Complications of Cirrhosis
Results in thrombocytopenia and increased risk for bleeding; leukopenia increasing the risk for infection.
What is splenomegaly?
Obvious yellowing of the skin, sclera, and mucous membranes
What is jaundice?
Medication prescribed to prevent cardiac and respiratory problems
What is a diuretic?
The four major pathophysiologic processes of acute pancreatitis
What are lipolysis, proteolysis, necrosis of blood vessels, and inflammation?
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Foul smelling fatty stools that may increase in volume as pancreatic insufficiency progresses
What is steatorrhea?
9th pg 1203 Chart 59-2
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Fragile, thin veins that become distended and tortuous due to portal hypertension.
What are varices- esophageal, gastric, and rectal?
Increased abdominal girth from the collection of free fluid in the peritoneal cavity (caused by increased hydrostatic pressure)
What is ascites?
A direct way to visualize and treat GI tract complications from hepatic failure
What is an esophagogastroduodenoscopy (EGD)?
Two common causes of acute pancreatitis
What are alcoholism and trauma from surgical manipulation of biliary tract?
Also gall stones and biliary/pancreatic obstruction
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10th pg 1184 Table 54-4
Chronic pancreatitis has these normal to moderately elevated levels
What are amylase and lipase?
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Cognitive syndrome that stems from unfiltered or unbroken down toxins that lead to metabolic abnormalities
What is hepatic encephalopathy?
Warm and bright red palms of the hands
Medications that should be avoided in the cirrhosis patient.
What are fat soluble vitamins (ADEK), narcotics and sedatives?
The most rapid reliable imaging technique to diagnose acute pancreatitis and causative factors
What is contrast enhanced CT of the abdomen?
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The cause of decreased pancreatic secretions and bicarbonate
What is the loss of pancreatic exocrine function?
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A poor prognostic indicator of liver failure with the symptoms of sudden oliguria, elevated BUN and creatinine levels, and increased urine osmolarity
What is hepatorenal syndrome?
Vascular lesions with a red center and radiating branches on the nose, cheeks, upper thorax and shoulders
What are spider angiomas?
Medications given to reduce ammonia levels and prevent/treat hepatic encephalopathy
What is lactulose and nonabsorbable antibiotics?
The two most important nursing plans for the acute pancreatitis patient
What are pain management and promotion of nutrition and hydration?
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The standard of care to prevent malnutrition, malabsorption, and excessive weight loss
What is pancreatic-enzyme replacement therapy (PERT)?
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Bacterial infection, most often migrating from the bowel, that infects the ascitic fluid in cirrhotic patients
What is spontaneous bacterial peritonitis (SBP)?
A coarse tremor characterized by rapid, nonrhythmic extensions and flexions of the wrists and fingers
What is asterixis?
Medications that can treat active bleeding until the patient can receive a scope.
What are vasoactive drugs and proton pump inhibitors?
Labs to trend in the acute pancreatitis patient
What are amylase, lipase, bilirubin, alkaline phosphatase, and alanine aminotransferase (ALT),and WBCs?
We EXPECT all these to be high at first but they should improve with treatment.
Three education points for prevention of chronic pancreatitis exacerbation
What are avoid alcohol and nicotine; eat small meals and snacks in high calories; eat a low fat diet?
Chart 59-4 pg 1204 9th ed.
pg 1189 10th ed