Portal HTN, colonoscopy, ascites

What is portal HTN?

persistent elevated BP in the portal venous system

• occurs as result of fibrosis/cirrhosis, hemochromatosis, hepatitis

what is the treatment for portal HTN?

TIPS procedure - shunt placement to connect portal and hepatic veins/bypass liver

What are the potential complications of portal HTN?

• Varices

• Splenomegaly

• Ascites, hydrothorax

• Hepatic encephalopathy

• distention, caput medusae

What is a colonoscopy?

procedure done to visualize colon up to ileocecal valve

What is a colonoscopy performed for?

• diagnose/treating:

  • IBD

  • tumors

  • polyps

  • strictures

What are the potential complications of colonoscopy?

• perforation

• bleeding

• sedation reactions

• infection

what are the potential post-procedure complications of colonoscopy?

• bleeding

• reactions to sedation

• infection

• perforation

what is ascites?

build-up of serous fluid in the peritoneal or abdominal cavity

what is a paracentesis?

sterile procedure where a catheter is used to draw fluid from the abdominal cavity

what are the causes of ascites?

• liver cirrhosis, HF, Kidney failure

• cancer, TB

• portal HTN

• hypoalbuminemia

• hypoaldosteronism

what is the treatment for ascites?

• Salt restrictions

• diuretics

• paracentesis

• TIPS procedure

• bedrest

what is the nursing care for paracentesis?

• monitor fluid volume carefully:

  • abdominal girth, weight, VS, I+O, labs (albumin, ammonia, electrolytes, LFTs, CBC)

• Monitor for sepsis and other complications

• Send fluid from paracentesis to labs