Appendicitis & Colostomy/Ileostomy: MS2 Exam 3 PDF

297 Appendicitis Med Surg: GI - Gastrointestinal Pathophysiology...

297 Appendicitis Med Surg: GI - Gastrointestinal Pathophysiology RUQ LUQ nflammation of the appendix, located in the RLQ RLQ LLQ ( ight ower uadrant) of the abdomen. RLQ - Right Lower Quadrant Signs & Symptoms Common NC uestion What is the typical n n tion of a client with n c ti ? Fever low-grade 1. Pain starts in the left side below the belly button RLQ pain with 2. Pain is di use and all over the abdomen rebound tenderness 3. Pain starts in the left upper uadrant radiating to the “Pain between the right shoulder 4. Pain starts around the hip area belly button umbilicus and then moves to the right lower quadrant Rebounce tenderness Complications NO heat pad or blanket NO laxatives e o o e ito i s NCLEX TIPS NO enemas Medical Emergency! High Fever Tachycardia,Tachypnea Rigid “board-like abdomen Rebound tenderness Interventions Surgery 1. NPO e dectomy 2. IV normal saline or LR (Lactated Ringers) o ti 3. Pain meds: Avoid lifting heavy ob ects Appendectomy IV morphine / hydromorphone Prevent Pneumonia NEVER give pain medications Assist with u tion PRIORITY unti n u on Deep breath & Cough Incentive spirometer PRIORITY Side note Prevent n ction 0.9% Sodium Chloride LACTATED RINGER’S NO baths - shower ONLY Report redness, swelling, & 250 mL drainage at incision sites  299 Colostomy & Ileostomy Med Surg: GI - Gastrointestinal Procedure Indication It is a surgical procedure that creates an opening in the abdominal wall to allow for the Colostomy passage of stool. This is done in order to bypass a blocked or diseased portion of the Ileostomy bowel. We are basically creating a rectum in the abdomen by cutting the intestines & placing an opening as a stoma on the surface of the abdomen. Key i erences Memory Trick he main difference is the location. Green / Yellow - Ileostomy Ileostomy: opening in the Ileum (small intestine) in the RLQ Brown is “Down” - Colostomy Colostomy: opening in the colon Scopy Ostomy Scope Opening Care of Ostomy DIET Red beefy - After Surg AVOID High Fiber / Gassy Foods GOOD Pink - long term 4 - 6 weeks Post-Op NCLEX TIP NO Broccoli Brussel sprouts Moist & Shiny u o NO Beans Report to HCP u ti n bread NO eggs Cold BAD n co o tion NO airy - cheese milk AVOID Hard to digest foods Pale, Grey usky Purple NO Popcorn NO seeds nuts Fluid Intake Common NC uestiono 3,000 mL/day (3 L) Saunders Client who has a n co o o The nurse Irrigation Use 500 to 1000 mL of tap should encourage which diet for the first The nurse is providing care water (NOT COLD) o postoperatively for a client with a recent Place bag above ostomy transverse colostomy o (shoulder height) hich observation Cramping: STOP fluid re uires immediate mpty when pouch is one-third full noti c tion of the primary health care provider Skin Breakdown RISK! Cleanse the peristomal skin u co o tion ticu ou of the stoma Psychological RISK! isturbed body image Com lications Fluid & electrolyte imbalances Saunders A client ust had surgery to create an ileostomy The nurse assesses the client in the o o ti period for which most Na Ca fre uent complication Fluid and electrolyte K imbalance  300 Diverticulitis Med Surg: GI - Gastrointestinal ‫دﮐﺗر ﺑﺎﺋﯽ‬ Pathophysiology i e ulosis li le ou es o st ess u les Diverticulosis: Little pouches of stress bubbles called diverticula form on the walls of the colon. ypically caused by a diet that lacks ber, resulting in constipation & increased pressure within the bowels. i e ul ti i fl o o di e ul Diverticulitis: nflammation of di erticula (the little