NSG 4100 — Exam 3 Quick Notes
Gastrointestinal, Hepatic, Hematologic, and Immune Disorders:
Condensed Content Review
Liver Disease
Cirrhosis Complications
● Ascites: portal HTN + ↓albumin → fluid shift; spironolactone preferred (K+-sparing)
● Hepatic encephalopathy: ↑ammonia → confusion, asterixis; treat with LACTULOSE
(goal 2-3 soft stools/day)
● Esophageal varices: nonselective beta blockers (propranolol) ↓ portal pressure; bleeding
= EMERGENCY
● Coagulopathy: ↓ clotting factor synthesis → ↑PT/INR; vitamin K may be given
● Paracentesis: have client void first; watch for post-procedure hypotension/fluid shift
Hepatitis
● Hep A: fecal-oral, does NOT become chronic
● Hep B/C: blood/body fluids, CAN become chronic
● Jaundice, dark urine, clay stools = impaired bilirubin excretion
Pancreatitis
Acute Pancreatitis
● ↑ lipase/amylase, epigastric pain radiating to back
● NPO to rest pancreas; manage pain
● Hypocalcemia from fat saponification → watch Chvostek's/Trousseau's
● Complication: ARDS/multi-organ dysfunction in severe cases
Chronic Pancreatitis
● Steatorrhea + weight loss = enzyme insufficiency
● Pancrelipase — take WITH meals/snacks
IBD & GI Bleeding
Crohn's vs UC
● Crohn's: anywhere mouth-to-anus, patchy, transmural, terminal ileum common
● UC: colon/rectum only, continuous, mucosal, bloody diarrhea + tenesmus
● Flare diet: low-residue/low-fiber; remission: reintroduce fiber gradually
● Ileostomy: liquid/semi-liquid output, protect skin, caution with high-fiber foods early on
Gastrointestinal, Hepatic, Hematologic, and Immune Disorders:
Condensed Content Review
Liver Disease
Cirrhosis Complications
● Ascites: portal HTN + ↓albumin → fluid shift; spironolactone preferred (K+-sparing)
● Hepatic encephalopathy: ↑ammonia → confusion, asterixis; treat with LACTULOSE
(goal 2-3 soft stools/day)
● Esophageal varices: nonselective beta blockers (propranolol) ↓ portal pressure; bleeding
= EMERGENCY
● Coagulopathy: ↓ clotting factor synthesis → ↑PT/INR; vitamin K may be given
● Paracentesis: have client void first; watch for post-procedure hypotension/fluid shift
Hepatitis
● Hep A: fecal-oral, does NOT become chronic
● Hep B/C: blood/body fluids, CAN become chronic
● Jaundice, dark urine, clay stools = impaired bilirubin excretion
Pancreatitis
Acute Pancreatitis
● ↑ lipase/amylase, epigastric pain radiating to back
● NPO to rest pancreas; manage pain
● Hypocalcemia from fat saponification → watch Chvostek's/Trousseau's
● Complication: ARDS/multi-organ dysfunction in severe cases
Chronic Pancreatitis
● Steatorrhea + weight loss = enzyme insufficiency
● Pancrelipase — take WITH meals/snacks
IBD & GI Bleeding
Crohn's vs UC
● Crohn's: anywhere mouth-to-anus, patchy, transmural, terminal ileum common
● UC: colon/rectum only, continuous, mucosal, bloody diarrhea + tenesmus
● Flare diet: low-residue/low-fiber; remission: reintroduce fiber gradually
● Ileostomy: liquid/semi-liquid output, protect skin, caution with high-fiber foods early on
