Podcast
Questions and Answers
What is the primary purpose of using a Transjugular intrahepatic portosystemic shunt (TIPS)?
What is the primary purpose of using a Transjugular intrahepatic portosystemic shunt (TIPS)?
- To alleviate ascites (correct)
- To facilitate liver transplant
- To treat hypertension
- To manage liver cancer
Which medication is primarily used to manage excess ammonia in hepatic encephalopathy patients?
Which medication is primarily used to manage excess ammonia in hepatic encephalopathy patients?
- Lactulose (correct)
- Antifibrotics
- Famotidine
- Spironolactone
What lab test is most indicative of hepatic encephalopathy?
What lab test is most indicative of hepatic encephalopathy?
- Complete blood count
- Liver function tests
- Serum ammonia levels (correct)
- Coagulation profile
Which of the following is a potential complication of TIPS?
Which of the following is a potential complication of TIPS?
What is a common early sign of hepatic encephalopathy?
What is a common early sign of hepatic encephalopathy?
What type of immunity is provided by the Hepatitis B vaccine?
What type of immunity is provided by the Hepatitis B vaccine?
Which of the following substances is critical for the synthesis of blood coagulation factors?
Which of the following substances is critical for the synthesis of blood coagulation factors?
What is a primary risk factor for contracting Hepatitis B?
What is a primary risk factor for contracting Hepatitis B?
Which diagnostic procedure uses fiberoptic technology to visualize the biliary system?
Which diagnostic procedure uses fiberoptic technology to visualize the biliary system?
What is a common symptom that gallstones can produce?
What is a common symptom that gallstones can produce?
What is a potential post-operative teaching point for a patient who has undergone a laparoscopic cholecystectomy?
What is a potential post-operative teaching point for a patient who has undergone a laparoscopic cholecystectomy?
Which of the following is a cause of pancreatitis?
Which of the following is a cause of pancreatitis?
In the management of pancreatitis, what is a common initial dietary recommendation?
In the management of pancreatitis, what is a common initial dietary recommendation?
Which symptom is associated with jaundice and gallstones?
Which symptom is associated with jaundice and gallstones?
What is a potential complication of cholecystectomy that requires monitoring?
What is a potential complication of cholecystectomy that requires monitoring?
What could indicate the presence of gallstones based on liver function tests (LFTs)?
What could indicate the presence of gallstones based on liver function tests (LFTs)?
What is a characteristic feature of compensated cirrhosis?
What is a characteristic feature of compensated cirrhosis?
Which of the following signs and symptoms are associated with decompensated cirrhosis?
Which of the following signs and symptoms are associated with decompensated cirrhosis?
What is the recommended lifestyle change for patients with liver issues regarding dietary habits?
What is the recommended lifestyle change for patients with liver issues regarding dietary habits?
Which laboratory result would indicate liver dysfunction in a patient?
Which laboratory result would indicate liver dysfunction in a patient?
What is a common complication that nursing management should focus on for patients with cirrhosis?
What is a common complication that nursing management should focus on for patients with cirrhosis?
Which of the following interventions can help improve nutritional status in patients with cirrhosis?
Which of the following interventions can help improve nutritional status in patients with cirrhosis?
To reduce pressure on the diaphragm for improved breathing, patients should be positioned in which way?
To reduce pressure on the diaphragm for improved breathing, patients should be positioned in which way?
What role does skin care play in the management of patients with cirrhosis?
What role does skin care play in the management of patients with cirrhosis?
What condition is characterized by increased intraocular pressure due to inadequate drainage or overproduction of aqueous humor?
What condition is characterized by increased intraocular pressure due to inadequate drainage or overproduction of aqueous humor?
Which medication is used to constrict pupils and improve the outflow of aqueous humor in glaucoma treatment?
Which medication is used to constrict pupils and improve the outflow of aqueous humor in glaucoma treatment?
What is a common side effect of beta blockers used in the treatment of glaucoma?
What is a common side effect of beta blockers used in the treatment of glaucoma?
In which condition does fluid seep between the layers of the retina, leading to detachment?
In which condition does fluid seep between the layers of the retina, leading to detachment?
What is the pathophysiological cause of Meniere's disease?
What is the pathophysiological cause of Meniere's disease?
What is the primary focus of palliative care?
What is the primary focus of palliative care?
Which of the following is a goal of palliative care?
Which of the following is a goal of palliative care?