pouches) resulting in infection & swelling! Causes Signs & Symptoms Low Fiber (constipation) Fever & chills RUQ LUQ Pain LLQ (descending & RLQ LLQ Popcorn, Seeds, Nuts sigmoid colon) Labs HEMOGLOBIN HEMATOCRIT ecrease H H Increase BC Complications Nursing Care Highly tested NPO on ti PO T to HCP NCLEX TIP 1. Avoid constipation straining Abdominal pain LUQ 2. NPO (nothing per oral) Rigid “board-like abdomen 3. Pain meds Morphine Hydromorphone NO barium enema increases 4. I normal saline abdominal pressure NO colonoscopy Diet Medical Emergency! iverticul ti - flare up: NPO Diet Clear li uid diet: ello broth uices o ventually high fiber again iverticulosis: High Fiber diet Clean bowels & o con ti tion AVOID: Popcorn, Seeds, Nuts  301 Dumping Syndrome & GI Surgery Med Surg: GI - Gastrointestinal Pathophysiology Occurs when the stomach empties too quickly into the duodenum (small intestines) after eating. This DUMPING causes a massive fluid shift leading to severe pain, low blood pressure, & nausea/ vomiting minutes after eating Commonly seen after any ty e of ariatric surgery like a gastric y ass or gastrectomy (removal of the stomach), typically done for our bariatric clients who are morbidly obese. Causes GI SURGERY o ti Key terms Priority Gastrectomy Gastrojejunostomy (Billroth II surgery) Partial Gastrectomy 1. NPO until bowel sounds return NCLEX TIP !!! Sleeve Gastrectomy 2. Apply SCD (se uential compression devices) 3 arly ambulation Incentive spirometer Hour 5. Teach ntin nc on when coughing Signs & Symptoms o ction PRIORITY ACTION ehiscence visceration NCLEX TIPS Report to HCP / Surgeon NORMAL 1. Stay with client & call for help LOW Hypotension & Tachycardia 2. Position: Low Fowler’s with knees bent 0.9% Sodium Chloride 250 mL tin , Dizziness, NCLEX TIP 3. u & saline to cover the wound Severe abdominal pain, N&V HR > 100 4. Report to HCP / Surgeon 30 minutes AFTER eating MEMORY TRICK uc tion 4 NCLEX TIPS NORMAL 1. protein fiber fats foods LOW Low carbohydrates 2. Small, frequent meals 3. tin (left side) Think for Dumping syndrome- 4. o u with meals we see DUMPing of Blood pressure (30 min before after food) Common NC uestion A client recovering from a ti co presents KAPLAN with vomiting severe Following a co What n uction abdominal pain, blood pressure o ction for a client with bowel should the nurse include... to prevent o u n through abdomen u n n o 105/62, heart rate of 122/min, 1 temperature of 100.5 F. Which u on Divide meals into n o (the client needs ction should the nurse take? emergency surgery and the nurse should not leave the client) Which nu n ction o n after a patient has a ti co to prevent 1. Administer a bolus of I fluid further complications 2. Assess blood glucose for hypoglycemia Measure the patient s serum vitamin B12 level 3. noti o u on 4. Insert nasogastric tube B12 Notes  302 GI Bleed Med Surg: GI - Gastrointestinal Pathophysiology Bleeding anywhere inside the GI tract. Upper GI Classi ed as upper or lower GI bleed - one of the biggest problems is knowing the exact location of the bleed! Lower GI Causes & Risks Signs & Symptoms Upper GI ti tic u c oo c c nc omiting: Hematemsis Esophageal varices co ee ground emesis Lower GI ti tic c Stool: n dark or black tarry stools Hemorrhoids oo c c nc o iverticulosis lcerative colitis Bright red bleeding Diagnostics Complications u cF c ccu oo o o c oc (hemorrhagic shock) o ti HIGH L W o n on (Low BP) HR > 100 Gather supplies wash hands Step 1 c c (High H ) non gloves skin o Open apply oo to the Step 2 Cool Clammy o tic boxes on the slides Fatigue di y Open the back of the slide Step 3 o apply o o o n o ution Low H/H Step 4 Wait 30- 0 seconds Hemoglobin n n Step 5 ocu n the results Intervention Surgery Includes procedures to locate & stop the bleeding. o ction They put a little camera tube to scope out the bowels. 