Hepatobiliary Disorders

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What should be done if there is excessive incision drainage greater than 50 ml in 8 hours?

Document the findings and wait 8 more hours.

Continue to monitor without action.

Notify the surgeon immediately. (correct)

Apply a tighter dressing to the incision.

Which of the following symptoms indicates the potential for hemorrhage?

Decreased urinary output (correct)

Stable pulse rate

Increased blood pressure

Increased appetite

What is a key GI condition patients should be taught to report to their physician?

Slight cough

Occasional nausea

Severe pain in the right upper quadrant (correct)

Mild headache

What should be observed for as a complication of surgery regarding the common bile duct?

Jaundice Signup and view all the answers

What can be a consequence of portal hypertension?

Splenomegaly Signup and view all the answers

Which symptom is indicative of jaundice?

Clay-colored stools Signup and view all the answers

Which of the following could lead to bleeding tendencies in liver patients?

Presence of varices and hemorrhoids Signup and view all the answers

What is a common skin change associated with liver disease?

Palmar erythema Signup and view all the answers

What is a common clinical manifestation of acute gallstone formation?

Severe, colicky pain in the right upper quadrant Signup and view all the answers

Which symptom may cause confusion with a cardiac problem in gallstone patients?

Pain radiating to the back Signup and view all the answers

What is a characteristic objective finding in patients with acute cholecystitis?

Clay-colored stools Signup and view all the answers

Which diagnostic tool is often used to identify gallstones?

Ultrasound of the gallbladder (RUQUS) Signup and view all the answers

Which treatment is not recommended for pain control in gallstone management?

Morphine Signup and view all the answers

What symptom is often reported by patients after eating fatty foods?

Indigestion Signup and view all the answers

Which of the following is an indication of gallbladder perforation?

Fever and chills Signup and view all the answers

What type of stools are associated with a lack of bile in the intestinal tract?

Fatty stools (steatorrhea) Signup and view all the answers

What is a common characteristic of chronic cholecystitis symptoms?

Symptoms are decreased or absent Signup and view all the answers

What is the primary purpose of inflating one or both balloons in the management of bleeding varices?

To control bleeding by compressing vessels Signup and view all the answers

What is a critical reason for periodically deflating the esophageal balloon in an upper GI bleed?

To prevent necrosis Signup and view all the answers

Which shunting procedure involves diverting blood from the portal vein to the inferior vena cava?

Portacaval shunt Signup and view all the answers

What is a possible complication of surgical shunting procedures?

Decreased liver function Signup and view all the answers

What therapy is used to help remove ammonia in patients with hepatic encephalopathy?

Administering lactulose Signup and view all the answers

What is an effect of ammonia accumulating in the blood due to liver failure?

Worsening CNS function Signup and view all the answers

Which of the following signs may indicate worsening hepatic encephalopathy?

Flaring tremors Signup and view all the answers

What is the main goal of a surgical shunting procedure?

To reduce pressure and prevent bleeding Signup and view all the answers

What can be a direct effect of ammonia crossing the blood-brain barrier?

Interference with brain metabolism Signup and view all the answers

What is the primary goal of administering lactulose and a low protein diet for a patient with liver disease?

Improved mental status Signup and view all the answers

Which of the following dietary modifications should be implemented?

Low protein, high carbohydrate diet Signup and view all the answers

How does lactulose reduce serum ammonia levels?

By attracting ammonia and forming a non-absorbable compound Signup and view all the answers

Which nursing intervention should be prioritized when monitoring fluid and electrolyte status?

Strict intake and output monitoring Signup and view all the answers

What should the nurse instruct the patient to avoid to lessen the risk of complications?

Straining at stool and vigorous nose blowing Signup and view all the answers

When providing skin care, what practice should be emphasized?

Applying lotion to avoid puritis Signup and view all the answers

What type of medications should be used cautiously in patients undergoing treatment for ammonia reduction?

Drugs detoxified by the liver, such as Acetaminophen Signup and view all the answers

What is a key factor in evaluating a patient's prognosis?

Susceptibility of the individual and the disease's cause Signup and view all the answers

Which intervention is NOT recommended for managing blood ammonia levels?

Administering high doses of sodium Signup and view all the answers

Study Notes

Liver Diseases Summary

The liver, gallbladder, and exocrine pancreas aid in digestion.
Cirrhosis is a chronic, degenerative liver disorder resulting from generalized cellular damage.
Liver tissue (parenchyma) degenerates.
Liver lobules are infiltrated with fat.
Fibrous tissue restricts blood flow, leading to further liver destruction.
Liver size increases (hepatomegaly), then progressively shrinks.
Liver function is impaired, causing metabolism and digestion issues.
Ammonia conversion to urea is inhibited, increasing serum ammonia levels.
Reduced protein synthesis (albumin) decreases plasma oncotic pressure, causing fluid build-up (third spacing).
Blood coagulation and fluid/electrolyte balance are impacted.
Ascites (fluid buildup in the abdomen), edema, and low circulating volume trigger aldosterone release.
Liver damage progressively leads to stages of destruction, inflammation, fibrotic regeneration, and hepatic insufficiency.
Alcohol is the leading cause though causes may be unknown.
Other types of cirrhosis include Post-necrotic (worldwide) and Biliary/obstructive cirrhosis.
Chronic, inflammatory, or obstructive conditions of the bile ducts lead to biliary cirrhosis.
Various symptoms appear as liver damage progresses—headaches, anorexia, nausea/vomiting, indigestion, diarrhea, constipation, abdominal pain, and changes in bowel habits.

Symptoms often present only with advanced liver conditions and include weight loss, tissue wasting, fatigue, dyspepsia (indigestion), and changes in bowel habits.
Jaundice, a yellowish discoloration due to elevated bilirubin, usually becomes apparent as liver function declines.
Splenomegaly (enlarged spleen) and distended abdominal blood vessels are also common.
Portal hypertension, ascites, and hepatic encephalopathy are potential complications.
Portal hypertension leads to bleeding tendencies due to enlarged veins (varices).
Excessive bleeding can damage the esophagus or stomach, potentially causing internal bleeding.

Diagnostic tests

Elevation of liver enzymes (ALT, AST, LDH) and alkaline phosphatase are common signs of liver damage.
Prolonged prothrombin time (PT) indicates compromised. liver function.
Liver biopsy can reveal direct damage to the liver or evidence of fibrosis.
Ultrasound, CT scan, or MRI are used to visualize the liver, identify abnormalities or to measure the size of the liver or measure fluid build-up.

Medical and Nursing Management

Medical management focuses on supportive care and eliminating causes of liver damage.
Fluids, sodium, and protein restrictions are necessary interventions.
Medications like diuretics (e.g., spironolactone, furosemide) may be used to manage fluid balance.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on post-surgery patient care and complications with our quiz. This includes understanding incision drainage, hemorrhage symptoms, and liver health indicators. Ensure you're equipped with the right information for optimal patient recovery.