MED SURG 1 - CH

What is Hepatitis?

Inflammation of the liver cells.

What are common causes of Hepatitis?

Viral infections (HAV, HBV, HCV, HDV, HEV), bacterial infections, medications, alcohol, chemicals, metabolic disorders.

What are the signs and symptoms of Hepatitis?

Can be asymptomatic; if present, may include flu-like symptoms and RUQ pain.

What occurs during the Prodromal stage of Hepatitis?

Flu-like symptoms and right upper quadrant (RUQ) pain.

What characterizes the Icteric stage of Hepatitis?

Jaundice and worsening symptoms.

What happens in the Convalescent stage of Hepatitis?

Return to normal liver function.

What are possible complications of Hepatitis?

Liver failure, chronic infection, carrier state with risk of liver cancer.

What therapeutic interventions are used for Hepatitis?

Identify cause, monitor liver function, relieve symptoms, prevent cirrhosis, education on hydration/nutrition, and specific treatments.

What is Acute Liver Failure?

Sudden massive loss of liver tissue.

What are common etiologies for Acute Liver Failure?

Drug toxicity (e.g., acetaminophen overdose) or hepatitis.

What are signs and symptoms of Acute Liver Failure?

Early symptoms are vague; followed by jaundice, hepatic encephalopathy, and bleeding.

What are some therapeutic interventions for Acute Liver Failure?

Dialysis if overdose, supportive care, eliminate all drugs, diet changes, decrease ammonia levels, liver transplant.

Define Cirrhosis/Chronic Liver Disease.

Progressive, irreversible replacement of healthy liver tissue with scar tissue, leading to impaired liver function.

What is the most common etiology of Cirrhosis?

Chronic alcohol use.

What are the complications of Cirrhosis?

Clotting defects, portal hypertension, hepatic encephalopathy, hepatorenal syndrome, Wernicke-Korsakoff syndrome.

What therapeutic interventions are used for Cirrhosis?

Diuretics for ascites, beta blockers for esophageal varices, lactulose for hepatic encephalopathy.

What characterizes Cancer of the Liver?

Usually metastasized from another site.

What are risk factors for Liver Cancer?

Chronic HBV or HCV, nutritional deficiencies, exposure to hepatotoxins.

What symptoms may indicate Liver Cancer?

Encephalopathy, bleeding, jaundice, ascites.

What therapeutic interventions are used for Liver Cancer?

Surgery, chemotherapy, radiation.

What is Acute Pancreatitis?

Inflammation of the pancreas leading to autodigestion.

What are common causes of Acute Pancreatitis?

Alcohol, gallstones, elevated triglycerides, tumors.

What are the signs and symptoms of Acute Pancreatitis?

Severe abdominal pain, guarding, hypotension, tachycardia.

What complications are associated with Acute Pancreatitis?

Systemic inflammatory response syndrome (SIRS), cardiovascular failure, infection.

What are therapeutic interventions for Acute Pancreatitis?

IV fluids, nutrition, analgesics, antibiotics.

What characterizes Chronic Pancreatitis?

Progressive fibro-inflammatory disease leading to tissue death and exocrine insufficiency.

What are the common etiologies of Chronic Pancreatitis?

Chronic alcohol abuse, genetic factors, autoimmune diseases.

What are symptoms of Chronic Pancreatitis?

Epigastric pain, nausea, weight loss, steatorrhea.

What are complications of Chronic Pancreatitis?

Abscesses, diabetes, cancer.

What therapeutic interventions are used for Chronic Pancreatitis?

Stop alcohol use, NSAIDs, small low-fat meals, pancreatic enzyme replacement.

What is Cancer of the Pancreas?

Most commonly ductal adenocarcinoma of the exocrine pancreas.

What are the risk factors for Pancreatic Cancer?

Smoking, obesity, chronic pancreatitis.

What are the signs and symptoms of Pancreatic Cancer?

Weight loss, abdominal pain, jaundice.

What therapeutic options are available for Pancreatic Cancer?

Surgery, stenting, chemotherapy.

What are the main types of Gallbladder Disorders?

Cholecystitis, cholelithiasis, choledocholithiasis.

What risk factors are associated with Gallbladder Disorders?

Age, family history, obesity, and bile stasis.

What are the typical signs and symptoms of Gallbladder Disorders?

Elevated vital signs, jaundice, RUQ tenderness.

What are potential complications of Gallbladder Disorders?

Cholangitis, necrosis of gallbladder, acute pancreatitis.

What are therapeutic interventions for Gallbladder Disorders?

Analgesics, dietary changes, cholecystectomy.

Which is safer, enteral or parenteral nutrition?

Enteral nutrition is safer than parenteral nutrition.

What is the assessment order for abdominal examination?

Inspect → Auscultate → Percuss → Palpate.

What stool appearance indicates bleeding?

Black stool indicates bleeding.

What are the components of the GI tract pathway?

Mouth, pharynx, esophagus, stomach, small intestine, large intestine.

What role does the liver play in metabolism?

Regulates blood glucose, synthesizes amino acids and lipids.

What is the function of the gallbladder?

Stores and concentrates bile; releases bile in response to fatty foods.

