Unit 4

Diagnosed using ERCP (Endoscopic Retrograde Cholangiopancreatography), ultrasound, cholangiogram, laparoscopy, and blood tests (cholesterol, pancreatic enzymes, liver function tests).

Symptoms can vary from no symptoms to severe pain, radiating to the back/shoulder, nausea, vomiting, jaundice, itching (pruritus), and changes in bowel movements. May include vitamin deficiencies (A, D, E, K).

Endoscopic procedure visualizing the biliary system (gallbladder and bile ducts) using a camera. Pre-procedure fasting is necessary, and patients receive sedation.

Obstruction of pancreatic ducts, leading to the backs of digestive enzymes into the pancreas and causing inflammation. Common causes: gallstones, alcohol abuse, malnutrition.

Severe abdominal pain (often radiating to the back), tenderness, nausea, vomiting, fever, jaundice, and potential confusion. Abdomen may be rigid or show discoloration (ecchymosis).

Surgical removal of the gallbladder, typically using minimally invasive laparoscopic techniques.

NPO (nothing by mouth), NGT (nasogastric tube) for stomach decompression, and pain management focus are crucial aspects.

Monitor for complications (bleeding/infection), vital signs, and provide education on low-fat diet, pain management, and activity.

Tracking the levels of enzymes that help diagnose potential pancreatic issues.

A patient position that improves breathing by lessening pressure on the diaphragm.

Liver damage with continued relatively normal liver function.

Liver damage where function is significantly impaired.

Blood tests (like AST/ALT, Ammonia, and PTT) and albumin to evaluate liver function and possible problems.

Managing skin care, nutritional needs (low sodium, moderate protein, high calories), and complications of cirrhosis (like bleeding, fluid buildup).

Providing adequate nutrients through small, frequent meals with a focus on low sodium, moderate protein, and high calories, possibly with enteral or parenteral nutrition if needed.

Instructing patients on avoiding high-fat foods, heavy meals, and alcohol, as well as teaching through the "teach-back" method.

A procedure to treat ascites by creating a shunt between the portal vein and the hepatic vein.

Ammonia buildup due to severe liver damage or failure.

Mental status changes, motor disturbances, mood swings, asterixis, and fector hepaticus (bad breath).

Lactulose to trap and eliminate ammonia via stool, monitored for side effects.

Spread through blood, saliva, semen, vaginal secretions via broken skin/mucous membranes.

Close contact with carriers, hemodialysis, and frequent exposure to blood/body fluids.

Most blood clotting factors are produced in the liver.

Active immunity (vaccine) and passive immunity (immune globulin) available.

A philosophy and system of care for individuals with serious, life-limiting illnesses, focusing on managing symptoms and providing psychosocial and spiritual support.

A specific type of palliative care that focuses on comfort care at the end of life. It emphasizes quality of life and realistic preparation for death.

Identify the patient and family's goals of care, assist with informed decision making, and facilitate quality symptom management.

Contact palliative care for chronic or new conditions, discussions about goals of care, and symptom management in outpatient settings.

The initial stage of shock, where the body attempts to compensate for reduced blood flow. Symptoms include normal blood pressure, tachycardia, tachypnea, and cool extremities with warm central body temperature.

The decompensating stage of shock, where the body's compensatory mechanisms fail. Symptoms include hypotension, increased heart rate, rapid and shallow breathing, crackles, and declining mental status.

The final stage of shock, where organ damage is extensive and recovery is unlikely. This stage is marked by multiple organ dysfunction and death.

Shock can be caused by various factors, including hypovolemia, cardiac dysfunction, sepsis, anaphylaxis, and neurogenic impairment.

Increased pressure in the eye due to problems draining fluid (aqueous humor) or overproduction of this fluid. Can lead to vision loss and blindness if untreated.

Aims to reduce pressure in the eye to prevent optic nerve damage. Uses medications like miotics (pilocarpine, carbachol) to constrict pupils and improve fluid drainage or drugs like acetazolamide and timolol to reduce fluid production.

A condition that gradually damages the center of the eye (macula), leading to blurry vision and potential blindness.

An emergency condition where the layers of the retina separate, allowing fluid to seep between them. This can cause vision loss and needs immediate medical attention.

Caused by an excessive amount of fluid in the inner ear, leading to symptoms like dizziness, ringing in the ears (tinnitus), and hearing loss.

Multiple Organ Dysfunction Syndrome (MODS) is a life-threatening condition where two or more organs fail simultaneously.

