Term
|
Definition
CBC Complete Blood Culture —anemia, infection, detects changes in the elements of the blood.
GI bleeding is the most frequent cause of anemia in adults |
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Term
|
Definition
| liver enzyme elevated in most liver disorders |
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Term
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Definition
Fecal occult blood tests
Stool examination for ova, parasites, and bacteria |
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Term
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Definition
| ALT—liver enzyme elevated in most liver disorders |
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Term
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Definition
| begin to elevate within 12-24 hours of onset of acute pancreatitis and may remain elevated for 3-5 days |
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Term
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Definition
| more specific b/c can stay elevated for up to 2 weeks, so those who may not seek attn until much later can still be DX |
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Term
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Definition
| primary pigment in bile which is made and excreted by the liver and biliary system, evaluates liver and biliary tract fxn and measurement of jaundice. |
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Term
| Carcinoembryonic antigen (CEA) |
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Definition
| measures the amount of protien in the blood for people with some cancers. But can also be elevated in non malignant conditions. |
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Term
| Abdominal X-ray can reveal |
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Definition
Masses
Tumors
Strictures
Obstructions
Free air in bowel
Needs no special preparation
Normal x-ray
No special prep
Severe abdominal Pain—abdominal series is ordered which consists of CXR (may reveal hiatal hernia)supine abdominal film
upright abdominal film (assess for air in the peritoneum which would indicate a bowel perforation) |
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Term
| Computed Tomography (CT Scan |
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Definition
Purpose- to detect tissue densities and abnormalities in the abd, liver, pancreas, spleen, and biliary tract
Client Prep- with or without contrast (IV or PO contrast may be used), NPO 4 hours prior if contrast used, IV access |
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Term
| Upper GI Radiographic Series |
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Definition
Purpose-detect abnormalities of the esophagus, stomach, or duodenum (hiatal hernias, ulcers)
Client Prep- NPO (8hrs), PO contrast, no opioids or anticholinergic meds for 24 hrs prior |
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Term
| Upper GI radiography series 2 |
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Definition
Opioids slows GI MOTILITY.
Fluoroscopy used to track barium thru esophagus and stomach. Position of pt is changed several times during the test to coat the mucosa. If doctor also wants to see into the small bowel, then additional barium is consumed and more films are taken at different intervals. |
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Term
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Definition
Purpose- detect changes in large intestines
Client Prep- clear liquids only 12-24hrs prior, NPO 8hrs prior, bowel cleansing night before exam
Follow-Up Care- same as upper GI
Test usually done if pt c/o mucous or blood in the stool, or a change in bowel pattern (diarrhea or constipation), can also detect a bowel obstruction.
GoLytely prep is typically used for bowel cleansing |
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Term
| Esophagogastroduodenoscopy (EGD |
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Definition
Purpose- visualize the mucosal lining of esophagus, stomach, and duodenum
Client Prep- NPO at least 8 hrs prior
Follow-up Care- NPO until gag reflex returns, check temp freq for first 2 hrs post-procedure, begin with clears and advance as ordered |
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Term
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Definition
Can detect inflammation, ulcers, tumors, varices, etc.
TEMP, PAIN, OR BLEEDING are signs of perforation.
Local anesthetic is sprayed on throat prior to insertion of scope.
These exams are preferred over the Upper GI because of the direct visual, and quicker results. But this is obviously an INVASIVE PROCEDURE. |
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Term
| IMPORTANT THING ABOUT UPPER GI SERIES |
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Definition
| DRINK DRINK DRINK PLENTY OF FLUIDS STOOL CAN BE CHALKY WHITE. THIS CAN CONSTIPATE THEM. THEY NEED TO DRINK LOTS OF WATER AND FLUIDS! |
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Term
| Endoscopic Retrograde Cholangiopancreatogrophy (ERCP) |
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Definition
Ask about prior exposure to x-ray dyes and any allergic rxn or sensitivities, may need to give prednisone and benadryl if has had rxn or has asthma.
Endoscope is advanced further to the duodenum and the biliary tract. Once cannula is in the CBD the contrast medium is injected and pictures are taken to evaluate the biliary tract.
