Hepatitis
This Hepatitis is contracted through contaminated food/water
what is Hepatitis A
Bonus - who is at greatest risk of contracting Hep A
poor hygiene, working with toddlers/babies, contaminated food/water. Remember to TRACE the client
Complications of Hep A,
Phase of Hep A where jaundice occurs?
icteric
Hep C and Alcoholism leads to what biliary disease
What is Biliary Cirrhosis
Hep C also leads to what?
Chronic Hepatitis
Most common cause of Pancreatitis
What is Alcohol (ETOH).
Other causes ??
infection, ERCP, ARDS, biliary cirrhosis, DM, cholelithiasis (blockage of bile lead to irritation/inflammation of the pancreas)
Most common cause of pancreatic cancer?
chronic Pancreatitis and smoking
What is Pancreatitis?
inflammation of the pancreas
Clients with cirrhosis/ascites with leads to low osmotic pressure due to what?
what is hypoalbuminemia? low plasma albumin levels
ascites treatment?
Spiralactone to remove excessive fluid and reduce abdominal girth and/or Paracentesis directly remove fluid as a procedure (ensure the client voids prior to the procedure)
Varcies are common as a result of what complication due to cirrhosis of the Liver?
What is portal vein hypertension
This Medication would be contraindicated in Hepatitis/Liver Dysfunction
what is Tylenol
What else can be a treatment specific to ONLY the liver
Interferon for Hep B/C (side effect client can feel flu like symptoms)
Lactulose Hepatic Encephalopathy (side effect client will have several loose stools)
Common Sign of biliary concerns
What is clay/grey colored stools darker urine color
What is the most abundant bilirubin and gives stool its color (direct or indirect).
conjugated/direct bilirubin
What causes pruritis in biliary disease?
bile salts in the skin
Pancreatic Labs
What is Lipase and Amylase
Treatment for Hepatic Encephalopathy?
what is lactulose and neomycin (antibiotic)
How to administer lactulose to clients.
orally with juice in a cup
How do you know the medications are working or not working
working, clients mentation should improve and see loose BM's. Not working increased confusion and astrisxis and no stools
Emergency Management for Esophageal varcies rupture
what is S.B. tube or Esophageal tamponde tube
Hep D can only be contracted if the client has what?
What is Hep B
Cholelithiasis, ERCP procedure, and high triglycerides can lead to what other inflammatory disease
what is pancreatitis
Treatment for Pancreatitis
What are TPN, NPO, Pancrease (pancreatic enzymes), glucose monitoring/insulin H2 Blocker
Hepatic Encephalopathy first and major symptom?
What is AMS/Confusion changes in mental status
This is due to a build up of what?
ammonia (NH3)
your male client with esophageal varcies due to cirrhosis may have this symptom as a result of an increase in estrogen release
what is Gynecomastia
Transmission of Hep B includes
what are Sharing of chewing gum, Intercourse, Acupuncture and Tattoos
Treatment for pruritis related to cholelithiasis
what is Cholestyramine (Questran)
Why does an MD perscribe Carbonic anhydrase inhibitors, a glaucoma medication, for pancreatitis
what is reduce the volume of pancreatic secretion. Pancreatic duct hypertension and hyper-secretion of hormones.
Why do MD's prescribe Albumin infusions for Cirrhosis
what are changes the osmotic pressure and leads to decrease in ascites
What else can be used to reduce ascites?
spiralaction and paracentesis (used when the removal is more urgent such as difficult breathing, or increasing dyspnea)
Priority nursing interventions for a client with esophageal varcies?
what is reducing constipation, reducing food related injury inside the esophagus, no NSAIDS/ASA, bleeding precautions
What labs should be monitored with a client with Hepatitis
What are increased AST, decreased albumin, increased Bilirubin, extended coagulation times.
Signs of these?
Bleeding, bruising,
What Hepatitis (A,B,C,D, or E) is MOST directly linked to chronic Hepatitis?
Hep C
What is fetor hepaticus?
Stool breath
Medicinal treatment for acute cholecystitis to help reduce the amount of bile stored and leaving the gall bladder
what is anticholinergic drugs
Antibiotics can be used for infectious cholecystitis, your role?
monitor for allergic reactions and complications such as renal toxicity
Major Complications associated with Pancreatitis
What are Edema, Hypovolemic shock, Necrosis, Hemorrhage, Hypocalcemia, Pleural Effusions/Pneumonia, DM
Cullen's Sign? vs Turner's Sign
Cullen bruising around the umbilical, turners bruising around the flank region this is due to the seepage of bloody exudate into the abdominal cavity,
Chronic pancreatitis can lead to what long term disease
Signs/symptoms of advanced cirrhosis include
what are Hyperaldosteronism, Leukopenia, Palmar erythema, Thrombocytopenia
Treatment for Esophageal varcies to help prevent rupture?
what is GERD reduction H2 and PPI's.