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82 Cards in this Set
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Paracentesis
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Removal of ascitic fluid from peritoneal cavity
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Steatorrhea
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Excess fat in stools
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hepatomegaly
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enlargement of liver
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Icterus
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Stage of hepatitis marked by jaundice, light or clay colored stools, dark urine, and pruritis
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Preicterus
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Stage of hepatitis marked by malaise, severe headache, R. upper quadraant pain, anorexia, nausea, vomiting, fever, arthralgia, rash, enlarged lymph nodes, uticaria, enlargement and tenderness of liver
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Posticterus
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Stage of hepatitis marked by fatigue, malaise, liver enlargement,
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Jaundice
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Golden yellow color of skin, mucous membranes, and sclera of the eye
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Cirrhosis
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Chronic, progressive Liver disease
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Gynecomastia
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enlargement of breast tissue in males
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Cholecystectomy
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Surgical removal of gallbladder
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Choledocholithiasis
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Obstruction of common bile duct
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Cholelithiasis
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Presence of gallstones
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Ascites
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accumulation of excess fluid in the peritoneal cavity
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Paracentesis
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Removal of ascitic fluid from the peritoneal cavity
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Bilirubin
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Product of normal breakdown of old red blood cells in the liver
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Portal vein
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Delivers blood from the intestines to the liver
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Kupffer cells
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Ingest old red blood cells & bacteria
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Gallbladder
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Stores bile from liver and releases it into duonedum
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hepatic artery
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delivers blood from aorta to the liver
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Pancreatic duct
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connect pancreas to the duonenum
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Common bile duct
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formed by the hepatic duct and cystic duct joining
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Liver
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Large organ responsible for metabolism of glucose, protein,and lipids. Also responsible for detoxification, Production of antibodies& metabolizing adrenocortical hormones, estrogen, testosterone and aldosterone
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Cystic duct
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Passage that delivers bile produced in liver to the gallbladder
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Liver Biopsy
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Removal of a small specimen of liver tissue for study
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Pneumothorax
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Complication of liver biopsy if the lung is accidentally punctured during the procedure
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Ultrasonography
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The use of sound waves to produce an image of an internal orgag
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Liver scan
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a radioactive substance is injected into a vein, and visualized in a radiograph to reveal tumors or abscesses
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Hemorrhage
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Complication of liver biopsy, because of the rich blood supply and potential for impaired coagulation
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Hepatitis A
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Infectious hepatitis, caused by HAV & transmitted through water, food or medical equipment that has been contaminated with infected fecal matter
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Hepatitis B
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caused by HBV spread by intimate contact with carriers, as well as contact with contaminated blood or medical equipment
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Hepatitis C
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Transmitted by contact with contaminated blood, medical equipment or infected body fluids
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Hepatitis D
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caused by the Delta virus and can only survive in the presence of hepatitis B
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hepatitis E
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similar to Hepatitis A most commonly spread through water or food contaminated with fecal matter
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hepatitis G
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Identified in some blood donors, and spread through blood transfusions ( does not appear to chronic hepatitis)
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Noninfectious Hepatitis
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Unknown cause, but may be from exposure to toxins
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Alcoholic Cirrhosis
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caused by alcoholism the liver becomes enlarged and knobby and then shrinks
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Billiary Cirrhosis
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Caused by obstruction of bile flow
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Cardiac Cirrhosis
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Results from Venous congestion and hypoxia
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hepatic encephalopathy
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excessive ammonia in blood resulting in swelling of brain tissue and cognitive disturbances
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Esophageal varices
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Portal hypertension causes collateral vessels to develop in the esophagus and anterior abdominal wall. they are fragile and bleed easily and may cause fatal hemorrhage
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Portal Hypertension
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obstruction of blood coming into the liver causes blood to back up into the portal system
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hepatorenal syndrome
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Renal failure following diuretic therapy, Paracentesis, or GI hemorrhage in the Cirrhosis patient, reason is unknown
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Fatty liver
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Build up of fat cells in the liver caused by excess alcohol consumption. is reversible if alcohol intake ceases
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Alcoholic hepatitis
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inflammation of liver caused by heavy alcohol consumption
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Assessment of Patient with liver disease Present Illness
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Fatigue, weight changes, digestive disturbances, skin changes??