Can take up to 2 hours. |
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Term
| Endoscopic Retrograde Cholangiopancreatogrophy (ERCP) |
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Definition
Purpose- visualize the liver, gallbladder, bile ducts and pancreas, and determine obstructions
Client Prep- same as EGD
Follow-up Care- same as EGD, also educate on s/s of possible pancreatitis (nausea, abdominal pain, and elevated temp) |
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Term
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Definition
| s/s: Nausea, vomiting, severe abdominal pain jaundice turners sign, cullens sign, shock, coma and death |
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Term
| Gastroesophageal Reflux Disease (GERD) |
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Definition
Backward flow of GI contents in to the esophagus
S/S- dyspepsia, regurgitation, chronic cough especially @ noc, chest pain, dysphagia, odynophagia (painful swallowing)
Tx- diet changes, education, lifestyle changes, drug therapy, endoscopic therapy, surgery |
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Term
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Definition
Occurs when the gastric volume or intraabdominal pressure is elevated, the sphincter tone of the lower esoph sphinc is decreased (located 2-4 cm above gastoesoph junction), or the LES undergoes inappropriate relaxation
pH of normal esophagus is neutral @ 6-7, GI contents are highly acidic @ 1.5-2, so continual exposure to these contents result in an erosion of esoph mucosa
Complications associated with GERD |
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Term
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Definition
Lifestyle changes- HOB up at least 6 in, stop alcohol and smoking b/c these cause decrease LES pressure, wt reduction for obese client, do not wear restrictive clothing
Diet therapy- avoid foods that dec LES pressure (choc, fat, mints) and foods that can delay esophageal healing (spicy, acidic i.e OJ and tomatoes) carb. bev increase intra-abdom pressure, eat 4-6 small meals/day, don’t eat for 3 hrs prior to sleep. |
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Term
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Definition
Purpose- view large bowel for things such as: obtaining bx, removing polyps, evaluate cause of chronic bowel problems, locate source of GI bleeding
Client Prep- clear liquids 12-24 hrs prior, NPO 6-8hrs prior, bowel cleansing night before
Follow-up Care- VS monitoring freq, monitor for s/s of perforation and hemorrhage
Will have lots of gas afterwards (feeling of fullness & cramping) |
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Term
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Definition
Sedation with usually Versed & Demerol Nursing considerations
chill prep to make it more bearable to the pt and they should drink it quickly
teaching- fullness, cramping and gas is expected for a while after the test (due to the instillation of air during the procedure to aid in visualization), if polypectomy was done there may be some bleeding with the first stool, EXCESSIVE bleeding should be reported to the MD,
baseline chemistry should be done if certain bowel preps are done due to fluid and electrolyte loss |
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Term
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Definition
| protrusion of a portion of the stomach thru an opening (hiatus) in the diaphragm lying next to the esophagus. |
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Term
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Definition
| Sliding- part of stomach “slides” thru the hiatal opening into the thoracic cavity when pt is supine, and goes back into abd cavity when standing upright |
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Term
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Definition
| Rolling (paraesophageal) fundus and greater curvature of the stomach “roll” up thru the diaphragm, forming a pocket alongside the esophagus. |
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Term
| Hiatel hernia diesease process |
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Definition
Causes- weakening of diaphragm muscles around esophagogastric opening, factors that increase intra-abdominal pressure (obesity, pregnancy, ascites, tumors, physical exertion, heavy lifting), trauma, poor nutrition, and a forced recumbent position (bedrest) are also predisposing factors.
S/S- similar to GERD, and may mimic GB disease, angina, and peptic ulcer disease. MAY BE ASYMPTOMATIC. |
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Term
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Definition
| 2 reasons, suction or feeding to give bowel a rest |
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Term
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Definition
Esophageal Cancer- squamous-cell most common, adenocarcinoma is increasing in incidence
Predisposing Factors—Smoking, Excessive alcohol intake, Chronic trauma, Barrett’s esophagus, Spicy foods, Poor oral hygiene
S/S- usually don’t appear until later stages but may include: dysphagia, pain (epigastric, substernal, back) that increases with swallowing |
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Term
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Definition
May necessitate surgical removal of part or all of the esophagus. Radiation tx is also used. Because the s/s are usually not seen until late in the disease process, prognosis is poor.