1. Lower head of bed 2. I Normal Saline Stabili es Blood Pressure 3 Oxygen ndo co - Upper GI 4. oo n u on Colono co - Low GI Hemoglobin n Nasogastric lavage (NGT) F co for gastro o varices Clear li uids: Apple uice Broth soup Tea (unsweet) Notes  304 Hiatal Hernia Med Surg: GI - Gastrointestinal Pathophysiology Esophagus Protrusion of part of the stomach through the diaphragm & is Diaphragm Hiatal hernia now stuck in either the esophagus or to the side of the esophagus. Signs & Symptoms Dysphagia - di culty swallowing Gastric u : Heartburn epigastric pain Chest pain SOB Dysphagia Causes & Risk Increased abdominal pressure nn n heavy ob ects “ n exercises Obesity Nursing Care NCLEX TIP NCLEX TIP 1. Avoid n nn 2. NO tight clothing “Girdle” NCLEX TIP Diet: 3. Avoid fatty foods alcohol 4. o cco c n chocolate peppermint 5. Small, fre uent low fat meals NCLEX TIP 6. Sit up “elevate HOB” after eating at night Notes  306 Small Bowel Obstruction Med Surg: GI - Gastrointestinal Pathophysiology A small bowel obstruction is a blockage in the small intestines. Causes & Risks Signs & Symptoms on c nc o uction Paralytic Ileus RAPID Onset Key point c nc o uction Frequent vomiting nausea Adhesions (scar tissue) Abdominal distention from surgery Normal nu u c tion Hernias Colicky intermittent abdominal pain Intussusception Bowel sounds Tumor (cancer) Hyperactive ABOVE obstruction olvulus (twisting of bowel) Adhesions Hypoactive Below obstruction Complication !!! e ito i s Medical Emergency! NCLEX TIP 1 Fever Tachycardia Tachypnea Abdominal distention Rigid “board-like abdomen... Common NC uestion Client with a o o uction Treatment suddenly develops tachycardia and tachypnea with a high fever hat is most likely the problem 1. Pulmonary embolism 1. NPO N 2. o o tion noti 2. n tion NPO 3. Pneumonia 4. Atelectasis (nasogastric tube) 3. I fluids Surgery 4. Semi-Fowler s position 5. Pain control (non-opioids) Patients that fail to improve will need a bowel N resection to cut out the problem area & may AVOID Opioid analgesics: N n tion have an ostomy placed until bowels heal Morphine oco on Hydromorphone  307 GERD Med Surg: GI - Gastrointestinal Pathophysiology Signs & Symptoms Gastro Esophageal R u Disease Gastroeso hageal eflu isease Dyspepsia “heartBURN” ancy words for heartburn or acid reflux where Worse pain = Lying down Esophageal - Esophagus stomach acids burn the esophagus, leading to Gastro - Stomach pain, inflammation, e en C CE called Barrett’s esophagus (if the chronic acid reflux is not treated) Causes & Education tin NCLEX TIP nything that can weaken or damage the AVOID eating before lying down LES ( ower Esophageal phincter) the muscle Fried Foods (Fries c c n) (3 hours after meals) that closes the opening between the stomach F Foods “low fat diet = BEST” Sit up after meals esophagus. Citrus (Acidic) Elevate HOB n airy (milk cheese) at Small meals Chocolate n n NO Ca eine (co ) NO Cigarettes (tobacco) NO Alcohol 3 Hours Pharmacology HESI un Risk Factors: hen teaching a client with Acid reducers hat advice would the nurse give to o o u Stress a patient experiencing u n after meals about substances to avoid which items Antacids should the nurse nc u on this list Obese (BMI over 30) Histamine receptor blockers Identify and o c u ti oo c Hiatal hernia Raniti n Co ee PPIs: Proton pump inhibitors Chocolate Omeprazole Peppermint Fried chicken n Diaphragm n c Omeprazole