Biliary Disorders
How is Hepatitis A prevented?
Handwashing
When preparing the client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) for discharge and home management, which teaching information should be shared with the client?
Need for hydration and paying attention to urination.
Inadequate fluid intake during hyperglycemic episodes commonly leads to HHNS. By recognizing the signs of hyperglycemia (polyuria, polydipsia, and polyphagia) and increasing fluid intake, the client may prevent HHNS.
Name an oral antidiabetic agent that will inhibit the production of glucose by the liver and aid in the control of blood glucose?
Sulfonylureas exert their primary action by directly stimulating the pancreas to secrete insulin and therefore require a functioning pancreas to be effective.
what is a hypophysectomy?
pituitary gland removal
What are some signs and symptoms of acromegaly.
Enlarged hands and feet
Broad nose
enlarged tongue
Carpal tunnel syndrome
What is the significance between cirrhosis a low-sodium diet?
Due to ascites, a complication of cirrhosis, a low sodium diet is recommended to reduce fluid retention
what are some complications of diabetes?
diabetic neuropathy
Kidney failure
Blindness
cardiovascular disease
A client with type 2 diabetes has been prescribed a daily dose of metformin, the nurse should prioritize which of the following assessments?
Blood glucose levels
Review creatinine and BUN levels
Metformin has the potential to be nephrotoxic; consequently, the nurse should monitor the client’s kidney function.
The laboratory order includes obtaining cortisol level test is which gland of the endocrine system?
The adrenal cortex manufactures and secretes glucocorticoids, such as cortisol, which affect body metabolism, suppress inflammation, and help the body withstand stress. The thyroid gland. releases thyroxine (T4) and triiodothyronine (T3).
Which are clinical manifestations of diabetes insipidus?
large urine output
Thirst is excessive
Frequent voiding
Weight loss
The body is unable to concentrate urine due to ADH deficiency
History of alcohol use disorder and jaundice. What does the appearance of jaundice most likely indicate?
Liver disease
For diabetic ketoacidosis (DKA), which electrolyte imbalance must be monitored as a priority?
There is a risk of serum potassium dilution, causing hypokalemia. Potassium replacement must begin once potassium levels drop
Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?
Levothyroxine because its standard hormone content provides predictable results.
Which labs are critical for renal failure?
BUN, creatinine, potassium, magnesium, and phosphorus
What are signs and symptoms of Addison's disease?
Severe hypotension (due to lack of aldosterone/cortisol)
Confusion or altered mental status (from hypoglycemia, hyponatremia, poor perfusion)
Which teaching points should be included about hepatitis C?
Hepatitis C increases a person's risk for liver cancer.
Refrain from sharing blood borne items
Liver metabolizes all medications
Risk factors for gallbladder disease include?
Rapid weight loss
Fried and spicy foods
High-fat dairy products
What should patient education consist of for DI?
polyuria
polydipsia
dehydration
Monitor intake and output
Watch for signs of dehydration: dry mouth, dizziness, rapid heartbeat, low blood pressure
Persistent headache or changes in mental status
Nausea or vomiting
Sudden weight loss or gain
Confusion, fatigue, or muscle cramps (may signal sodium imbalance)
daily weight
Intake and output
wear ID bracelet
How is HHS confirmed?
Hyperglycemia, very high blood glucose (>600 mg/dL or >33.3 mmol/L)
Hyperosmolarity Serum osmolality >320 mOsm/kg
Severe dehydration due to osmotic diuresis
Confusion, lethargy, seizures, coma in severe cases
characterized by severe hyperglycemia, dehydration, and altered mental status, without significant ketoacidosis.
Infection can trigger HHS
What is the critical assessment for a patient with kidney transplant?
Strict monitoring of output
Why?
patient with right upper quadrant pain and weight loss is diagnosed with liver cancer.
What are some possible treatments?
Chemotherapy
Radiation
Resection of the liver
What are risk factors for pancreatic cancer?
age, cigarette smoking, exposure to industrial chemicals or toxins in the environment, and a diet high in fat, meat, diabetes mellitus, chronic pancreatitis, and hereditary pancreatitis are also associated with pancreatic cancer.
Which labs would the nurse expect for hypothyroidism?
High TSH Hypothyroidism (thyroid underactive)
Range is 0.4 – 4.0 mIU/L
Diagnostic findings for Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
Serum sodium↓ < 135 mEq/L (hyponatremia)
Serum osmolality↓ < 275 mOsm/kg (hypo-osmolality)
Urine sodium↑ > 40 mEq/L
Urine osmolality↑ > 100 mOsm/kg
BUN, creatinine are often normal
Pre and Post dialysis nursing management includes:
Vital signs
weight pre and post
AV fistula/graft or central venous catheter – look for signs of infection, thrill/bruit (for fistula)
Review labs: Electrolytes (especially potassium), BUN, creatinine hemoglobin
Check for edema, fluid overload signs (dyspnea, crackles, jugular venous distention)
Hold antihypertensives