What distinguishes hospice care from general palliative care?
What distinguishes hospice care from general palliative care?
When should a palliative care consult team be called?
When should a palliative care consult team be called?
What is a characteristic symptom during the compensatory stage of shock?
What is a characteristic symptom during the compensatory stage of shock?
Which of the following signs and symptoms is associated with the progressive stage of shock?
Which of the following signs and symptoms is associated with the progressive stage of shock?
What is an essential treatment measure in the progressive stage of shock?
What is an essential treatment measure in the progressive stage of shock?
What condition is NOT a recognized cause of shock?
What condition is NOT a recognized cause of shock?
What characterizes multiple organ dysfunction syndrome (MODS)?
What characterizes multiple organ dysfunction syndrome (MODS)?
Which medication is primarily indicated to manage pain and anxiety in cardiogenic shock?
Which medication is primarily indicated to manage pain and anxiety in cardiogenic shock?
What are common symptoms associated with cardiogenic shock?
What are common symptoms associated with cardiogenic shock?
What is a critical aspect of the management for preventing further myocardial damage?
What is a critical aspect of the management for preventing further myocardial damage?
Which symptom does NOT indicate worsening metabolic acidosis?
Which symptom does NOT indicate worsening metabolic acidosis?
In cases of MODS, which of the following management strategies is crucial?
In cases of MODS, which of the following management strategies is crucial?
What should be continuously monitored to assess treatment efficacy in cardiogenic shock?
What should be continuously monitored to assess treatment efficacy in cardiogenic shock?
Which of the following represents potential complications of pulmonary dysfunction in metabolic acidosis?
Which of the following represents potential complications of pulmonary dysfunction in metabolic acidosis?
What is a common side effect associated with the use of carbonic anhydrase inhibitors for treating glaucoma?
What is a common side effect associated with the use of carbonic anhydrase inhibitors for treating glaucoma?
Which of the following describes the primary pathophysiological aspect of macular degeneration?
Which of the following describes the primary pathophysiological aspect of macular degeneration?
What is a critical aspect of managing retinal detachment?
What is a critical aspect of managing retinal detachment?
What is the primary goal of treatment for glaucoma?
What is the primary goal of treatment for glaucoma?
What condition is primarily associated with an increased amount of fluid in the inner ear?
What condition is primarily associated with an increased amount of fluid in the inner ear?
Which of the following is a primary symptom indicating the presence of multiple organ dysfunction syndrome (MODS)?
Which of the following is a primary symptom indicating the presence of multiple organ dysfunction syndrome (MODS)?
What is the primary cause of cardiogenic shock?
What is the primary cause of cardiogenic shock?
Which treatment is considered essential in the management of cardiogenic shock?
Which treatment is considered essential in the management of cardiogenic shock?
What should be monitored closely when administering medications like nitroglycerin and dobutamine in cardiogenic shock?
What should be monitored closely when administering medications like nitroglycerin and dobutamine in cardiogenic shock?
In the context of cardiogenic shock, what is a potential outcome of decreased stroke volume and cardiac output?
In the context of cardiogenic shock, what is a potential outcome of decreased stroke volume and cardiac output?
Which diagnostic test employs fiberoptic technology to visualize the biliary system?
Which diagnostic test employs fiberoptic technology to visualize the biliary system?
What symptom is commonly associated with the presence of gallstones?
What symptom is commonly associated with the presence of gallstones?
What is an important management strategy for patients experiencing MODS?
What is an important management strategy for patients experiencing MODS?
What is a critical sign that may indicate renal involvement in multiple organ dysfunction syndrome?
What is a critical sign that may indicate renal involvement in multiple organ dysfunction syndrome?
What is a primary complication to monitor after a laparoscopic cholecystectomy?
What is a primary complication to monitor after a laparoscopic cholecystectomy?
Which symptom is least likely to be associated with worsening metabolic acidosis?
Which symptom is least likely to be associated with worsening metabolic acidosis?
What is the primary symptom of pancreatitis that differentiates it from gallbladder issues?
What is the primary symptom of pancreatitis that differentiates it from gallbladder issues?
What physical examination finding can suggest gallstones?
What physical examination finding can suggest gallstones?
Which treatment is commonly recommended post laparoscopic cholecystectomy to ease discomfort?
Which treatment is commonly recommended post laparoscopic cholecystectomy to ease discomfort?