Acid reducers o on u n o >30 Whole Milk n ti n n c o oc Procedures Surgery eritonitis he main goal here is to tighten up the E pper gastrointestinal endo co eport to HCP - Lower esophageal sphincter F Esophagogastroduodeno co Fever (over 100 3F) Stretta procedure deli ers radiofre uency oun n n energy wa es through electrodes to tighten the “Rigid” or “board-like abdomen E. Increasing Pain tenderness Esophagus Restless Duo Gastro n Fast HR & RR o o EGD o uo no co (tachycardia tachypnea) HESI Fundoplication wrap the upper cur e of the stomach called the fundus around the esophagus A patient has persistent gastroesophageal sew it shut. elping to tighten this esophageal reflux disease despite diet changes and proton pump inhibitors hich test does sphincter. the nurse anticipate being performed to determine o o nc co nc on tin n o co  308 PUD - Peptic Ulcer Disease Med Surg: GI - Gastrointestinal Pathophysiology Signs & Symptoms Dyspepsia: Burning Pain “Epigastric” “Back” PUD (Peptic Ulcer Disease) happens when gastric acids erode G Gastric lcer Gastric Ulcer (stomach) the gastric lining creating open PAIN Increased with food NCLEX TIP P tic Ulcer Disease G Gut Paint with food 30 - 0 min after meals sores / holes in the esophagus, Weight LOSS Vomits blood Hematemesis” stomach, or duodenum. Duodenal Ulcer (intestine) D Duodenal lcer PAIN Decreased with food NCLEX TIP 2 - 3 hours after meals D Don’t have pain with food Worse at NIGHT Weight Gain Blood in stool melena (dark tarry stool) Complication Saunder’s HESI o tion Peritonitis Sepsis Client with a tic u c. Which hich complications does the nurse monitor Report to HCP! assessment finding would most likely for while assessing a patient with tic u c indicate perforation of the ulcer disease (PUD) Fever (over 100.3F) Select all that apply. Rebound tenderness A rigid, board-like abdomen “Rigid” or “board-like abdomen” Perforation Increasing Pain, tenderness Hemorrhage estless Gastric outlet obstruction Fast H (tachycardia tachypnea) Hematemesis and melena Hemorrhage (bleeding) Melena (black tarry stools) Hematemesis (vomiting of blood) c ou o uction Diagnostics Causes & Risk Esophagogastroduodenoscopy (EGD) n uc tion H.Pylori o tion Peritonitis Sepsis NPO (no eating or drinking) 1. H. Pylori bacteria No smoking 2. NSAIDs PRIORITY - Report to HCP! 8 hours BEFORE the procedure Fever (over 100.3F) c Naproxen uring: Abdominal cramping Indomethacin pper GI Series with barium contrast After: Chalky white stool Ibuprofen Flush the Contrast 3 Stress (prolongs the ulcer) NAPROXEN Increase fluid intake Kaplan NCLEX TIP 1 HCP Take ti - Nursing school NCL Indomethacin > 100.3 F Pharmacology HESI Patient Education A patient is diagnosed with Helicobacter o o tic u c The Antibiotics: H Pylori bacteria nurse anticipates administering which drugs Common NC uestion Select all that apply. Amoxicillin Clarithromycin Bismuth Diet The nurse is educating the client Tetracycline Avoid Spicy Fatty Fried Acidic foods on tic u c ntion. Tetracycline Metronida ole NO Ca eine (co o ) hich statement by the client Metronidazole NO Alcohol shows correct understanding Bismuth (brand: Pepto-Bismol) NO Cigarettes (tobacco) Select all that apply Acid reducers ecrease Stress 1. “I will not drink beer at the Antacids HESI Avoid NSAIDs party this weekend” 2. “I will avoid using naproxen” Histamine receptor blockers Naproxen hich classes of drugs are used to reduce 3. “I should avoid drinking excess Indomethacin Raniti n the symptoms of tic u c co o o Ibuprofen PPIs: Proton pump inhibitors Select all that apply. 