Remove part of the esophagus and anastomosis remaining part to the stomach (esophagogastostomy), resxn portion of esophagus and anastomosis of a segment of the colon to the remaining part (esophagoenterostomy). |
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Term
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Definition
| where intestinal tissue begins to replace esophogeal tissue |
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Term
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Definition
inflammation of the gastric mucosa
Causes- ASA, NSAIDS, alcohol, smoking, radiation, NG sxn, endoscopic techniques, Helicobacter pylori
S/S- abdominal pain,anorexia, N/V, epigastric tenderness, feeling of fullness, and possible hemorrhage with alcohol abuse |
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Term
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Definition
Results from the breakdown in the normal gastric mucosal barrier that normally protects the stomach tissue from autodigestion by acid an the enzyme pepsin.
ASA & NSAIDS- irritating to gastric mucosa
Alcohol—local destruction of epithelial cells, can progress to mucosal destruction, edema, and hemorrhage |
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Term
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Definition
Pepsinogin is activated to pepsin in the presence of HCL acid and a pH of 2-3
Normal stomach mucosa can repair itself except in extreme instances when cell breakdown surpasses the cell renewal rate.
Peptic ulcers develop in the presence of an acid environment, but excess gastric acid is not necessary.
H-pylori has also been known to play a role in peptic ulcers |
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Term
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Definition
S/S- not uncommon to be asymptomatic, but when symptoms DO occur, usually burning, cramping, back pain depending on the location of the ulcer.
LABS- monitor H/H & coag studies monitor VS and replace volume loss via IV fluids or blood products |
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Term
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Definition
Erosion of the GI mucosa resulting from the digestive action of HCL acid and pepsin
Acute- minimal inflammation and superficial erosion, short duration and quickly resolved when cause is identified and removed
Chronic- long duration, eroding thru muscular wall with the formation of fibrous tissue. May be present intermittently throughout life, or for several months |
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Term
| Pud diff between dupdenal and gastric |
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Definition
Duodenal ulcer has pain with empty stomach and discomfort is relieved with food or antacids, Normal appetite.
Gastric Pain with food and vomiting relieves pain. assoc. with anorexia, etc |
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Term
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Definition
| h. pylori raises the incidence of cancer. spread by direct extension into tge pancreas via the lymphatics. occurs in the lesser curvature. |
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Term
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Definition
No specific etiology, only risk factors.
family HX
h. pylori infection
low socioeconomic status - poor diet
radiation
tobacco smoke
asbestos
high alchohol intake
more common in men |
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Term
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Definition
often very vaguepresence of masses
weight loss
feeling of fullness
vomit that looks like coffee grounds
blood in stool may result in anemia
mild indigestion + mild fatigue |
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Term
| Gastric Cancer Diagnostic tests |
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Definition
Upper GI tract x ray exam
gastroscopy
gastric acid stimulation test
CBC
liver function test
radioimmunoassay |
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Term
| Gastric Cancer Assesments |
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Definition
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Term
| gastric Nursing Diagnosis |
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Definition
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Term
|
Definition
weakness in the abdominal muscle wall thru which a segment of bowel or other abd structure protrudes
Inguinal, Umbilical, Incisional are most common |
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Term
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Definition
chronic GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abd pain and bloating.
