Pancreatitis
Complications of pancreatitis. List 4.
Pseudocyst
Abscess
Shock
Stroke
MODS
Systemic inflammation → multi-organ failure.
Inflammation → leaks enzymes → systemic damage
must monitor for infusion reactions- can cause TB reactivation, cannot administer live vaccines
Infliximab
What are the hallmark lab findings in SLE
ANA, anti-dsDNA, low C3/C4 levels
Signs/symptoms that you should limit the protein intake for the client with cirrhosis.
hepatic encephalopathy: fetor hepaticus and asterixis, AMS
In addition to removing dead tissue, what is the primary purpose of an escharotomy?
restore circulation to compromised extremities; also can improve chest expansion
What is the best position(s) for pain relief in acute pancreatitis? List 2.
Knee to chest (fetal position)
or Semi-Fowler's
DC this med 3mo before pregnancy, takes 4-6 weeks to work
Methotrexate
What are nonspecific signs of JRA in pediatric clients. List 2.
Fever, eye issues, rash
Diuretic that is commonly used for ascites in liver patients.
What is the puprose of a pressure garment?
scar tissue formation/flattening
Pressure garments and masks should never be worn over unhealed wounds. Pressure garments are worn up to 23 hours a day for as long as 12 to 18 months.
What lab is most specific to pancreatitis?
Lipase
Can cause hepato and retinal toxicity
hydroxychloroquine
*can also be used during pregnancy
Name 3 join characteristics of RA.
RA causes chronic inflammation → joint destruction + deformities:
Ulnar drift = fingers shift outward
Boutonniere deformity = tendon damage
Rheumatoid nodules = autoimmune inflammation
swan neck, boutonniere, hallux valgus
This electrolyte imbalance is common due to fluid retention and dilution.
Hyponatremia
After this procedure, keep patient lying on right side for minimum of 2 hr to splint puncture site. Then maintain bed rest for 12–14 hr, as ordered
Liver biopsy
Why is the client NPO and for how long?
Eating → enzyme release → worsens autodigestion.
24 hrs (start feeding within 48 hours typically)
Name 2 ABX that decrease bacterial flora, thus reducing ammonia formation
neomycin sulfate
rifaximin
A client with RA is prescribed methotrexate. Which nursing consideration is most important?
Monitoring for infection.
Methotrexate suppresses immunity; infection prevention is critical.
A cirrhosis patient becomes confused and lethargic. The nurse notes a flapping tremor. This medication should be administered immediately.
Lactulose
Name 3 interventions/orders for the nurse to complete prior to a paracentesis
• Have the patient void or insert an indwelling catheter.
• Obtain baseline vital signs and pulse oximetry. Weigh patient, inspect and palpate abdomen, and assess abdominal girth. Assess bladder for distention and determine last voiding.
• Assess baseline laboratory values (e.g., CBC, electrolytes, coagulation studies).
• Give any sedation or analgesia, if ordered.
• Teach patient to remain immobile during the procedure.
Why is it a priority to assess the client with numbness and tingling?
Hypocalcemia → tetany, seizures, cardiac dysrhythmias
This is a life-threatening electrolyte imbalance
Both of these medications produce vasoconstriction of the splanchnic arterial bed, decrease portal blood flow, and decrease portal hypertension.
Octreotide
Vasopressin (used less often d/t side effects)
Name 3 differences between OA and RA regarding patho, joint involvement, and symptoms
Administered during or after a large volume paracentesis.
Albumin
What is the purpose of an ERCP?
ERCP can visualize the pancreatic and common bile ducts.
Pancreatic drainage procedures can relieve ductal obstruction and are often done with ERCP.