4. o n c tion Omeprazole Report black tarry stools to HCP 5. I will avoid spicy foods but Antacids fried chicken is ok” Mucosal protectants Mucosal healing agents Sucralfate Proton pump inhibitors Misoprostol Histamine receptor blockers  309 Ulcerative Colitis (UC) & Crohn’s Disease Med Surg: GI - Gastrointestinal Causes & Triggers S S S IBD Inflammatory Bowel Disease Stress NCLEX TIP Smoking n ction Both conditions are autoimmune diseases (the body is attacking itself), so naturally signs & symptoms come & go during times of stress, smoking & sepsis (infection). UC Crohn’s Signs & Symptoms ULCERATIVE COLITIS Saunders Pathophysiology 15 - 20 bloody li uid stools per day The nurse is caring for a client with u c ti co ti hich finding Anemia does the nurse determine is nflammation ulcers in the colon (big long open Decreased H/H consistent with this diagnosis sores that bleed) leading to decreased hemoglobin (hemoglobin Hematocrit) Decreased hemoglobin ebound tenderness Report to HCP The nurse is caring for a hospitali ed client with a diagnosis of u c ti co ti hich finding if noted on assessment of the client should the 1 day HEMOGLOBIN HEMATOCRIT nurse mention to the primary health 15 - 20 bloody care provider (PHCP) ebound tenderness Signs & Symptoms CROHN’S DISEASE Pathophysiology 5 loose stools day nflammation granulomas (bumps lumps) from mouth to anus, but mainly in the small intestines that do not bleed. This deep (mucus pus) inflammation can lead to stulas, which are open tunneling of the GI tract that can contaminate the body. Steatorrhea (fatty stools) Memory trick Crohn s disease Crown s disease 1 day Notes  310 Ulcerative Colitis (UC) & Crohn’s Disease II Med Surg: GI - Gastrointestinal Nursing Care Pain - administer analgesics Common NC uestion Fluid & E+ AVOID Alcohol Client with u c ti co ti... Strict I & O monitoring interventions Select all that apply. Reduce n (co ee tea) 2 Liters of water daily + more 1. Discuss plans to decrease with diarrhea PsychoSocial client’s stress Hypokalemia low potassium: Stress reduction 2. n c c 3.5 or less Encourage clients to aily multivitamins containing discuss feelings 3. Limit fluids to 500 ml per day Calcium 4. Increase protein foods with meals Diet 5. Monitor Input & Output High: Protein & Calories ANALGESICS closely Low: Fiber 6. ecommend high fiber and Keep food journal NCLEX TIP low calorie diet Small frequent meals Complication 2 Liters 3.5 or less K Bowel rupture from a toxic megacolon, on ti NCLEX TIP which can lead to peritonitis (deadly Report to HCP! infection in the peritoneal cavity). F (over 100 3F) Saunders oun n n o o Toxic megacolon The nurse is providing discharge abdomen” teaching for a client with newly Increasing Pain, tenderness diagnosed Crohn's disease about dietary measures to Restless implement during c tion Fast HR & RR episodes. Which statement (tachycardia tachypnea) made by the client indicates a n o u n uction “I should nc 1 in my diet Surgery Pharmacology Most clients get a colostomy or ileostomy after a bowel resection, where we cut out the part of the bowel causing the problem. Sulfasalazine “STOPS body SULFASALAZINE attacking itself Colon n tin Steroids “Sooth the Swelling PredniSONE STEROIDS Antidiarrheal: Loperamide “Low bowel movements Dicyclomine “Dry Cycle Loperamide Imodium  337 Cirrhosis Med Surg: GI - Gastrointestinal Pathophysiology Causes Liver cirrhosis THINK liver Scarrrosis. nything that causes inflammation scarring Since normal healthy tissues get replaced with to the liver: SCAR tissue, making the liver hard like a rock! Alcohol abuse Chronic Hepatitis (inflammation) Cystic rosis (serious mucus clogs the entire