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Assessment of Patient with liver diseases: Past Medical History
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Previous liver disease, hepatitis b vaccination, recent and current medications
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Assessment of patient with liver disease: Review of Systems
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Weakness, fatigue, pruritus, dyspnea, anorexia, abdominal pain, nausea and vomiting, diarrhea, bloody stools, changes in urine or stool color, numbness or tingling in extremities
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Assessment of patient with liver disease: Functional assessment
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Diet, alcohol intake, occupation, exposure to toxins, stress and coping strategies, interpersonal relationships
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Assessment of patient with liver disease: Physical exam
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Vital signs: Hypertension, tachypnea, Height and weight, Skin - dryness, scratches, jaundice, bruises, Eye: sclera icterus, Thorax: spider angiomas, Breast: gyneomatia,Abdomen: distention, prominent veins, girth, liver enlargment
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Assessment of patient with gallbladder disease: Present Illness
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Digestive disturbances, pain - location, onset, intensity, duration, relationship to meals, aggravating and relieving factors,
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Assessment of patient with gallbladder disease: Past medical history
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Gallbladder disease, pregnancy, surgery, recent and current medications
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Assessment of patient with gallbladder disease: Family history
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Gallbladder disease
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Assessment of patient with gallbladder disease: Review of systems
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Pruritis, indigestion, fat intolerance, dyspepsia, nausea, vomiting, light colored stools, dark urine
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Assessment of patient with gallbladder disease: Physical exam
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Vital signs: tachycardia, tachypnea, fever. Skin: dryness, jaundice. Abdomen: guarding, distention
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Assessment of patient with a pancreatic disorder: present illness
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General well-being, digestive disturbances, pain
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Assessment of patient with a pancreatic disorder: Past medical history
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Disorders of biliary tract or duodenum, abdominal trauma or surgery, metabolic disorders, medication history, esp loop diruetics, estrogens, corticosteroids, sulfonamide agents, opiate agents
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Assessment of patient with a pancreatic disorder: Family history
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Pancreatic disorders
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Assessment of patient with a pancreatic disorder: Review of systems
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General survey: restlessness, flushing, diaphoresis. Vital signs: low grade fever, tachycardia, tachypnea, hypotension. Skin: dryness, jaundice, scratches. Abdomen: distention, tenderness, diminished bowel sounds, discoloration
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Cholecytitis Key signs and symptoms
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Episodic colicky pain in epigastric are which radiates to back and shoulder, Indigestion or chest pain after eating fatty or fried foods, Nausea, vomiting or flatulence
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Cholecytitis: Key test results
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Blood chemistry reveals increased alkaline phosphotase, bilirubin, direct bilirubin, transaminase, amylase, lipase, aspartate aminotransferase(AST) and lactate dehydrogenase (LD) levels. Cholangiogram shows stones in biliary tree
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Cholecytitis: Key treatments
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Laproscopic cholecystectomy or open cholescystectomy. analgesic morphine
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Cholecytitis: Key interventions
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Monitor abdominal status and pain, Provide postop care( monitor dressings for drainage, if open cholecystectomy monitor and record T-tube drainage, monitor incision for signs of infection, get client out of bed asap, encourage PCA, Maintain the position, patentcy and low suction of NG tube
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Cirrhosis: Key signs and symptoms
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Abdominal pain, anorexia, ascities, fatigue, jaundice, nausea, vomiting
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Cirrhosis: Key Test results
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Liver biopsy; definitive test detects destruction and fibrosis of hepatic tissue, CT scan with IV contrast reveals enlarged liver, identifies liver masses, and hepatic blood flow and obstructions
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Cirrhosis: Key Treatments
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Blood tranfusions, Gastric intubation, and esophageal balloon tamponade for bleeding esophageal varices, IV therapy using colloid volume expanders or crystalloids . hemostatic vasopressin for esophageal varices, Diuretics (lasix and spironolactone for edema ( requires careful monitoring. Vitamin K for bleeding tendencies due to hypoprothrombin
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Cirrhosis: Key Interventions
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Monitor respiratory status, frequently reposition patient, Monitor for signs of bleeding, Observe for behavior or personality changes ( increased stupor, lethargy, hallucinations, and neuromuscular dysfunction. Monitor level of consciousness. Monitor ammonia levels. Carefully evaluate before, during and after parecnetesis
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Pancreatitis: Key signs and symptoms
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abdominal tenderness and distention, abrupt onset of pain in epigastric region radiating to shoulder, substernal area back and flank. Aching, burning, stabbing, pressing abdominal pain, nausea, vomiting, tachycardia, and tachypnea
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Pancreatitis: Key Test results
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Blood chemistry shows increased amylase, lipase, LD, glucose, AST, & lipid levels, decreased calcium, and potassium levels, cullen's sign is positive, Grey Turner's sign is positive, Ultrasonography reveals cysts, bile duct inflammation, and dilation
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Pancreatitis: Key Treatments
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Bedrest, IV fluids, Transfusion therapy with packed RBCs, analgesic morphine antidiabetic insulin, corticosteroids, potassium supplements
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Pancreatitis: Key Interventions
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Monitor cardiac, abdominal and respiratory status, evaluate fluid balance, perform bedside glucose monitoring, Monitor IV fluids, turn client every 2hrs
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Advantages of the use of shunts for cirrhotic ascites
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provides a mechanism to collect protein rich ascitic fluid and return it to the vascular system and Increases urine output which eliminates excess sodium and water
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Fulminate liver failure
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Liver failure associated with injury
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Corticosteroids and immunosuppressant agents
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Used to prevent liver transplant rejection
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Pancreatic enzymes
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Tripsin - protein digestion
Amylase - Starch, sucrose & fructose digestion Lipase - fat digestion |
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Gluconeogenesis
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synthesis of glucose from substances other than carbohydrates
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Glycogenesis
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Formation of glucagon from glucose
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Glycogenolysis
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splitting of glycogen into glucose
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Early signs of shock
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Tachycardia and restlessness
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Late signs of shock
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Hypotension
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Urine output for a patient with pancreatitis
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At least 40ml per hour
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Signs and symptoms of inadequate pancreatic enzymes
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Steatorrhea - Bulky, frothy stools with high fat content
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3 kinds of alcohol-induced liver disease
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1. fatty liver disease
2. Alcoholic hepatitis 3. Alcoholic Cirrhosis |