Pancreas Functions and Aging
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Questions and Answers

What is a potential postoperative complication of surgery related to biliary drainage?

  • Pneumothorax
  • Hyperglycemia
  • Biliary leak (correct)
  • Respiratory infection

    • Which nursing diagnosis is directly associated with a high abdominal surgical incision?

  • Imbalanced nutrition: less than body requirements
  • Impaired gas exchange (correct)
  • Acute pain and discomfort
  • Deficient knowledge about self-care activities

    • In what position should the patient be placed after recovery from anesthesia to promote comfort and ventilation?

  • Prone position
  • Low Fowler position (correct)
  • Supine position
  • Sitting position

    • Which intervention is appropriate to relieve abdominal distention after surgery?

    <p>Administration of IV fluids</p> Signup and view all the answers

    What is part of the goals for a patient recovering from surgery?

    <p>Adequate ventilation</p> Signup and view all the answers

    What is the primary dietary recommendation for patients recovering from acute gallbladder inflammation?

    <p>Follow a low-fat liquid diet</p> Signup and view all the answers

    Which assessment finding is least likely to indicate impaired nutritional status?

    <p>Shallow respirations</p> Signup and view all the answers

    What is a common symptom that may arise due to gastrointestinal issues post-surgery?

    <p>GI bleeding</p> Signup and view all the answers

    Which of the following foods should be avoided after an episode of gallbladder inflammation?

    <p>Fried foods</p> Signup and view all the answers

    Which information should be included in patient education about incision care?

    <p>Identifying reportable signs like fever or bleeding</p> Signup and view all the answers

    For which patient group is pharmacologic therapy with UDCA generally indicated?

    <p>Patients who refuse surgery or are contraindicated for it</p> Signup and view all the answers

    What is a significant drawback of treatment with ursodeoxycholic acid (UDCA)?

    <p>The success rate of this therapy is low with high recurrence</p> Signup and view all the answers

    Which of the following symptoms may occur during the monitoring of patients treated with UDCA?

    <p>Pruritus</p> Signup and view all the answers

    How long may treatment with UDCA be required to dissolve gallstones?

    <p>6-12 months</p> Signup and view all the answers

    What dietary factor can trigger an episode of cholecystitis in susceptible patients?

    <p>Ingestion of fatty foods</p> Signup and view all the answers

    Which of the following is NOT a recommended component of a post-inflammation diet?

    <p>Rich dressings</p> Signup and view all the answers

    What is the primary reason for the pain experienced during a bout of biliary colic?

    <p>Contraction of the gallbladder</p> Signup and view all the answers

    Which analgesic is traditionally avoided in the management of acute cholecystitis due to concerns of sphincter spasm?

    <p>Morphine</p> Signup and view all the answers

    What skin condition is typically associated with jaundice due to biliary obstruction?

    <p>Yellow discoloration and itching</p> Signup and view all the answers

    What change in urine color is indicative of bile pigment excretion issues?

    <p>Very dark brown</p> Signup and view all the answers

    Obstruction of bile flow can lead to deficiencies in which type of vitamins?

    <p>Fat-soluble vitamins</p> Signup and view all the answers

    What serious complications can arise from continued obstruction of the cystic duct?

    <p>Generalized peritonitis</p> Signup and view all the answers

    What is the primary purpose of inserting a tube into the common duct during the procedure?

    <p>To drain bile until edema subsides</p> Signup and view all the answers

    Which substance is responsible for the grayish or clay-colored feces seen in biliary obstruction?

    <p>Absence of bile pigments</p> Signup and view all the answers

    What diagnostic procedure is most likely unnecessary in a patient with known biliary obstruction issues?

    <p>Liver biopsy</p> Signup and view all the answers

    Under what circumstances is a surgical cholecystostomy typically performed?

    <p>When the acute inflammatory reaction is severe</p> Signup and view all the answers

    What is a significant risk associated with surgical cholecystostomy?

    <p>High mortality rate due to infection</p> Signup and view all the answers

    What type of patients typically undergo percutaneous cholecystostomy?

    <p>Patients who are poor risks for surgery or anesthesia</p> Signup and view all the answers

    Which technique is used to guide needle insertion during percutaneous cholecystostomy?

    <p>Ultrasound or computed tomography</p> Signup and view all the answers

    What is a common consequence of cholesterol saturation in bile as people age?

    <p>Increased hepatic secretion of cholesterol</p> Signup and view all the answers

    What immediate effect can result from performing a percutaneous cholecystostomy?

    <p>Relief of pain and symptoms of cholecystitis</p> Signup and view all the answers

    What is the primary method of administering antibiotics during percutaneous cholecystostomy?

    <p>Intravenous route before and during the procedure</p> Signup and view all the answers

    What is the primary advantage of ultrasonography over abdominal x-ray in the diagnosis of gallbladder disease?

    <p>It does not expose patients to ionizing radiation.</p> Signup and view all the answers

    Which diagnostic test is often employed when ultrasonography results are inconclusive?

    <p>Radionuclide imaging or cholescintigraphy</p> Signup and view all the answers

    What is a necessary preparation step for patients undergoing ultrasonography for gallbladder evaluation?