body the li er) on c titi Year 3 ! Year 2 Year 1 ! ! ! ! ! Liver l umin Albumin Transports drugs o c n cu o o on ti in the body Producing Detoxing ammonia Drug metabolism Storing Glycogen Ca A - Albumin B - Bile C - Coagulation factors NH NH NH NH NH NH NH A - Albumin A - Attracts water drugs binds with calcium Bile Clotting Factors Which we call the Bile Bus helping to scoop up In liver disease, the blood can’t clot fast enough excess Cholesterol Biliru in and take them leads to a E risk of bleeding. from the body to the toilet via the bowels. Our #1 concern is the BLEEDING! When the liver fails we get higher cholesterol high bilirubin. ilirubin causes aundice in the body. his is see as yellowing of the skin the eyes, speci cally the white part of the eye called HESI uestion the sclera. Memory Trick hich complication is a patient with cirrhosis at risk for Bilirubin Cholesterol Bleeding ! Bile Bus ! !  338 Cirrhosis II Med Surg: GI - Gastrointestinal Signs & Symptoms Jaundice Yellow skin & eyes from build up of bilirubin (dead RBCs) as bile can not take it from the body into the toilet. Portal Hypertension ! Is high pressure in the portal vein, since the liver is hard like a rock! over 10mmHg ! aturally, blood flow will back up fluid now spills o er into the ! abdomen called ascites (third spacing) Ascites A Ascites uge fluid lled abdomen as fluid backs up from the hard li er A - Abdominal fluid now spills into the third space. Clients will look pregnant with fluid. Esophageal Varices on The enlargement of veins in the esophagus! As blood backs up from the liver it forces major pressure on the esophagus causing NO nasogastric tube (NGT) the vessels to bulge to the max! Like a ticking time bomb of blood NO straining (bowel movement) it can explode & blood can block the airway - VERY DEADLY! n uestion Common NC uestions HESI uestion PRIORITY First action when a client with Client with a history of cirrhosis … with hich nursing intervention would be c o begins o tin oo suspected gastroesophageal varices. the highest priority in managing a after a meal: Which order would the nurse u tion? patient with ruptured esophageal Obtain n New n o c c ? Airway (probable esophageal varices) u insertion Protecting the Client with cirrhosis … o n on A patient with cirrhosis and c , and o c. Which of esophageal varices is vomiting and Breathing the following is co c patient teaching the nurse notes hematemesis. Which action should the nurse take first o nn when having a Place the patient in the bowel movement n o tion Circulation Hepatic Encephalopathy un Top Missed NC uestions tic nc o o Which n would indicate if a Cloudy brain from ammonia A client with c o … shows oc tion c n ti in the client with cirrhosis has progressed to arms & legs = Asterixis. signs of tic nc o. (protein waste). The liver can The nurse should plan a dietary c tic nc o Mental status changes: not detox the ammonia & now on u on & bizarre o consultation to limit which ingredient? Ask the client for it builds up in the blood. Sleepiness. o n their o n n n oc tion Assess n o n with arms extended. Tell the client to n on Assess n u with on on BLOOD TEST BLOOD TEST those from previous shifts Compare on BLOOD TEST Assess recent oo oo with that o on levels. of previous shifts Lab Values LIVER FAILURE LABS NCLEX TIP Common NC uestions c c n o oc c Trousseau's Which oo values are The ABCs of the liver will Ammonia HIGH Hepatic ncephalopathy expected to be in a be low. Including Low A Albumin o (under 3 5) Calcium o client with worsening liver c o ? NH Calcium from the low o platelets c albumin leading to the B Bilirubin HIGH 2 classic signs - C Coagulation Panel (clotting time HIGH) 1. on o Trousseau’s & Chvostek’s HIGH PT, PTT, INR 2. u n ALT & AST 3. o o n ti PT 4. Albumin 5. Calcium ALT AST o titi  339 Cirrhosis III Med Surg: GI - Gastrointestinal Interventions Common NC uestions A client with worsening liver Ascites Paracentesis Pruritus - itchy skin failure presents to the med-surg floor which assessment A - Ascites 1. Apply a cool moist cloth n n should the nurse A - Abdominal fluid to a ected areas expect 1. 