NURS460_GI

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Author:
GerberTri
ID:
23265
Filename:
NURS460_GI
Updated:
2010-06-13 11:16:18
Tags:
Critical Care Nursing Lab Values
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Description:
GI
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  1. Lactulose use, route
    • d/c ammonia levels
    • Route: PO, NGT, enema
    • *treats/prevents hepatic encephalopathy
  2. Kayexalate use, route
    • Use: d/c K+ levels
    • Route: PO, NGT, enema
  3. Protonix/Nexium use
    Prophylaxis of PUD
  4. Vitamin K use, alternative
    • I/c ability to clot
    • *coumadin pts with i/c PT, end stage renal disease
    • Alternative: fresh frozen plasma
  5. Sandostatin (octreotide): use, route
    • Use: esophageal varices, GI bleed (vasoconstrictor specific GI system)
    • Route: IV
  6. Ammonia
    • 15-49
    • ^ indicates hepatocyte damage (liver ocnverts NH3 to urea)
    • i/c --> hepatic emvephalopathy
    • s/s: change in LOC, neuromuscular disturbances, impaired thinking
    • tx: lactulose
  7. Hgb/Hct
    • Hgb: 12-18
    • Hct 40-55
  8. ALK Phos
    • 20-90
    • LFT
    • ^ obstructive jaundice, intrahepatic cholestasis, liver metastasis, or granulomas
    • *liver issues (shock, cirrosis)
  9. Albumin
    • 35-55
    • d/c: cirrhosis, chronic hepatitis
    • Low levels show evidence of ascites
    • *acts by drawing fluid from the interstitial ot he intravascular spaces
  10. Total bilirubin
    • 0.2-1.3
    • Direct: Abnormal in biliary and liver disease; causes clinical jaundice
    • Indirect: bnormal in hemolysis and in functional disorders of uptake or conjugation
    • (liver not changing unconjugated bili to conjugated bili/liver holding on to RBC due to failure--jaundice)
  11. magnesium
    • 1.3-2.2
    • d/c in alcoholics
  12. amylase
    • 25-125
    • ^ Peak with acute pancreatitis, then fall to normal with 48-72 hrs.
    • Low indicates pancreatic insufficiency

  13. lipase
    • 10-40
    • ^ only in pancreatitis, markedly in acute pancreatitis an dpancreatic duct obstruction
    • -remains elevted after amylase returns to baseline
  14. WBC
    4.5-11
  15. PT
    • 11-14 sec
    • Prolonged in liver disease (will not return to normal with vitamin K administration)
  16. PTT
    • 25-36
    • Increased with severe liver disease or therapy with anticoagulants
  17. 9 functions of the LIVER
    • 1. carbohydrate metabolism
    • 2. protein metabolism
    • 3. fat metabolism
    • 4. bile production and excretion
    • 5. metabolism of steroid hormones
    • 6. vitamin storage
    • 7. drug metabolism
    • 8. synthesis of clotting factors
    • 9. blood filtration
  18. 3 types of carbohydrate metabolism
    • glycogenesis
    • glycogenolysis
    • gluconeogenesis
  19. glycogenesis
    • Glucose to glycogen
    • conversion of excess carbs to glycogen as reserve
  20. glycogenolysis
    • Breakdown of glycogen to glucose
    • converts large stores of glycogen in muscle and liver to glucose
  21. Gluconeogenesis
    • Formation of glucose from amino acids or fatty acids
    • Formation of glucose from non-carb substrates (fat, muscles--amino acids, glycerol).
    • -When the body changes from aerobic to anaertobig metabolism and lactic acid is produced
  22. 3 types of cirrhosis
    • 1. Alcoholic (most common)
    • 2. post-necrotic
    • 3. biliary
    • 4. cardiac
  23. Treatment of GI bleed
    • IVG (colloids/crystalloids)
    • Labs: H&H
    • Endoscopy
  24. Pancreatitis s/s
    • Abdominal pain, N/V, fever, jaundice, elevatd amlase, lipase, WBC
    • Hypokalemia, hypocalcemia
  25. Treatment of pancreatitis
    NPO, TPN, IVF, NGT, PUD drugs
  26. Risks with pancreatitis
    • ETOH use
    • I/C risk for ARDs

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