Acute Pancreatitis and Gallbladder Disorders

Acute Pancreatitis

• Most common cause: Alcohol
• Serum lipase and amylase are key lab tests
• Lipase is the most specific enzyme test
• Priority for client with acute pancreatitis: Alteration in Comfort
• Cramping pains before intake of heavy meals are NOT a likely finding
• Endoscopic Retrograde is the MOST useful diagnostic test

Sphincter of Oddi Spasm

• Morphine can cause spasm of the sphincter of Oddi
• Jackson Pratt drain is placed in gallbladder bed or a T tube in the common bile duct after surgery

Gallbladder / Cholelithiasis

• Cholelithiasis is a gallstone in gallbladder
• Risk factors: "5 F's": Female, Fair skin, 40, Fat, Fertile
• Deep breathing can worsen pain
• Obstructive jaundice is characterized by clay-colored stool

Post-Laparoscopic Cholecystectomy

• Avoid lifting for 4-6 weeks
• Expect brown stools to return in about a week
• Diarrhea is common, avoid gas forming foods
• Follow a low fat diet for recurrence prevention

Inflammatory Bowel Disease

• Exercise is crucial for lifestyle changes
• Causes: Surgery, Autoimmune, DiGeorge
• Tetany, hypocalcemia, hyperphosphatemia, decreased PTH are findings

Cushing's Disease

• Is caused by hypercortisolism due to excess ACTH stimulation of the adrenal cortex
• Chronic exogenous corticosteroid use is another cause
• Colonoscopy is the confirmatory test for pheochromocytoma
• Dilantin's generic name is Phenytoin

Addison's Disease

• High salt, low potassium diet, and fluid encouragement are recommended
• Prednisone (Deltasone) is the primary medication
• Side effects of corticosteroid therapy: osteoporosis, GI upset/PUD, blood sugar elevation, weight gain, edema, hypertension
• Signs of corticosteroid toxicity: Fluid retention, round face, buffalo bump
• Addisonian crisis is precipitated by stress, infection, trauma, surgery, decreased salt intake (hyponatremia), cold exposure, or over exertion
• Solu-Cortef is initially given for an Addisonian crisis.
• Kayexalate, insulin, and 5% dextrose are used to correct electrolyte imbalances in an Addisonian crisis

Cardiovascular

• Atropine is the drug of choice for bradycardia
• It increases heart rate
• Osteoarthritis is also known as Degenerative Joint Disease
• Colonoscopy is the screening test for colorectal cancer
• Veracity is observing truthfulness
• Obesity is a predisposition to Type 2 DM
• GERD is also known as chalasia.
• Dopamine is the drug of choice for shock

Others

• The cuff pressure for a tracheostomy should be 18 mm Hg.
• Don't use positive pressure ventilation with a cuffed tracheostomy tube
• Countertransference is a term used when a healthcare professional's feelings towards a patient are influenced by their own personal experiences.
• Affordable, calcium-rich food option: Anchovies.
• The best position for suctioning a patient with a tracheostomy is Semi-Fowler's Position
• Apply suction intermittently for 5-10 seconds
• The client should be in a standing position for an inguinal hernia
• Surgical repair of an inguinal hernia is recommended to prevent strangulation of the bowel.
• Pink eye is also known as viral conjunctivitis
• For intramuscular injections in children, use a needle size of 1/2 inch, 26-27 gauge.
• A 24-hour urine collection with vanillylmandelic acid (VMA) is performed to diagnose pheochromocytoma.
• The aorta is located in the epigastric region.
• Aortic aneurysm is located at the epigastric region
• A client who is not speaking clearly is a reason to call an ambulance.
• The patient undergoes a cholecystectomy for the removal of the gallbladder.
• A condom catheter is applied spirally around the shaft of the penis
• Myasthenia gravis can be confirmed with a Tensilon (edrophonium) test.
• The patient's parents should be informed if a teenager discloses they have been raped.
• The cone of light is absent in otitis media.
• The tympanic membrane should be bright red and lack the characteristic light reflex.
• Phentolamine Mesylate (Regitine) is the drug of choice for pheochromocytoma
• The patient should be kept 100% oxygenated before suctioning them.
• The main goal after a tracheostomy is to maintain a patent airway
• Sterile gloves are used when cleaning the inner cannula of a tracheostomy.
• The heart takes 3-4 minutes to become brain dead after an oxygen deprivation
• Left Side HF: cough, crackles, pulmonary edema, difficulty breathing, left-sided S3 sound, paroxysmal nocturnal dyspnea.
• Right Side HF: prominent jugular veins, right-sided S3 sound.
• Hypokalemia: muscle weakness, U waves on ECG, polyuria, rhabdomyolysis.
• Hyperkalemia: ventricular arrhythmias, peaked T waves on ECG, muscle weakness.
• Congestive Heart Failure: left side HF, right side HF.