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Michelle25
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An increase in bilirubin causes what symptom?
Jaundice
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What gerontolical considerations need to be considered involving the liver?
- medication metabolism is decreased
- decrease in size and weight
- decrease in hepatic blood flow
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In viral hepatitis, what should be expected with palpation of the liver?
tenderness
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In alcoholic hepatits, what should be expected with palpation of the liver?
No tenderness
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After a liver biopsy, what nursing interventions is most important?
Turn patient to right side (must remain for 4 hours)
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An acute or chronic inflammation of the gallbladder, usually associated with a gallstone impacted in teh cystic duct, causing painful distention of the gallbladder
Cholecystitis
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What is the most common cause of portal hypertension?
Obstruction caused by cirrhosis of the liver
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_______ becomes evident when the bilirubin level exceeds 2.5 mg/dL
Jaundice
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________ jaundice is caused by cirrhosis or hepatitis
Hepatocellular
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______ jaundice is a result of increased destruction of red blood cells
hemolytic
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______ jaundice is caused by occlusion of the bile duct either from a gall stone, tumor, or enlarged organ. Stools are clay colored.
Obstructive
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What drug is usually given when patient has Ascites?
Aldactone (diuretic therapy)- given b/c it is potassium sparing
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What is the goal of dietary modification in the patient with ascites?
- achieve a negative sodium balance
- avoid salt
- use salt substitutes (very high in potassium)
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______ occurs with profound liver failure
hepatic encephalopathy
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_____ results from accumulation of ammonia and other toxic metabolites in the blood
hepatic encephalopathy
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______ is considered to be the major etiologic factor in the development of encephalopathy
ammonia
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What levels will be sky high in hepatic encephalopathy?
Ammonia levels
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What does lactulose do?`
Increases excretion of ammonia in the stool
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Fecotr hepaticus (sweet, fecal odor to breath), asterixis (flapping temor of the hands), and AMS are all s & s of _________
hepatic encephalopathy
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What are the side effects of lactulose?
- Intestinal bloating and cramping
- Potential for skin break down (due to diaper)
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What sign is monitored because it may indicate medication overdose when taking lactulose?
Watery diarrheal stools
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What nutrtional guidelines do you need to give patient who has hepatic encephalopathy?
- Reduce dietary protein to 20 g/day
- matain low protein, high calorie diet
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what complication can you think of related to balloon tamponade?
- ASPIRATION!
- - patient is already vomiting
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Where do you get hepatitis A from?
fecal/oral
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Where do you get hepatitis B,C, and D from?
blood
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Where do you get hepatitis E from?
fecal/ oral
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______ stores bile. You need to be near bathroom if you eat high fat content foods
Gallbladder
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_________: n & v, pain in the midsternal area of the right shoulder.
cholecystitis (inflammation of the gallbladder)
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The 4 F's are risk factors for what? (fat, forty, flatulent, female)
Cholelithiasis
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What type of vegetable is high in vitamin K?
dark green leafy
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When do we instruct patients to avoid dark green leafy vegetables?
When taking coumadin
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________: patient presents with pain, sometimes jaundie, stool is clay colored or like putty
cholelithiasis
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In which procedure are gallstones visualized and removed?
ERCP: endoscopic retrograde cholangiopancreatography
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What nutritional teaching do you need to provide for patinet with cholelithiasis?
Low fat diet, no eggs, cream, pork fried foods, cheese rich dressing, gas forming vegetables, alcohol
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How long does the procedure take to dissolve gallstones?
6-12 months
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