec |
viral load, liver enzyme, rate of disease progression |
|
interferon SE |
flu like sx, anemia, anorexia, depression, insomnia |
|
hep a - wash |
hands and food |
|
hep a vac |
2 shots, immune after 30 days |
|
hep a immune globulin |
1-2 weeks post exposure |
|
hep b and c screen |
donated blood |
|
hep b and c use |
disposable needles |
|
hep b and c wash |
hands |
|
hep b and c safe |
sex |
|
hep b and c avoid sharing |
toothbrush, razors |
|
hep b vac |
3 shots, 1st at birth last at 18 months |
|
liver dysfunction early sns |
RUQ pain |
|
liver dysfunction later sns |
jaundice, ascites, anasarca, skin lesions/bruising |
|
liver - bleeding from |
portal HTN |
|
inc serum ammonia causes pt to |
be confused |
|
ascites |
loss of cell structure cause no protein production |
|
itchy liver pt |
can scratch and make abrasion and fluid from ascites will leak like crazy |
|
acetaminophen metabolized by |
liver |
|
ibuprofen metabolized by |
kidneys |
|
esophageal varices drug therapy goal |
stop bleeding |
|
acute ugi bleed drugs |
octreotide, vasopressin |
|
acute ugi bleed - what prevents hepatic encephelopathy |
lactulose, neomycin |
|
hepatic encephalopathy from |
rbc breakdown/ammnonia |
|
ascites diet |
high carb low sodium |
|
paracentesis |
drain it (ascites) |
|
peritoneovenous shunt |
drain fluid from ascites into vena cava |
|
peritoneovenous shunt complications |
fluid overload, infection, thrombosis |
|
do what before paracentesis |
empty bladder |
|
paracentesis post procedure patient position |
right side to splint puncture site |
|
hepatic encephalopahty aka |
end stage liver disease |
|
asterixis |
liver flap |
|
hepatic encephalopahty sns |
asterixis, inc ammonia |
|
hepatic encephalopathy goal |
dec ammonia production |
|
lactulose traps ammonia where |
in gut |
|
hep enceph diet |
high calorie |
|
hep enceph give |
b complex vit, vit k |
|
nursing eval hep enceph reports increased |
ease of breathing |
|
most common GI prob |
N&V |
|
GERD post op complication |
barrets esophagus |
|
peptic ulcer disease from |
stress, meds, H pylori |
|
melena appearance |
black tarry stool, very foul odor |
|
two upper GI bleed |
obvious, occult |
|
obvious upper GI bleed |
hematemesis, melena |
|
hematemesis |
bright red, coffee ground |
|
why do you want a foley for upper GI bleed |
kidneys may have less perfusion = less output |
|
do what w/in 24 hrs of upper GI bleed |
endoscopy |
|
diarrhea hand hygeine |
soap and water |
|
c diff |
isolation, 10% bleach |
|
appendicitis RLQ pain |
mcburney's point |
|
apendix rupture cuases |
peritonitis then sepsis |
|
ulcerative colitis for >10 yrs high risk for |
colon cnancer |
|
fistula |
abn opening from one organ to another |
|
fistula common in |
chrons |
|
avoid what for IBD |
fiber |
|
watch for what when suctioning gastric fluid |
k levels, k is in gastric fluid |
|
study JPs flashcards |
aymondnursing unit 1 adult |