Which factor is NOT considered a common cause of pancreatitis?
Which factor is NOT considered a common cause of pancreatitis?
What dietary change is often recommended during the management of pancreatitis?
What dietary change is often recommended during the management of pancreatitis?
What does compensated cirrhosis indicate about liver function?
What does compensated cirrhosis indicate about liver function?
Which symptom is commonly associated with decompensated cirrhosis?
Which symptom is commonly associated with decompensated cirrhosis?
What dietary changes should patients with cirrhosis focus on?
What dietary changes should patients with cirrhosis focus on?
What is a critical nursing management task for patients experiencing skin breakdown due to cirrhosis?
What is a critical nursing management task for patients experiencing skin breakdown due to cirrhosis?
Which assessment finding would indicate a need for immediate intervention in a cirrhosis patient?
Which assessment finding would indicate a need for immediate intervention in a cirrhosis patient?
Which of the following is part of the education/discharge teaching for a patient with pancreatitis?
Which of the following is part of the education/discharge teaching for a patient with pancreatitis?
Which laboratory test result is typically seen in decompensated cirrhosis?
Which laboratory test result is typically seen in decompensated cirrhosis?
What patient positioning is recommended to improve breathing in patients with cirrhosis?
What patient positioning is recommended to improve breathing in patients with cirrhosis?
Which condition is NOT typically associated with liver dysfunction leading to reduced coagulation factors?
Which condition is NOT typically associated with liver dysfunction leading to reduced coagulation factors?
What is a common side effect of external radiation therapy to the abdomen?
What is a common side effect of external radiation therapy to the abdomen?
What specific care should be taken to maintain during external radiation therapy?
What specific care should be taken to maintain during external radiation therapy?
Which of the following is an important precaution for a patient undergoing internal radiation therapy?
Which of the following is an important precaution for a patient undergoing internal radiation therapy?
What type of cancer treatment involves high doses of radiation for a short period of time?
What type of cancer treatment involves high doses of radiation for a short period of time?
What is a common lab finding associated with cancer that reflects a decrease in blood cells?
What is a common lab finding associated with cancer that reflects a decrease in blood cells?
Which of the following medications is commonly used to manage symptoms of stomatitis in cancer patients?
Which of the following medications is commonly used to manage symptoms of stomatitis in cancer patients?
Which of the following is a risk factor for developing cancer?
Which of the following is a risk factor for developing cancer?
What is the primary focus of hospice care?
What is the primary focus of hospice care?
During which stage of shock would you expect to find hypotension and increased heart rate greater than 150?
During which stage of shock would you expect to find hypotension and increased heart rate greater than 150?
What is NOT an objective of palliative care?
What is NOT an objective of palliative care?
Which symptom is associated with the compensatory stage of shock?
Which symptom is associated with the compensatory stage of shock?
What is a defining characteristic of irreversible shock?
What is a defining characteristic of irreversible shock?
What does the palliative care consult team assist with?
What does the palliative care consult team assist with?
Which symptom is least likely to indicate the need for a palliative care consult?
Which symptom is least likely to indicate the need for a palliative care consult?
What goal does palliative care NOT typically support for patients?
What goal does palliative care NOT typically support for patients?
Flashcards
Gallstones: Diagnosis
Gallstones: Diagnosis
Diagnosed using ERCP (Endoscopic Retrograde Cholangiopancreatography), ultrasound, cholangiogram, laparoscopy, and blood tests (cholesterol, pancreatic enzymes, liver function tests).
Gallstones: Symptoms
Gallstones: Symptoms
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).
ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP (Endoscopic Retrograde Cholangiopancreatography)
Endoscopic procedure visualizing the biliary system (gallbladder and bile ducts) using a camera. Pre-procedure fasting is necessary, and patients receive sedation.