chronic GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abd pain and bloating. |
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
hereditory tendency
more common in women, young middle aged
can also be caused by other illness, infections, or the menstrual cycle |
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Term
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Definition
| Mechanical- bowel is obstructed by disorders outside of the intestine or by blockages in the lumen of the intestine |
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Term
| intestinal obstruction non mechanical |
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Definition
| Nonmechanical (paralytic ileus)- result of neuromuscular disturbance resulting in decreased or absent peristalsis causing back up of intestinal contents |
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Term
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Definition
Mechanical- disorder= hernias, adhesions, twisting of the intestine blockages=tumors, strictures, fecal impaction, inflammation
Complications- intestinal contents accumulate at and above obstruction---results in intest distention b/c unable to absorb contents and mobilize them down tract-peristalsis increases to compensate for lag-stimulates more secretions which increases distention-causes edema with increased capillary permeability-plasma leaks into peritoneal cavity-F&E absorption is decreased-reduced circulatory blood volume and electrolyte balances occur-hypovolemia which can cause many other problems. |
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Term
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Definition
Barrett’s epitelium- epithelial lining that the body substitutes for the normal lining in the lower esophagus during the healing process that becomes more resistent to acid, but is considered pre-malignant and increases risk for CA in pts with prolonged GERD
Fibrosis and scarring that accompany the healing process results in the narrowing of lumen (stricture) that causes dysphagia
esophageal ulceration
hemorrhage
aspiration pneumonia |
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Term
|
Definition
Drug Therapy- Antacids (Maalox, Mylanta, MOM, TUMS) for occ episodes, increase the pH of gastric contents, Histamine Antagonists (Pepcid, Zantac, Tagamet, ), PPIs (Prilosec, Prevacid, Protonix, Nexium)
Endoscopic therapy and surgery are rare, no need to discuss |
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Term
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Definition
Begins as slow growing tissue or sysplasia in esophagus.
infiltrative tumors of esophogus expand locally and rapidly causing wall thickening and narrowing of lumen |
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Term
| Esophageal cancer Etiology |
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Definition
SCC- cigarette smoking or alcohol consumption.
HPV found in 70% of cases
AC barrett's esophagus, obesity, eating smoked meats, poor intake of Vitamin a & C, Magnesium, selenium, zinc |
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Term
| Know transmisson of Hepititis |
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Definition
Hepatitis- inflammation of the liver
Hep A- transmitted fecal-oral route
Hep B- transmitted sexually, percutaneously, perinatal, human bile
Hep C- percutaneously, and less frequently sexually and perinatally |
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Term
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Definition
Follow-up Care- none specific unless sedation was needed
CT helps analyze at different depths so much more detailed than Xray.
MUST ask about seafood (shellfish) and iodine allergies if IV contrast is used
Remove jewelry or metal
Lie still and hold breath while pictures are taken
May take 1-2 hours to complete |
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Term
| Upper Gi radiographic series |
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Definition
| Follow-up Care- drink plenty of fluids to eliminate barium. Laxative may be given. Stool may be chalky for 24-72 hrs after exam. |
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Term
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Definition
ursing consideratons
Informed consent- explain procedure, risks, etc.
manage discomfort afterwards (throat lozenges, analgesics)
NPO until gag reflex returns
Monitor VS frequently for first 2 hours or follow facility standards |
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Term
|
Definition
Can actually remove stones in the CMD during procedure.
Can induce pancreatitis, cholangitis, perforation, & sepsis. May present anywhere from a few hours to several days after procedure. High fever, abd pain, N/V that does not resolve. |
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Term
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Definition
DX Study- Barium Swallow
Surgical Therapy- Nissen Fundiplication (Laparscopic or Open)
Wrapping the fundus of the stomach around the esophagus to reduce the hernia, provide more appropriate LES pressure, and prevent movement of the gastroesophageal junction.
Complications – too loose-reflux isn’t prevented; TOO TIGHT– dysphagia & gas bloat syndrome occur |
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Term
|
Definition
Post-op Teaching- report heartburn, regurg, dysphagia, epigastric fullness, bloating
avoid foods that are gas-forming
chew food thoroughly
pt will NOT be able to voluntarily belch or vomit immediately after surgery, may also have mild dysphagia post-op due to edema 2 to surgical trauma, but this should resolve.