2. Apply moisturizing cream Select all that apply 2 ital Signs over unbroken skin 1. nlarged abdomen from ascites 3 Measure o n 3 ear longsleeved clothes circumference weight 2. Bruise marks on the skin 60.00 cotton gloves 4. HOB UP - High fowlers 3. F ti u and possible confusion Trim n n short 4. Sclera that appears yellow 5. eports of itchy skin HESI A nurse is assisting with a paracentesis Ascites for a patient with ascites caused by cirrhosis ? ? Which ction should the nurse take ? ? ? ? Have the patient Diagnostics Albumin IV Liver biopsy NCLEX TIP NCLEX Increased BP Bounding pulses Albumin IV After procedure Assess vital signs! NCLEX TIP Lay on RIGHT SIDE to Must remain within normal limits prevent bleeding NORMAL = albumin has been cti u n on ti Nursing Care Ammonia Diet Low Protein Low Ammonia Soft toothbrush prevents tic nc o tic nc o lectric ra or Low Sodium Fluid Low Swelling Ascites Monitor blood in stools NO Alcohol Esophageal Varices AVOID alsalva Maneuver: HESI NO bearing down (bowel movements) The nurse is caring for a patient with severe liver cirrhosis and nc nu tion. NO new NGT nasogastric tube hich nursing intervention would prevent nu tion in this patient Provide oral care before meals Pharmacology Neomycin KAPLAN K Lactulose NH Lactulose: NH Lactulose NH NH NH Lose the ammonia NH NH NH K Loose bowels Monitor for hypokalemia K K K K Lose potassium (hypokalemia) Hypokalemia K  340 Hepatitis Med Surg: GI - Gastrointestinal Pathophysiology Type n on efers to an inflammatory condition of the A Fecal-oral (contaminated food) li er, commonly caused by a iral infection. B oo o u Non-viral causes are lcohol C oo o u utoimmune dissease where the body attacks itself D Co-infection with Hep B B here are types, but the most tested are the B & C E Fecal-oral Contaminated drinking water D Causes & Risk MEMORY TRICK C blood body fluids BCD A - Anus to mouth drug use, tatoos, body piercings BC - Blood Cu u haring ra ors nprotected sex E - E Coli water (contaminated water) Signs & Symptoms Normal Liver Disease Signs eadache n Itching pruritus PT Fever A T bilirubin aPTT ALT & AST Jaundice atigue (malaise) Dark colored urine N/V Bilirubin Clay color stools Pale stools PT aPTT Bruising o Albumin Edema Diagnostics Complications o Acute liver failure Education After procedure Cirrhosis Lay on to Liver cancer prevent bleeding 1. Small u n to prevent nausea Gallbladder issues o o n (all liver disease) Low fat foods (until nausea subsides) 2. Frequent o 3 Protected sex Treatments 4. AVOID drinking alcohol Acetaminophen (tylenol) typically resol es on B treated with 5. AVOID sharing shaving ra ors A toothbrushes its own with bed rest C anti iral medications un un Common NC uestion Common NC uestion Common NC uestion Modes of transmission for The nurse is teaching the client with The nurse should incorporate which A client is admitted with A client has titi hat titi this disease is hepatitis C n to ensure optimal nutrition titi and complains of advice should the nurse include characteri ed by which c c during the acute phase of titi c constant c n hat n n n c regarding on n