Pancreatitis: Cause
Pancreatitis: Cause
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Pancreatitis: Symptoms
Pancreatitis: Symptoms
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Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
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Pancreatitis: Treatment
Pancreatitis: Treatment
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Post-op Cholecystectomy Care
Post-op Cholecystectomy Care
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Monitor for Amylase and Lipase
Monitor for Amylase and Lipase
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Semi-Fowler's Position
Semi-Fowler's Position
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Cirrhosis (Compensated)
Cirrhosis (Compensated)
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Cirrhosis (Decompensated)
Cirrhosis (Decompensated)
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Cirrhosis Assessment Labs
Cirrhosis Assessment Labs
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Cirrhosis Nursing Management
Cirrhosis Nursing Management
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Cirrhosis Nutritional Support
Cirrhosis Nutritional Support
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Discharge Teaching for Liver Disease
Discharge Teaching for Liver Disease
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TIPS Procedure
TIPS Procedure
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Hepatic Encephalopathy Cause
Hepatic Encephalopathy Cause
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Hepatic Encephalopathy Symptoms
Hepatic Encephalopathy Symptoms
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Hepatic Encephalopathy Treatment
Hepatic Encephalopathy Treatment
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Hepatitis B Transmission
Hepatitis B Transmission
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Hepatitis B Risk Factors
Hepatitis B Risk Factors
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Liver Disease Coagulation
Liver Disease Coagulation
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Hepatitis B Immunity
Hepatitis B Immunity
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Palliative Care
Palliative Care
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Hospice Care
Hospice Care
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Palliative Care Goals
Palliative Care Goals
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When to Call Palliative Care
When to Call Palliative Care
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Shock: Compensatory Stage
Shock: Compensatory Stage
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Shock: Progressive Stage
Shock: Progressive Stage
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Shock: Irreversible Stage
Shock: Irreversible Stage
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Shock: Causes
Shock: Causes
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Glaucoma
Glaucoma
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Glaucoma: Treatment
Glaucoma: Treatment
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Macular Degeneration
Macular Degeneration
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Retinal Detachment
Retinal Detachment
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Meniere's Disease
Meniere's Disease
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What is MODS?
What is MODS?
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What are common signs of MODS?
What are common signs of MODS?
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What are some key management strategies for MODS?
What are some key management strategies for MODS?
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Cardiogenic Shock
Cardiogenic Shock
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What are some common symptoms of Cardiogenic Shock?
What are some common symptoms of Cardiogenic Shock?
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What is the primary goal in managing Cardiogenic Shock?
What is the primary goal in managing Cardiogenic Shock?
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What are some key medications used to manage Cardiogenic Shock?
What are some key medications used to manage Cardiogenic Shock?
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What is the importance of delegation in the management of these conditions?
What is the importance of delegation in the management of these conditions?
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Gallstones: Cause
Gallstones: Cause
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Biliary Colic
Biliary Colic
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Decompression for Pancreatitis
Decompression for Pancreatitis
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Decompensated Cirrhosis
Decompensated Cirrhosis
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Cirrhosis: Nutritional Needs
Cirrhosis: Nutritional Needs
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Cirrhosis: Potential Complications
Cirrhosis: Potential Complications
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Cirrhosis: Education
Cirrhosis: Education
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Monitor: Amylase and Lipase
Monitor: Amylase and Lipase
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Monitor: VS, I's and O's
Monitor: VS, I's and O's
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Improve Breathing in Liver/Pancreatic Patients
Improve Breathing in Liver/Pancreatic Patients
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Goals of Palliative Care
Goals of Palliative Care
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Shock
Shock
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Compensatory Stage of Shock
Compensatory Stage of Shock
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Progressive Stage of Shock
Progressive Stage of Shock
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Causes of Shock
Causes of Shock
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Irreversible Stage of Shock
Irreversible Stage of Shock
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Liver Dysfunction & Coagulation
Liver Dysfunction & Coagulation
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Cancer: External Radiation Therapy
Cancer: External Radiation Therapy
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What are common side effects of external radiation?
What are common side effects of external radiation?
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Internal Radiation Therapy (Brachytherapy)
Internal Radiation Therapy (Brachytherapy)
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What are the safety rules for patients receiving brachytherapy?
What are the safety rules for patients receiving brachytherapy?
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Cancer & Lab Values
Cancer & Lab Values
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Palliative Care vs Hospice
Palliative Care vs Hospice
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What is the goal of palliative care?
What is the goal of palliative care?
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Acoustic Neuroma
Acoustic Neuroma
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MODS: What is it?
MODS: What is it?
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MODS: Common Signs
MODS: Common Signs
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MODS: Management
MODS: Management
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Cardiogenic Shock: What is it?
Cardiogenic Shock: What is it?