Common signs of MODS include dyspnea, respiratory failure, hyperglycemia, increased BUN (blood urea nitrogen), and other organ-specific symptoms.

Managing MODS involves early detection, controlling the initiating event, supporting organ function, providing nutrition, and maximizing patient comfort.

Cardiogenic shock occurs when the heart fails to pump efficiently, even with adequate blood volume. This leads to reduced oxygen delivery to the heart and tissues.

Symptoms of cardiogenic shock include tachycardia, hypotension, oliguria, cool clammy skin, and tachypnea.

The primary goal in cardiogenic shock management is to reduce further myocardial damage, preserve healthy myocardium, and improve cardiac function.

Key medications used in cardiogenic shock include morphine, oxygen, dobutamine, aspirin, nitroglycerin, dopamine, and norepinephrine. Careful monitoring for arrhythmias is essential.

Delegation is crucial for managing complex, critically ill patients as it allows nurses to prioritize tasks and optimize patient care.

Gallstones form when cholesterol or bilirubin crystals build up and harden in the gallbladder.

Severe pain in the upper right abdomen that radiates to the back or right shoulder, often triggered by eating fatty foods.

A nasogastric (NG) tube is inserted to decompress the stomach and remove bile, preventing ulcers.

A severe stage of liver disease where the liver can no longer perform its essential functions effectively.

Patients with cirrhosis should follow a diet low in sodium, moderate in protein, and high in calories, with small, frequent meals.

Cirrhosis can lead to complications like bleeding, hepatic encephalopathy (brain damage), and fluid buildup (ascites).

Patients with cirrhosis should be educated on avoiding alcohol, preventing infections, and following a healthy diet.

These enzymes are monitored to assess pancreatic health and identify potential pancreatitis.

Vital signs (VS), intake and output (I&O) are closely monitored for signs of fluid and electrolyte imbalances, particularly in patients with liver or pancreatic diseases.

Positioning patients in semi-Fowler's position helps ease breathing by decreasing pressure on the diaphragm.

Palliative care aims to identify patient and family goals, facilitate informed decision-making, and manage symptoms.

A life-threatening condition where the body's tissues and organs are not getting enough oxygen due to inadequate blood flow.

The initial stage of shock where the body attempts to compensate for reduced blood flow. Symptoms include normal blood pressure, increased heart rate, and rapid breathing.

The decompensating stage of shock where the body's compensatory mechanisms fail. Symptoms include low blood pressure, rapid heart rate, and shallow breathing.

Shock can be caused by various factors, including low blood volume, heart problems, infection, allergic reaction, and nervous system issues.

The final stage of shock where organ damage is extensive and recovery is unlikely.

Damaged liver (cirrhosis, hepatitis, tumor) can't produce enough clotting factors, leading to bleeding risks.

High-energy rays target cancer cells, but can also harm healthy ones. Requires precise positioning and skin care.

Nausea, vomiting, gastritis, and mouth sores (stomatitis) are common side effects, especially when targeting the abdomen.

Radiation source placed inside the body, either for a short, high dose or a long, low dose.

Patients are radioactive, so visitors are limited, especially children or pregnant women. Wear dosimeter badges for safety.

Cancer impacts all cell lines, leading to low blood cell counts (pancytopenia). Medications like filgrastim can help.

Palliative care focuses on managing symptoms and providing support for any serious illness. Hospice care is specialized for end-of-life care.

To determine the patient and family's goals of care, provide informed decision-making support, and manage symptoms.

A slow-growing, non-cancerous tumor on the eighth cranial nerve (vestibulocochlear nerve), which controls hearing and balance.

Multiple Organ Dysfunction Syndrome (MODS) is a serious condition where two or more organs fail at the same time.

Some common signs of MODS are trouble breathing, respiratory failure, high blood sugar, and high BUN (a measure of kidney function).

Managing MODS involves early detection, controlling the initial problem, supporting organ function, providing nutrition, and making the patient comfortable.

Cardiogenic shock occurs when the heart fails to pump blood effectively, even though there is enough blood volume. This leads to reduced oxygen delivery to the heart and other tissues.

Common symptoms include fast heart rate, low blood pressure, decreased urine output, cool and clammy skin, and rapid breathing.

The main goal is to minimize further heart damage, protect healthy heart tissue, and improve the heart's function.

Common medications include morphine, oxygen, dobutamine, aspirin, nitroglycerin, dopamine, and norepinephrine. Careful monitoring for heart rhythm problems is essential.

Delegation is a key skill in managing complex and critical patients, allowing nurses to prioritize tasks and optimize patient care.