HIATAL HERNIAS CAN USUALLY BE TX SUCCESSFULLY WITH DIET, MED, AND LIFESTYLE CHANGES. |
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Term
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Definition
Nursing DX
altered nutrition (may necessitate need for feeding tube)
Pain
Fluid Volume Deficit
risk for aspiration
anxiety |
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Term
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Definition
-pylori- Type B gastritis- involves the antrum of the stomach- acquired in childhood and is able to survive the hostile environment of the gastric lumen. It is able to promote breakdown of gastric mucosal barrier under CERTAIN conditions, thus having a destructive effect on its host environment.
Nursing Mngmt
NPO, IV fluids, meds for N/V, occ NG tube to keep stomach empty of precipitating toxins |
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Term
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Definition
omplications- hemorrhage (caused by erosion of the granulation tissue at he base of the ulcer during healing process or erosion of the ulcer thru a major blood vessel), perforation (most lethal complication gastric more lethal than duodenal, spillage of gastric or duodenal contents into the peritoneal cavity), gastric outlet obstruction (caused by scarring, edema, inflammation, symptoms include abd bloating, N/V) will need NG tube until healing can occur.
Upper GI bleeding- coffee ground vomit, or bright red depending on location of bleed, tarry stools, |
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Term
| intestinal obstruction cont |
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Definition
Mngmt
NG tube decompression, IV fluids, TPN, NPO, pain mngmt (opioids not recommended b/c of constipation effects), drugs to increase GI motility (sandostatin, reglan)
Nursing Mngmt
teaching, VS, fluid mngmt, NG tube mngmt, I&O,
Surgical mngmt
exploratory lap, colon resxn, possible temp or permanent colostomy, tumor removal |
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Term
|
Definition
inflammation of the appendix
Causes- obstruction of the lumen by accumulated feces, foreign bodies, tumor of the cecum or appendix, or thickening of mucosa.
S/S- increased WBCs, peri-umbilical pain eventually shifting to RLQ, rebound tenderness, N/V, anorexia, possible low-grade fever
Tx- surgical removal, abx therapy prior to OR if ruptured |
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Term
|
Definition
- chronic, nonspecific inflammatory bowel disorder that can affect any part of GI tract but mainly terminal ileum, jejunum, and colon.
S/S- diarrhea, abd pain, cramping, tenderness developing into wt loss, malnutrition, dehydration, electrolye imbalances |
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Term
|
Definition
Areas of involvement are not continuous and will often see areas of normal bowel b/t diseased portions. Ulcerations will develop and penetrate b/t islands of inflamed, edematous mucosa. Thickening of the bowel wall occurs as well as narrowing of the lumen with stricture development. Abscesses or fistula tracts that communicate with other loops of the bowel , skin, bladder, rectum, or vagina may develop
Attacks are unpredictable and intermittent usually recurring over a period of several weeks to months. |
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Term
|
Definition
inflammation and ulceration of the colon and rectum starting distally and spreading upward
S/S- abd pain, bloody diarrhea, fever, wt loss, tachycardia, dehydration
Complications- hemorrhage, perforation, colon CA, dilation and paralysis of the colon
TX- meds, surgery, diet changes (low-residue diet |
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Term
|
Definition
Abscesses develop in the intestinal glands breaking thru submucosa and leaving ulcerations that destroy mucosal epithelium causing bleeding and diarrhea
Meds- antimicrobials, corticosteroids, anticholinergics (dec GI motility and muscle spasms), antidirrheals
Proctocolectomy with ileostomy (perm)- remove colon, rectum, anus with closure of the anus with perm ileostomy
DIET- NPO initially, high calorie, high protein, low residue diet |
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Term
|
Definition
Cause: low-fiber diets
Diverticula- outpouching of mucosa throught he smooth muscle of intestinal wall
Diverticulosis- presence of many diverticula
Diverticulitis- inflammation of one or more diverticula resulting when it perforates and a local abscess forms
S/S- over affected area of colon, fever, chills, nausea, anorexia |
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Term
|
Definition
Diverticulitis- is related to the retention of stool and bacteria in the diverticula forming a hardened mass that causes inflammation and usually small perforations. This can spread to surrounding areas of the intestines causing tissue to become edematous and possilby lead to perforation with peritonitis.