What enzymes does the pancreas produce?

Amylase, lipase, trypsin.

What happens to GI motility with aging?

Decreased motility leads to constipation.

How does liver disease affect bleeding risk?

Liver disease increases bleeding risk due to decreased clotting factor synthesis.

What is the significance of elevated amylase/lipase levels in the context of pancreatitis?

It indicates pancreatic inflammation.

What immediate care should be given post-liver biopsy?

Lie on the right side and monitor for bleeding.

What is the purpose of an NG tube?

To decompress the stomach, provide feeding, or administer medication.

What is the effect of cholecystokinin on the gallbladder?

It stimulates the gallbladder to release bile.

What increases the risk of liver cancer?

Chronic HBV or HCV infections.

What is the common symptom of hepatotoxicity?

Jaundice due to liver dysfunction.

What dietary modifications might be suggested for patients with gallbladder issues?

Low-fat diet.

What is the function of the pyloric sphincter?

Controls emptying of stomach contents into the small intestine.

Which dietary substance increases the risk of gallstones?

High cholesterol intake.

What should be done if a patient is suspected to have pancreatitis?

Monitor for elevated amylase and lipase levels.

What does an elevated bilirubin level indicate?

Possible liver or gallbladder dysfunction and jaundice.

What condition can result from portal hypertension in cirrhosis?

Varices and ascites.

What lifestyle changes can help manage Chronic Pancreatitis?

Abstaining from alcohol and following a low-fat diet.

What is the role of the liver in detoxification?

The liver converts harmful substances into less harmful ones.

How does Gallbladder disease manifest after meals?

Typically manifests as pain after fatty food consumption.

What is the primary function of the pancreas in digestion?

To produce digestive enzymes and bicarbonate.

What indicates the need for a cholecystectomy?

Complications from gallstone obstruction or chronic cholecystitis.

What should be monitored in older adults regarding medication use?

Lower medication doses due to decreased liver metabolism.

What is a common sign of hepatic encephalopathy?

Confusion or altered mental status due to ammonia accumulation.

What is the common treatment for esophageal varices?

Beta blockers and variceal banding.

How is surgical intervention beneficial in Pancreatic Cancer?

It can remove the tumor and relieve symptoms.

What are the consequences of hepatic failure?

Potential for severe complications including hepatic encephalopathy and bleeding disorders.

How is nutritional support provided to patients with a functional GI tract?

Through enteral feeding.

What is the significance of hepatic portal circulation?

It allows the liver to process nutrients and detoxify substances before they enter systemic circulation.

What potential complication arises from HIDA scans?

Risk of pancreatitis.

What feedback indicates the rectal results following barium studies?

Expect white stools after barium studies.

What does a Murphy sign indicate?

Gallbladder disease due to pain upon palpation in RUQ.

What should be observed when assessing stool appearance?

Black stools indicate bleeding, clay stool indicates liver issues.

How does the liver help in protein metabolism?

It converts ammonia into urea for excretion.

What mechanism allows the liver to regulate blood glucose levels?

By storing excess glucose as glycogen and releasing it as needed.

What are potential signs of pancreatitis?

Severe abdominal pain, hypotension, jaundice.

What indicates the end of the prodromal stage in Hepatitis?

The onset of jaundice in the icteric stage.

What clinical significance does Wernicke-Korsakoff syndrome hold?

A complication of chronic liver disease, particularly with alcohol use.

What influences the absorption of fats in the digestive process?

Bile produced by the liver.

How does aging generally affect the gastrointestinal system?

Decreased motility and altered digestion.

How can NG tube placement affect patient care?

Improper placement can lead to complications and ineffective nutrition.

When should a gag reflex be checked in patients who have undergone endoscopy?

After procedure before resuming oral intake.

What are the signs of chronic liver disease?

Fatigue, easy bruising, jaundice, and swelling.

What laboratory test is used to monitor for liver function?

Liver enzyme tests such as AST and ALT.

What prevents the absorption of fats?

Impaired bile secretion due to gallbladder disease.

What is the first step in assessing a patient with suspected hepatitis?

Obtain a thorough medical history.

What is the most effective method of pain management for acute pancreatitis?

Aggressive IV fluids and analgesics.

What is the first indication of liver failure?

Altered mental status due to metabolic disturbances.

How does the liver respond to drug toxicity?

By detoxifying harmful substances and synthesizing excretion products.

What should the nursing care plan include for patients with liver disease?

Monitoring for bleeding and managing nutrition.

What is the importance of early detection of liver cancer?

It can improve the chance for effective treatment.

What is indicated by clay-colored stools?

Possible liver or gallbladder obstruction.

How can chronic alcohol consumption lead to liver damage?

It causes inflammation and fibrosis over time.

Why is low-fat nutrition recommended for patients with pancreas issues?

To reduce pancreatic stimulation and inflammation.

What is a common complication of untreated Cholecystitis?

Necrosis or perforation of the gallbladder.

What does an ultrasound detect?

Gallstones and abnormalities in liver structure.

How should nutritional support be tailored for someone with hepatic encephalopathy?

May require a protein-restricted diet to reduce ammonia production.