    <p>Fasting overnight</p> Signup and view all the answers

    Which statement about oral cholecystography is true?

    <p>It can detect gallstones and assess gallbladder function.</p> Signup and view all the answers

    What is a limitation of the abdominal x-ray in the detection of gallstones?

    <p>Only 10% to 15% of gallstones are calcified enough to be visible.</p> Signup and view all the answers

    Which of the following is a characteristic of cholescintigraphy?

    <p>It is primarily used for diagnosing acute cholecystitis.</p> Signup and view all the answers

    What factor most influences the accuracy of ultrasonography in detecting gallstones?

    <p>The distension of the gallbladder through fasting.</p> Signup and view all the answers

    What determines the use of an iodide-containing contrast agent in oral cholecystography?

    <p>The patient's allergy to iodine or seafood.</p> Signup and view all the answers

    What symptoms may accompany biliary tract disease in older adults, instead of typical symptoms?

    <p>Oliguria and hypotension</p> Signup and view all the answers

    What is a significant risk factor for older adults undergoing surgery for biliary tract disease?

    <p>Chronic illness prevalence</p> Signup and view all the answers

    What is emphasized to patients to enhance recovery after gallbladder surgery?

    <p>Avoidance of smoking</p> Signup and view all the answers

    What type of cholecystectomy undergoes lower risk when performed electively in older patients?

    <p>Elective laparoscopic cholecystectomy</p> Signup and view all the answers

    How has the trend in elective surgical procedures, such as cholecystectomy, changed recently?

    <p>Elective procedures are decreasing due to reimbursement changes.</p> Signup and view all the answers

    What is a common symptom of septic shock that older adults may exhibit in the context of biliary tract disease?

    <p>Tachycardia</p> Signup and view all the answers

    What should the assessment focus on regarding older patients undergoing surgery for gallbladder disease?

    <p>The patient's respiratory status</p> Signup and view all the answers

    Which of the following medications should be avoided prior to gallbladder surgery to prevent complications?

    <p>Aspirin and nonsteroidal medications</p> Signup and view all the answers

    Study Notes

    General Information about the Pancreas

    • The pancreas has endocrine and exocrine functions
    • Endocrine functions include glucagon, epinephrine, adrenocorticosteroids, growth hormone, and thyroid hormone
    • Major exocrine function is facilitating digestion through enzyme secretion
    • Secretin and CCK from the GI tract control pancreatic secretions
    • Neural factors also influence secretions
    • Normal pancreatic enzyme secretion is 1500-3000mL/day

    Gerontologic Considerations

    • Pancreatic size remains largely unchanged with age
    • Increased fibrous and fatty deposits occur in those over 70
    • Localized arteriosclerotic changes are common
    • Decreased enzyme secretion (amylase, lipase, trypsin) and bicarbonate output are noted in elderly
    • Impaired fat absorption may be caused by delayed emptying of the stomach and pancreatic insufficiency
    • These changes can affect interpretation of diagnostic test results and require dietary counseling for older patients

    Disorders of the Gallbladder

    • Several disorders affect the biliary system, impacting normal bile flow into the duodenum
    • Disorders include biliary inflammation and carcinoma
    • Gallbladder disease with stones is the most common biliary disorder
    • Most patients (15 million Americans) with gallstones are asymptomatic

    Cholecystitis

    • Cholecystitis (inflammation of gallbladder) is acute or chronic
    • Causes pain, tenderness, and rigidity in the upper right abdomen, possibly radiating to the midsternal area or right shoulder
    • Associated with nausea, vomiting
    • Empyema (accumulation of pus) in the gallbladder can occur
    • Calculous cholecystitis (caused by gallstones) accounts for over 90% of cases
    • Gallstones obstruct bile outflow, causing bile buildup, autolysis, edema, and compression of blood vessels. This can lead to gangrene and perforation
    • Bacterial infection (E. coli, Klebsiella species, Streptococcus) may occur secondarily

    Cholelithiasis

    • Calculi (gallstones) form in the gallbladder from bile components. They vary in size, shape, and composition
    • Prevalence increases with age, typically affecting women between 20-70 years old far more frequently than men.
    • Two main types: cholesterol stones (75% of cases) and pigment stones (10-25% of cases).
    • Cholesterol stones are caused by decreased bile acid synthesis and increased cholesterol synthesis
    • Risk factors for cholelithiasis include: obesity, multiparity, oral contraceptive use, estrogen or clofibrate use, and certain medical conditions (e.g., Crohn's disease, ulcerative colitis, and cirrhosis).

    Symptoms of Gallbladder Problems

    • Silent gallstones - No symptoms
    • Pain- related to gallbladder and/or bile duct obstruction. Pain is in epigastric or right upper quadrant (RUQ) of abdomen, often severe, radiates to the back or right shoulder. May be intermittent (colic), but can also be constant. Pain typically increases after eating fatty foods
    • Other symptoms- Nausea, vomiting, fever, jaundice (yellowing of skin and eyes), changes in urine and stool color (dark urine and clay-colored stool)

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    Description

    Explore the dual roles of the pancreas and its changes with age in this insightful quiz. Learn about its endocrine and exocrine functions as well as how aging can affect pancreatic health and digestive efficiency. Ideal for students in health sciences and gerontology.

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