Anatomy/Function
The majority of blood supply to the liver, which is rich in nutrients from the gastrointestinal tract, comes from this vessel.
What is the portal vein?
Diuretic medication most often used for a patient with ascites.
What is Spironolactone (Aldactone)?
Oral diuretics such as furosemide (Lasix) may be added but should be used cautiously. Ammonium chloride and acetazolamide (Diamox) are contraindicated because of the possibility of precipitating hepatic coma.
Superior diagnostic test for esophageal varices.
What is endoscopy?
*Recommended screening exam for those diagnosed with cirrhosis (present in 50% of patients).
Good personal hygiene, stressing careful hand hygiene after bowel movements and before eating, and environmental sanitation.
What is the specific education for patients and families about reducing risk of contracting HAV?
Difference between cholecystitis and cholelithiasis.
What is inflammation of the gallbladder (cholecystitis) and formation of calculi or gallstones in the gallbladder?
What is the sphincter of Oddi?
Comes in powder form, may be mixed with water or other non-carbonated beverage, and treats pruritis.
What is a bile sequestrant/cholestyramine (Questran)?
Provides direct visualization of the hepatobiliary system, requires the patient to start in the left semi prone position, and uses fluoroscopy to evaluate the presence and location of ductal stones.
What is an ERCP?
Characterized by constructional apraxia, fector hepaticus, asterixis, altered LOC, abnormal EEG.
What is Hepatic Encephalopathy?
This disease includes approximately 200,000 cases per year in the U.S., of which 80% are the result of cholelithiasis or sustained alcohol abuse.
What is acute pancreatitis?
The secretions of the exocrine portion of the pancreas.
What are pancreatic enzymes amylase (carbohydrates), trypsin (proteins), lipase (fats)?
Lactulose indication and side effect(s).
What is to reduce serum ammonia levels and intestinal bloating, cramps, and loose stools.
*Two or three soft stools per day is the goal.
90% accuracy in diagnosing cholelithiasis.
What is an ultrasound?
Results from the obstruction of blood flow into and through a damaged liver?
What is portal hypertension?
Major symptoms of chronic pancreatitis.
What is recurrent attacks of severe upper abdominal and back pain accompanied by vomiting?
*Acute pancreatitis presents with fever, jaundice, confusion, agitation, ecchymosis in the flank or umbilical area, and abdominal guarding.
The eight functions of the liver.
What are glucose metabolism, ammonia conversion, protein metabolism, fat metabolism, vitamin and iron storage, bile formation, bilirubin excretion, and drug metabolism?
Synthetic hormone that decreases bleeding from esophageal varices.
What is Octreotide (Sandostatin)?
*Hormone is somatostatin
*Usual continuous infusion of 25-50 mcg/hr
This enzyme, when measured by a blood test, is often elevated with biliary tract obstruction.
What is alkaline phosphatase?
*Normal value 30-120 U/L
Assessment of I&O, abdominal girth, daily weights, respiratory status, and laboratory values.
What are nursing measures associated with ascites?
Only 7% diagnosed in early stages; 80% to 85% have advanced disease when first detected.
What is pancreatic cancer?
Insulin, glucagon, and somatostatin.
What are the secretions associated with the endocrine function of the pancreas?
Insulin and somatostatin - lower blood glucose. Glucagon - raises blood glucose.
Must be taken with meals, cannot be retained in mouth prior to swallowing, and side effects include N&V, diarrhea, and mouth/skin irritations.
What is pancreatic enzyme replacement therapy (PERT) or pancrelipase?
Frequent monitoring of vital signs, assessment of bleeding, assessment of infection, and having patient lie on right side for at least two hours.
What is the nursing care for a patient post-liver biopsy?
Non-surgical treatment modalities for the patient with bleeding esophageal varices.
What are medications (propranolol, vasopressin, octreotide), injection sclerotherapy, endoscopic variceal ligation, TIPS procedure, and balloon tamponade?
Nursing interventions for this disease include relieving pain and discomfort, improving breathing pattern, improving nutritional status, maintaining skin integrity, and monitoring and managing potential, often life-threatening, complications.
What is acute pancreatitis?