Complications- perf w/peritonitis, abscess and fistula formation, bowel obstruction, uteral obstruction, bleeding |
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Term
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Definition
| Causes thought to be related to low dietary fiber which slows transit time and more water is absorbed from the stool making it harder to pass through the lumen. Decreased bulk of the stool along with narrowed lumen in the sigmiod colon causes high intraluminla pressures which contribute to the formation of diverticula. |
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Term
|
Definition
- chronic, progressive disease of the liver characterized by destruction of liver cells causing scarring.
Common Causes- hepatitis & alcoholism
Early S/S- GI disturbances, RUQ abd pain enlarged liver and spleen, fatigue
Late S/S- jaundice, ascites, peripheral edema
Complications- portal HTN, ascites, jaundice, bleeding esophageal varices, coagulation defects |
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Term
|
Definition
| Jaundice- result of derangement of liver cells and compression of bile ducts by connective tissue overgrowth resulting in a decreased ability to excrete bilirubin. If obstruction of the biliary tract occurs it may cause pruritis as a result of accumulation of bile salts underneath the skin. |
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Term
|
Definition
| HTN- persistent increase in pressure within the portal vein resulting from an increased resistence to or obstruction of the flow of blood. The blood flow meet resistance and seeks alternate venous channels around high pressure areas. Blood flow backs up into the spleen causing splenomegaly. Veins in the esophagus, stomach, intestines, abd, and rectum become dilated. |
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Term
|
Definition
| varices- thin-walled esoph veins become distended from increased pressure from the blood that has backed up from the liver into these vessels that are supposed to carry it to the systemic circulation. Most often occur in the distal esophagus. Eventually they will become too engorged from high pressure causing irritation and ulceration and they will eventually rupture. Alcohol, poorly chewed food, acid reflux, vomiting, coughing, or sneezing may precipitate the rupture. |
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Term
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Definition
| accumulation of serous fluid in the abd cavity. Proteins move from the blood vessels to the lymph space as a result of portal HTN. When the lymphatic system is unable to carry off the excess proteins and water, they leak through the liver into the peritoneal cavity. The osmotic pressure of the proteins will pull additional water in to the cavity. Pt will exhibit signs of dehydration, and a decreased urinary output from increased ADH levels. |
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Term
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Definition
| decreased bile synthesis in the liver results in prevention of fat-soluable vitamin absorption (Vit K). Without Vit K, certain clotting factors are not produced in sufficient quantities, and pt is prone to bleeding and bruising. So prothrombin time will be increased |
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Term
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Definition
inflammation of the liver
Hep A- transmitted fecal-oral route
Hep B- transmitted sexually, percutaneously, perinatal, human bile
Hep C- percutaneously, and less frequently sexually and perinatally |
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Term
|
Definition
HEP A- usually small outbreaks by fecal contamination of food or drinking water. Practice good handwashing techniques. IMMUNE GLOBULIN given up to 2 weeks after exposure to hepatitis A. HEP A vaccine can be given to prevent it (going to country with high rate).
Hep B- first line of defense is the HBV (hep B vaccine) b/c most effective. 3 injections (1st, 1 month, 6 months). Post exposure –HBIG (hep B immune globulin) should be given within 24 hours of exposure. THIS IS MOST COMMON HEP HEALTH CARE WORKERS WILL BE EXPOSED TO. |
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Term
|
Definition
Hep C- nothing to prevent Hep C. person should have baseline blood work done to test for antibodies to HCV. Presence of antibodies is a marker for acute or chronic infection
LABS- elevated bilirubin, AST & ALT (will decrease as jaundice disappears), prothrombin time |
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Term
|
Definition
COMPLICATIONS- fistulas (can cause UTI in urinaty tract), scar tissue narrows lumen causing obstruction, inflammation predisposes pt to perforation, abscesses and peritonitis, impaired absorption of fat (A,D,E, K deficiency due to this)
DX tests barium studies, colonoscopy, sigmoidoscopy, bx performed
TXS- corticosteroid to dec inflam, flagyl in chrohn’s of perianal area, TPN to give bowel rest, promote wound healing, and reuce complications, no milk or milk products, SURGERY with severe symptoms
Discuss Nurs DX for Chrohn’s and possible surgery and pre/post op interventions |
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Term
|
Definition
DX- Barium Enema, stool for occult blood, colonoscopy
Acute Care- NPO, ABXS, IV fluids, NG sxn, POSSIBLE SURGERY (resect obstructing inflammatory mass or to drain abscess, possible temp colostomy until colon is healed then reanastamosis is done)
General Care- high residue diet, stoll softeners,clear liquids, oral abxs, bulk laxatives |
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Term
|
Definition
Cholecystitis- inflammation of the gallbladder caused by gall stones or bacteria. Cystic duct may become occluded and wall of GB will scar.
