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65 Cards in this Set
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chronic liver failure
CHEAP |
C=clotting disorders
H=hepatorenal syndrome E=Encephalopathy A=Ascites P=Portal Hypertension |
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Hepatitis
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inflammation of the liver
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What is hapatitis caused from?
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from infection by viral agents or exposure to drugs toxic to the liver or occasionally bacterial infection
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What are the symptoms of Hepatitis?
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range from nearly none to life-threatening symptoms due to death of liver cells
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Hepatitis is usually caused by 6 viruses:
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Heaptitis A=infectious hepatitis
Hepatitis B=serum heapatitis Hepatitis C=Non-A , Non B,(NANB) Hepatitis D Hepatitis E Hepatitis G |
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Hepatitis A
Mode of transmission Incubation period symptoms Diagnostic tests Preventative vaccine Groups at risk |
Mode of transmission=Oral-Fecal contamination of water, oysters, eating utensils or equipment
Incubation period symptoms= 3-7 weeks early (prodromal): fatique, anorexia, malaise, nausea or vomitting Later: Icteric-Jaundice, pale stools, amber or dark urine, RUQ pain, Diagnostic tests=Elevated serum liver enzymes(ALT, AST), elevated serum Bilirubin, Hepatitis Panel-HAV Antigen Preventative vaccine=Immune Globulin-temp.passive, gives antibodies to fight with Groups at risk=military and day care |
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Heapatitis B
Mode of transmission Incubation period symptoms Diagnostic tests Preventative vaccine Groups at risk |
Mode of transmission=Blood or body fluids, such as: saliva, semem and breast milk; equipment contaminated by blood
Incubation period symptoms= 2-5 months Early-Prodromal: 1-2 months of fatique, malaise, anorexia, low grade fever, nausea, headache, abdominal pain, muscle aches may have no early symptoms later: Icteric-Jaundice, rashes Diagnostic tests=elevated serum liver enzymes(ALT, AST), elevated serum bilirubin, HBV antigen Preventative vaccine=immune globulin, or HBIG Groups at risk=IV drug abusers, homosexuals, health care workers, transplant, and hemodialysis patients |
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Hepatitis C
Mode of transmission Incubation period symptoms Diagnostic tests Preventative vaccine Groups at risk |
Mode of transmission=blood transfusions, IV drug users, unprotected sex
Incubation period symptoms=1 week to months: same as HBV, usually less severe Diagnostic tests=elevated liver enzymes (AST, ALT), serum bilirubin, HCV antigen Preventative vaccine=none Groups at risk=same as HBV |
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Hepatitis D
Mode of transmission Incubation period symptoms Diagnostic tests Preventative vaccine Groups at risk |
Mode of transmission=blood or body fluids as with HBV, strongly linked as a confection with HBV
Incubation period =same as HBV and HAV but more severesymptoms=same as HBV Diagnostic tests=same as HAV, HBV but HDV antigen Preventative vaccine=HBIG Groups at risk=same as HBV |
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Neurotransmitters pass through the synaptic knob's membrane into the ____ ___
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Synaptic Cleft
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Pancreas-Lab values
serum glucose >150mg% |
abnormal-elevated because damage to the islets Langerhans causes decreased insulin production
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Pancreas-Lab values
serum amylase>500 IU/L |
the digestive enzyme amylase is released in large quantities by inflammed pancreas
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Pancreas-Lab values
serum Lipase >15 IU/L |
normal 0-160 IU/L
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Pancreas-Lab values
pleural effusion |
abnormal
is caused by a local inflammatory reaction to the irritation from pancreatic enzymes |
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Pancreas-Lab values
blood pressure and pulse 15 % from Pt.'s baseline |
normal
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Pancreas-Lab values
serum albumin<3.2 g/dl normal-3.5 to 5.5 g/dl |
abnormal because albumin is decresed usually from decresed protein metabolism
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Pancreas-Lab values
positive Cullens sign |
abnormal
a positve Cullens sign indicates hemorrhage from pancreatic destruction |
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Pancreas-Lab values
urinary output <30 ml/hr |
abnormal
can indicate hepatorenal syndrome or shock from circulatory collapse |
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Pancreas-Lab values
positive Chvosteks sign |
indicates neuromuscular irritability from decreased serum calcium levels
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Pancreas-Lab values
foul smelling, fatty stools |
abnormal
indicates malabsorption of dietary fats from decreased lipase |
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what is important with a esophageal tamponade with a Senstaken-Blakemore tube?
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keeping a pair of scissors by the bedside
having oral suction available maintaining traction on the tube, if ordered |
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instructions to Pt. with portal hypertension?
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avoid straining to have a bowel movement
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Fulminant liver failure is most often caused by?
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Hepatitis B virus
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Pt with chronic liver failure has asterixis and fetor hepaticus and is confused...these symptoms are related to?
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Hepatic Encephalopathy
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risk factors for gallbladder disease?
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obese
multiple pregancies age 40 or older fasting |
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Pt. with biliary colic...nurse nonsurgical intervention?
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administering probantheline(Pro-Banthine)
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Pt. with pancreatic disease usually has a history of?
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alcohol abuse
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Pt with pancreatitis describe pain as?
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dull, boring, begining in mid epigastrium and radiating to the back
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ascites
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fluid in the abdomen from decreased albumin
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asterixis
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liver flaps
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Cirrhosis
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scarring and hardening of the liver from inflammation
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Encephalopathy
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neurological changes from excess ammonia
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Fetor Hapaticus
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foul breath
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Hepatorenal syndrome
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Oliguria and sodium retention without kisney defects
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Hepatitis
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inflammation of liver cells
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Jaundice
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yellowing of the sclerae and skin from excess bilirubin
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Portal hypertension
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increased pressure in the portal circulation
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Pancreatectomy
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removal of all or part of the pancreas
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Steatorrhea
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fatty, foul smelling stools
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Varices
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weakened, swollen veins
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cholecytisis
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inflammation of the gallbladder
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cholesterol
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composition of gallstones
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Flatulence
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intestinal gas expelled via the rectum
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Murphys sign
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inability to take a deep breath when fingers are pressed under liver margin
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Bilirubin
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pigment from the breakdown of red blood cells
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Extrcorporeal shock wave lithotripsy(ESWL)
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a procedure that shatters gall stones using sound waves
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T-Tube
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a surgical drain used to ensure that bile drains from gallbladder after surgery
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Laparscopic cholecystectomy
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removal of the gallbladder through a small abdominal incision
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Choledochoscopy
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use of an endoscope to explore the common bile duct
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visible veins around the umbilicus
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caput medusae
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liver shunt
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abreviations
TIPS |
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liver flaps
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Asterixes
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Abreviations for infectious hepatitis
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HAV
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confusion and coma are symptoms
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encephalopathy
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this syndrome causes anuria
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hepatorenal syndrome
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liver location
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Right Upper Quadrant
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chronic liver failure is?
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Laennec's Cirrhosis
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collection of fluid in peritoneal cavity
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ascites
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dilated esophageal veins
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varices
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low vitamin K places Pt. with chronic liver failure at risk for?
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bleeding
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IN Chronic liver disease, Lactulose gives Pt diarrhea to?
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keep ammonia levels controled
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Pt with jaundice and dark amber urine...what is most likely the cause?
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bile duct obstruction
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intervetntion that will help a Pt that has had and open cholecystectomy 24 hours ago?
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provide analgesics for pain relief
encourage coughing and deep breathing assist with splinting during coughing |
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serum amylase normal level
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59-160 IU/L
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white blood cell normal count
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5000 to 10,000 cells per mm
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