Understanding Medical Surgical Nursing, 4th Edition Nursing Care of Patients with Liver, Pancreatic, and Gallbladder Disorders
Understanding Medical Surgical Nursing, 4th Edition Hepatitis Inflammation of the Cells of the Liver, Usually Caused by a Virus Types of Hepatitis HAV HBV HCV HDV HEV HGV
Understanding Medical Surgical Nursing, 4th Edition Prevention of Hepatitis Hand Hygiene Vaccines HAV HBV Standard Precautions Immune Globulin
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Prodromal Stage: 1 Week Flu-like Symptoms, RUQ Pain Icteric Stage: 2 to 6 Weeks Jaundice, Worsening Symptoms Convalescent: 2 to 6 Weeks Returning to Normal Liver Function
Understanding Medical Surgical Nursing, 4th Edition Complications Liver Failure Acute Chronic Chronic Infection Carrier Risk of Liver Cancer
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests Liver Enzymes Serum Bilirubin Prothrombin Serologic Tests Liver Biopsy
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Rest Nutrition Interferon Therapy Antivirals Avoidance of Alcohol and Liver-toxic Drugs
Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses Pain Imbalanced Nutrition Risk for Impaired Skin Integrity Risk for Ineffective Self-Health Management
Understanding Medical Surgical Nursing, 4th Edition Acute Liver Failure Pathophysiology Sudden Massive Loss of Liver Tissue Etiology Drug Toxicity Hepatitis
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Jaundice Encephalopathy Confusion Coma Bleeding
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests ALT AST Serum Bilirubin PT Potassium Blood Glucose
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Bedrest Eliminate all Drugs Possible Dialysis High-calorie, Low-sodium, and Protein Diet Lactulose, Neomycin, Magnesium Citrate, Sorbitol Transplant
Understanding Medical Surgical Nursing, 4th Edition Cirrhosis Progressive, Irreversible Replacement of Healthy Liver Tissue with Scar Tissue 12 th Leading Cause of Death
Understanding Medical Surgical Nursing, 4th Edition Cirrhosis (cont’d) Etiology Chronic Alcohol Use – Most Common Hepatotoxins Hepatitis Gallbladder Obstruction Heart Failure
Understanding Medical Surgical Nursing, 4th Edition Pathophysiology Inflammation of Liver Cells Infiltration with Fat and WBC Fibrotic Scar Tissue Replaces Liver Tissue Abnormal Regeneration Impaired Liver Blood Flow Impaired Liver Function
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms
Understanding Medical Surgical Nursing, 4th Edition Complications of Cirrhosis Clotting Defects Portal Hypertension Varices Ascites Encephalopathy Hepatorenal Syndrome
Understanding Medical Surgical Nursing, 4th Edition Portal Hypertension
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests Liver Enzymes Bilirubin Serum Ammonia Prothrombin Abdominal X-Ray Ultrasound Esophagastroscopy Liver Biopsy
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Ascites Diuretics Sodium Restriction Paracentesis Albumin Infusion TIPS
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions (cont’d) Esophageal Varices Vasoconstrictors Banding Sclerotherapy Vitamin K Antibiotics
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions (cont’d) Encephalopathy Lactulose Neomycin Restrict Dietary Protein Dialysis
Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Acute and Cirrhosis Excess Fluid Volume Imbalanced Nutrition Pain Risk for Disturbed Thought Processes Risk for Ineffective Breathing Pattern Risk for Deficient Fluid Volume Risk for Infection
Understanding Medical Surgical Nursing, 4th Edition Patient Education Disease Process Signs and Symptoms to Report Adequate Rest Diet Avoid Narcotics, Sedatives, Tranquilizers, Alcohol Follow-up Care
Understanding Medical Surgical Nursing, 4th Edition Liver Transplant Candidates Liver Failure No Cancer No Complications Otherwise Stable
Understanding Medical Surgical Nursing, 4th Edition Anti-Rejection Meds Cyclosporine (Cyclosporin A) Tacrolimus (Protopic) Azathioprine (Imuran) Prednisone (Deltasone) Mycophenolate mofetil (Cellcept)
Understanding Medical Surgical Nursing, 4th Edition Signs of Rejection Pulse >100 bpm Temperature >101°F RUQ Pain Increase in Jaundice Decrease in Bile from T-tube Elevated Liver Enzymes
Understanding Medical Surgical Nursing, 4th Edition Cancer of the Liver Usually Metastasized from Another Site Risk Factors Chronic Hepatitis B Nutritional Deficiencies Exposure to Hepatotoxins