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Cardiogenic Shock: Common Symptoms
Cardiogenic Shock: Common Symptoms
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Cardiogenic Shock: Goal of Management
Cardiogenic Shock: Goal of Management
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Cardiogenic Shock: Medications
Cardiogenic Shock: Medications
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Delegation in Critical Care
Delegation in Critical Care
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Study Notes
Gallstones
- Diagnosis (Dx): Endoscopic Retrograde Cholangiopancreatography (ERCP) visualizes the biliary system, including gallbladder and biliary ducts. NPO (nothing by mouth) several hours before, with moderate sedation.
- Tests: Ultrasound, cholangiogram, laparoscopy, cholesterol levels (elevated), pancreatic enzymes (amylase and lipase), liver function tests (LFTs).
- Symptoms (S/s): Gallstones can be silent or cause mild gastrointestinal symptoms. Epigastric distress, fullness, abdominal distension, right upper quadrant (RUQ) pain, radiating to the back/right shoulder. Biliary colic (pain, nausea, and vomiting after a large meal). Jaundice and itching (pruritus), changes in urine or stool color (steatorrhea, or gray-colored stool). Vitamin deficiencies (vitamins A, D, E, and K).
- Physical exam: Referred pain to the right shoulder.
- Treatment (Tx): Laparoscopic cholecystectomy.
Pancreatitis
- Teaching: Upright posture (sitting or standing) helps. Heating pads are helpful. Splinting (using a pillow) supports the abdomen during coughing and breathing. If right shoulder or scapular pain occurs, use a heating pad (15-20 minutes hourly). Post-op: monitor for bleeding/infection, vital signs, and low-fat diet. Avoid high fat foods, heavy meals, alcohol.
- Causes: Gallstones, alcohol abuse, malnutrition.
- Symptoms (S/s): Severe abdominal pain, abdominal tenderness, back pain, decreased peristalsis, nausea and vomiting (N/V), fever, jaundice, mental confusion, rigid or board-like abdomen, ecchymosis (bruising) in the flank area, and agitation.
Cirrhosis
- Compensated: Liver is damaged but functioning well. Symptoms may include abdominal pain, ankle swelling, firm liver, excessive gas, indigestion, and spider-like blood vessels.
- Decompensated: Liver cannot function well. Symptoms may include purpura (easy bruising), ascites, clubbing of fingers, muscle wasting, weakness, jaundice, weight loss, and low blood pressure.
- Assessment/dx: Labs (increased AST/ALT, ammonia, prolonged PTT, decreased albumin. Ultrasound, CT, MRI, liver scans.
- Treatment/Care: Skin care, rest, nutritional support (low sodium, moderate protein, high calories, small frequent meals), hydration, prevention of complications (bleeding, hepatic encephalopathy, fluid imbalance).
Hepatitis B
- Transmission: Blood, saliva, semen, vaginal secretions through broken mucous membranes.
- Risk Factors: Close contact with carriers, blood transfusions, hemodialysis, frequent exposure to blood.
- Immunity: Vaccination, Immune Globulin (for exposure).
Liver Disease
- Pathophysiology: Liver synthesizes blood-clotting factors. Liver dysfunction reduces clotting factors.
- Symptoms (S/s): May experience minor bleeding or significant bleeding after surgery/trauma.
Cancer
- External Radiation Therapy: Exact positioning is essential, shields are used to protect healthy tissue.
- Internal Radiation Therapy (Brachytherapy): High dose radiation for a short period or low dose over a longer period. The radiation source is placed within the patient.
Shock
- Stages: Compensatory (initial) vs. Progressive.
- Compensatory: Normal blood pressure, increased heart rate and breathing rate, cool clammy skin.
- Progressive: Decreased blood pressure, rapid and shallow breathing, low heart rate, confusion, metabolic acidosis, jaundice.
Irreversible MODS
- Symptoms: Worsening metabolic acidosis, pulmonary dysfunction leads to respiratory arrest and cardiac arrest (tachypnea, rapid shallow respirations, crackles, atelectasis, pulmonary edema, cool clammy skin, petechiae).
- Treatment: Early detection, control of initial event, promotion of adequate organ perfusion, nutritional support, maximum comfort.
Cardiogenic Shock
- Pathophysiology: Heart cannot effectively pump blood, despite adequate blood volume. Reduced oxygen supply to organs and tissues.
- Symptoms (S/s): Tachycardia, hypotension, oliguria (<30 mL/hr), cool clammy skin, and tachypnea.
- Treatment: fluids, mechanical assistance (intubation), 12-lead electrocardiogram, medications.
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