NR 325 Final Client teaching for acute cholecystitis - Answer Low-fat diet (decreases episodes of biliary colic) Ambulate frequently Manifestations of acute cholecystitis - Answer Sharp pain in the RUQ Evidence of Murphy's sign (pain with deep inspiration during right subcostal palpation) What are patients with acute pancreatitis at risk for? - Answer Hyperglycemia due to possible destruction of beta cells (Type 1 DM) Physical findings of acute pancreatitis - Answer Grey Turner's sign (ecchymosis of the flanks) Cullen's sign (bluish-gray periumbilical discoloration) What are expected labs following acute pancreatitis? - Answer Amylase rises within first 24 hours Blood lipase increases slowly ("ases" are high) What is a treatment to help with acute pancreatitis? - Answer NPO until the pain is gone (allows the pancreas to rest and reduces secretion of pancreatic enzymes) When diet is resumed: bland, high-protein, low-fat diet with no stimulants; small frequent meals What medication can a patient with chronic pancreatitis take? - Answer Pancrelipase (aids in the digestion of fats and proteins) Take medication with meals (3x a day) followed by a full glass of water What is ascites? - Answer Bloating or swelling due to fluid buildup in abdomen or legs If a patient has ascites, what do you want to restrict? - Answer Restrict sodium and fluids What is a primary cause of liver cirrhosis? - Answer Alcohol abuse What could sodium do to a patient with liver cirrhosis? - Answer Cause fluid retention What is a physical finding of liver cirrhosis? - Answer Petechiae Nursing interventions for a patient with liver cirrhosis - Answer Diuretics Low-sodium diet Measure abdominal girth daily Daily weights What is a paracentesis? - Answer Procedure involving a large needle used to relieve ascites 1 / 2
NR 325 Final Make sure the patient is supine with the HOB elevated Paracentesis post procedure nursing interventions - Answer Monitor HR and BP (d/t the risk of developing pulmonary edema or cardiac distress) Monitor for increased RR with cough and blood-tinged, frothy sputum What is hepatic encephalopathy? - Answer When patients have a poorly functioning liver and it is unable to convert ammonia and other waste products to a less toxic form.These products are carried to the brain and cause neurological manifestations What medication is given to patients with hepatic encephalopathy? - Answer Lactulose is given to reduce the ammonia levels in the blood stream via intestinal excretion What is HPV? - Answer HPV is the most common type of STI. Some types can cause genital warts and cervical cancers What strains of HPV cause genital warts? - Answer Strains 6 and 11 What is HSV? - Answer Herpes simplex virus Incurable viral infection, very common
HSV I: oral lesions
HSV II: genital lesions
What is syphilis treated with? - Answer Penicillin G IM in a single dose (safe during pregnancy) Doxycycline or tetracycline orally if allergic to PCN as alternative therapy (do not give if pregnant) What can occur if syphilis goes untreated? - Answer Nervous system changes (difficulty coordinating muscle movements) and blindness; aneurysms; death Route of transmission for hepatitis A - Answer Fecal-oral Risk factors for hepatitis A - Answer Ingestion of contaminated food/water, especially shellfish Contacted with infected stool Route of transmission for hepatitis B - Answer Blood Risk factors for hepatitis B - Answer Unprotected sex Infants born to infected mothers Contact with infected blood (transmitted to healthcare workers via needle sticks) Substance use disorder Route of transmission for hepatitis C - Answer Blood
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