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Encephalopathy Bleeding Jaundice Ascites
Understanding Medical Surgical Nursing, 4th Edition Diagnosis Serum Alkaline Phosphatase Abdominal X-Ray Liver Scan Ultrasound Biopsy
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Surgery Chemotherapy
Understanding Medical Surgical Nursing, 4th Edition Acute Pancreatitis Pathophysiology Inflammation Autodigestion Elevated Enzymes Fluid Loss Complications Shock DIC Chronic Pancreatitis
Understanding Medical Surgical Nursing, 4th Edition Etiology Alcohol Biliary Disease Trauma Certain Drugs
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Abdominal Pain Guarding Rigid Abdomen Hypotension or Shock Respiratory Distress Low-grade Fever Nausea and Vomiting Jaundice
Understanding Medical Surgical Nursing, 4th Edition Complications Cardiovascular Failure Acute Respiratory Distress Syndrome Acute Renal Injury Hemorrhage Infection
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests Serum Amylase Serum Lipase X-Ray CT Scan Ultrasound
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions NPO IV Fluids/TPN, Nutrition NG Suction Analgesics, Anti-anxiety Agents Oxygen Blood Products PRN
Understanding Medical Surgical Nursing, 4th Edition Chronic Pancreatitis Pathophysiology Progressive Fibrosis Obstructed Ducts Ulceration Etiology Alcohol Biliary Disease
Understanding Medical Surgical Nursing, 4th Edition Prevention Alcohol Abstinence Biliary Disease Treatment Nutritional Intake Monitoring
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Remissions and Exacerbations LUQ Pain Anorexia and Weight Loss Malabsorption Diabetes Mellitus
Understanding Medical Surgical Nursing, 4th Edition Diagnosis Pancreatic Enzymes Normal High Fecal Fat Level Changes on CT Scan
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Analgesics Pancreatic Enzyme Replacement Surgery
Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Acute and Chronic Pancreatitis Pain Imbalanced Nutrition Risk for Ineffective Breathing Pattern Risk for Injury
Understanding Medical Surgical Nursing, 4th Edition Cancer of the Pancreas Ductal Adenocarcinoma of Exocrine Pancreas Risk Factors High-fat Diet Smoking Diabetes Mellitus Alcohol Chronic Pancreatitis
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Weight Loss Abdominal Pain Radiates to Back Anorexia Nausea and Vomiting Weakness Jaundice
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests Serum Amylase/Lipase Alkaline Phosphatase Bilirubin Coagulation Studies CEA CT, ERCP Biopsy
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Surgery Pancreatectomy Whipple Procedure Stent to Relieve Biliary Obstruction Chemotherapy Radiation
Understanding Medical Surgical Nursing, 4th Edition Whipple Procedure
Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses Pain Imbalanced Nutrition Risk for Deficient Fluid Volume Risk for Impaired Skin Integrity
Understanding Medical Surgical Nursing, 4th Edition Patient Education Management of Hyperglycemia Pancreatic Enzyme Replacement Dressing/Drain Care Complications to Report Hospice Referral
Understanding Medical Surgical Nursing, 4th Edition Gallbladder Disorders Cholecystitis: Inflammation Cholelithiasis: Stones Choledocholithiasis: Stones in Common Bile Duct
Understanding Medical Surgical Nursing, 4th Edition Etiology Bile Stasis High Cholesterol Intake Fasting Sedentary Lifestyle Family History, Female Risk Increases with Age
Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms Increased Vital Signs Vomiting Jaundice Epigastric Pain RUQ Tenderness Nausea Indigestion Positive Murphy’s Sign Biliary Colic
Understanding Medical Surgical Nursing, 4th Edition Complications Cholangitis Necrosis/Perforation of Gallbladder Empyema Fistulas Adenocarcinoma of Gallbladder Pancreatitis
Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests Ultrasound ERCP Radionuclide Scan WBC Bilirubin Serum Amylase
Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions Analgesics Bile Acid Sequestrants Anti-Emetics Diet
Understanding Medical Surgical Nursing, 4th Edition Cholelithiasis Treatment Cholecystectomy Laparoscopic Traditional ESWL Medication to Dissolve
Understanding Medical Surgical Nursing, 4th Edition T-Tube
Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses Acute Pain Risk for Deficient Fluid Volume
Understanding Medical Surgical Nursing, 4th Edition Postoperative Nursing Diagnoses Risk for Impaired Skin Integrity Risk for Ineffective Breathing Pattern