Liver & Biliary Disorders
Pain in this abdominal quadrant commonly occurs with gallbladder disease.
What is the right upper quadrant (RUQ)?
The three classic symptoms of diabetes mellitus.
What are polyuria, polydipsia, and polyphagia?
This hormone is deficient in adrenal insufficiency.
What is cortisol?
This bacterium is the most common cause of peptic ulcer disease.
What is Helicobacter pylori?
A 48-year-old patient with Addison disease presents with:
What is the nurse's priority intervention?
What is administer IV hydrocortisone and begin rapid isotonic IV fluid replacement?
Teaching Point:
The immediate priorities are restoring circulating cortisol and correcting hypovolemia to prevent cardiovascular collapse.
This assessment finding is commonly present in cholecystitis.
What is a positive Murphy sign?
Kussmaul respirations are commonly seen with this diabetic emergency.
What is diabetic ketoacidosis (DKA)?
Hyponatremia with concentrated urine is characteristic of this endocrine disorder.
What is SIADH?
This inflammatory bowel disease is characterized by skip lesions and transmural inflammation.
What is Crohn disease?
A patient arrives with:
The provider has prescribed IV insulin.
What should the nurse anticipate as the priority intervention before or concurrent with insulin therapy?
What is initiate aggressive IV isotonic fluid replacement?
Teaching Point:
Fluid resuscitation is the first priority to restore intravascular volume and improve tissue perfusion before insulin corrects hyperglycemia and acidosis.
Confusion in a patient with cirrhosis may indicate this complication.
What is hepatic encephalopathy?
This diabetic emergency is characterized by profound dehydration and very high blood glucose without significant ketosis.
What is hyperosmolar hyperglycemic state (HHS)?
This life-threatening emergency results from acute adrenal insufficiency.
What is Addisonian crisis?
Bloody diarrhea is most commonly associated with this inflammatory bowel disease.
What is ulcerative colitis?
A patient with cirrhosis becomes increasingly confused and difficult to arouse. Ammonia levels are elevated.
What is the priority nursing intervention?
What is administer lactulose as prescribed while closely monitoring neurologic status and ensuring patient safety?
Teaching Point:
Lactulose promotes ammonia excretion through the gastrointestinal tract and helps improve neurologic status.
This medication is commonly used to reduce ammonia levels in hepatic encephalopathy.
What is lactulose?
The first priority in treating diabetic ketoacidosis.
What is IV fluid replacement?
The priority medication administered during an Addisonian crisis.
What is IV hydrocortisone?
The priority nursing intervention for a patient with suspected bowel perforation.
What is keep the patient NPO and notify the provider immediately?
A patient admitted with Crohn disease suddenly develops:
What is the nurse's priority intervention?
What is keep the patient NPO and notify the surgeon/rapid response team immediately while preparing for emergency surgery?
Teaching Point:
These findings indicate possible perforation and peritonitis, which require urgent surgical intervention.
The triad of fever, jaundice, and right upper quadrant pain suggests this emergency.
What is ascending cholangitis?
This electrolyte must be monitored closely during insulin therapy for DKA.
What is potassium?
The priority nursing intervention for a patient with severe hyponatremia secondary to SIADH.
What are implement seizure precautions and monitor neurologic status?
This life-threatening complication of ulcerative colitis is characterized by severe colonic dilation.
What is toxic megacolon?
A patient with cirrhosis suddenly vomits a large amount of bright red blood. The patient becomes pale, diaphoretic, and hypotensive.
What is the nurse's FIRST priority intervention?
What is assess and support the airway and circulation, activate the rapid response team/provider, initiate IV access, and prepare for blood product administration?
Rationale:
This presentation suggests bleeding esophageal varices, a life-threatening complication of portal hypertension. The nurse's priority is stabilization using ABCs (Airway, Breathing, Circulation) before definitive treatment such as endoscopic intervention.