Cholelithiasis- stones in the gallbladder thought to be caused by precipitation of cholesterol, bile salts, and calcium. |
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Term
| S/S of Cholecystitis and Cholelithiasis |
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Definition
Objective: evidence of inflammation, (increased TPR), vomiting, jaundice
Subjective: c/o epigastric pain, RUQ tenderness, nausea,
Biliary Colic: severe, steady epigastric pain caused by a blocked common bile duct. Pain will often radiate to RUQ, back and rt shoulder |
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Term
|
Definition
Stones are primarily cholesterol.
S/S- cholecystitis- indigestion, mod-sever pain in RUQ radiating to rt shoulder and scapula, N/V, fat intolerance, heartburn, flatulence
S/S lithiasis- maybe none unless stone moves up thru common bile duct causing spasms and severe pain called BILIARY COLIC. Will usually occur 3-6 hours after heavy meal or when lying down. Will begin suddenly and lasts 1-3 hours. JAUNDICE present due to the blocked duct. |
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Term
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Definition
Acute Pancreatitis- acute inflammation of the pancreas caused by biliary disease, alcoholism, trauma, viral infections, others
S/S - abdominal pain LUQ or mid-epigastric radiating to the back, rigid abdomen, respiratory problems r/t fluid in retroperitoneal space, shallow resp r/t pain, N/V, low-grade fever, jaundice.
Complications-
Dx Tests- |
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Term
|
Definition
Acute- NSAIDS, oral contraceptives, thiazide diuretics), penetrating duodenal ulcer
S/S- abdominal pain LUQ or mid-epigastric radiating to the back. Aggravated by eating and is sudden, severe, and steady. N/V, low-grade fever, tachycardia, jaundice, Cullen’s Sign (bluish discoloration around umbilicus caused by blood stained exudate that seeps from pancreas. |
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Term
|
Definition
S/S Chronic- abd pain, ascites, wt. loss, jaundice, dark urine, steatorrhea due to malabsorption syndrome (clay colored stools, fatty, foul smelling),
LABS- Lipase more specific than amylase, elevated WBC. Elevated serum glucose levels
Nursing DX- nausea, pain, ineffective breathing pattern, imbalanced nutrition: Less than (main ones) |
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Term
|
Definition
Chronic Pancreatitis- progressive destructive disease related to alcoholism and/or chronic obstruction of the CBD
S/S - epigastric & LUQ pain , wt loss, anorexia, steatorrhea, diabetes late in disease.
Complications-
Dx Tests- |
|
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Term
|
Definition
| Systemic complications– hyperglycemia (decreased insulin release and increased glucagon release d/t damaged pancreatic cells), pulmonary due to passage of exudate containing pancreatic enzymes from the peritoneal cavity through the transdiaphramatic lymph channels |
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Term
|
Definition
Diagnosis – GB US to detect stones best because doesn’t require contrast medium. Stones may be retrieved via ERCP.
TX stones- removal, ESWL (lithotripsy to break up stones) after which they will pass through the CBD into the small intestine. Mixed success with this procedure, but will not produce pancreatitis like ERCP may.
Cholecystitis- diet teaching (low fat decreases GB stimulation, drugs to tx symptoms of pain, N/V, anticholinergics to relax smooth muscle (Atropine), of course surgery.
DISCUSS NURS DX FOR PTS WITH THESE |
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