NSG 252 Final Exam – Questions With Fully
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Terms in this set (221)
Cirrhosis Chronic liver damage leading to fibrosis and liver
failure. Caused often by alcohol abuse or hepatitis.
Pathophysiology of Cirrhosis Healthy liver tissue is replaced by scar tissue. Blood
flow through the liver is blocked (portal
hypertension). Liver cannot detoxify blood, produce
clotting factors, or metabolize drugs properly.
Signs/Symptoms of Cirrhosis Jaundice: bilirubin buildup because liver can't
conjugate it; Ascites: fluid buildup in abdomen due to
portal hypertension; Peripheral edema:
hypoalbuminemia leads to third-spacing; Easy
bruising/bleeding: low clotting factors;
Fatigue/weakness: metabolic dysfunction; N/V,
anorexia; Spider angiomas, palmar erythema.
,Labs for Cirrhosis ↑ AST, ALT (liver cell injury); ↑ Bilirubin (cholestasis); ↓
Albumin (poor protein synthesis); ↑ INR/PT (clotting
issues); ↑ Ammonia (encephalopathy risk).
Symptomatic Management for Ascites Spironolactone (K+-sparing diuretic), low-sodium diet,
possible paracentesis.
Symptomatic Management for Lactulose (traps ammonia in stool), Rifaximin (kills
Encephalopathy ammonia-producing bacteria).
Symptomatic Management for Varices Non-selective beta-blockers (propranolol) to lower
bleeding risk.
Anticipated Complications of Cirrhosis Variceal hemorrhage (life-threatening bleeding);
Hepatic encephalopathy (confusion ➔ coma);
Hepatorenal syndrome (acute kidney injury).
Addressing Underlying Causes of Alcohol cessation programs (biggest priority);
Cirrhosis Hepatitis management if viral; Monitor nutrition
(protein needs to be restricted if encephalopathy
present).
Acute Pancreatitis Trigger Alcoholism.
Pathophysiology of Acute Pancreatitis Pancreatic enzymes are activated inside pancreas ➔
autodigestion ➔ inflammation and tissue death.
Symptoms of Acute Pancreatitis Severe LUQ abdominal pain radiating to back; Fever;
Nausea/vomiting; Tachycardia; Abdominal distension.
Labs for Acute Pancreatitis ↑ Amylase and Lipase (especially Lipase—gold
standard); Hypocalcemia (fat necrosis binds calcium);
Hyperglycemia (islet cell injury).
, Treatment for Acute Pancreatitis NPO (no oral intake to rest pancreas); Aggressive IV
fluids (prevent hypovolemic shock); IV opioids
(morphine, dilaudid); Correct electrolytes.
Septic Shock Definition Life-threatening infection ➔ widespread vasodilation
➔ hypotension ➔ organ failure.
Symptoms of Septic Shock Hypotension unresponsive to fluids; Tachycardia;
Confusion (brain not perfused); High serum lactate (>2
mmol/L); Oliguria; Hypothermia or fever.
Pathophysiology of Septic Shock Severe infection ➔ cytokine storm ➔ systemic
vasodilation ➔ capillary leak ➔ hypoperfusion.
Labs for Septic Shock ↑ Lactate; ↓ Platelets (sepsis uses them up—DIC risk); ↑
Creatinine (AKI); ABG: Metabolic acidosis (lactic
acidosis).
Treatment for Septic Shock Immediate broad-spectrum antibiotics; 30 mL/kg NS
bolus; Norepinephrine (vasopressor of choice);
Oxygen to maintain tissue perfusion.
Fluid Challenge for Septic Shock 30 mL/kg bolus (adult standard); For 80kg patient:
30×80 = 2,400mL NS over first hour; Pediatrics: much
more cautious — 10-20 mL/kg.
Vasopressors for Septic Shock Norepinephrine to maintain MAP >65 mmHg.
MODS Definition Progressive dysfunction of 2 or more organ systems
due to uncontrolled inflammatory response.
Symptoms of Hepatitis A Dark urine; Pale stools; RUQ tenderness; Icteric
sclera; Fatigue.
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Terms in this set (221)
Cirrhosis Chronic liver damage leading to fibrosis and liver
failure. Caused often by alcohol abuse or hepatitis.
Pathophysiology of Cirrhosis Healthy liver tissue is replaced by scar tissue. Blood
flow through the liver is blocked (portal
hypertension). Liver cannot detoxify blood, produce
clotting factors, or metabolize drugs properly.
Signs/Symptoms of Cirrhosis Jaundice: bilirubin buildup because liver can't
conjugate it; Ascites: fluid buildup in abdomen due to
portal hypertension; Peripheral edema:
hypoalbuminemia leads to third-spacing; Easy
bruising/bleeding: low clotting factors;
Fatigue/weakness: metabolic dysfunction; N/V,
anorexia; Spider angiomas, palmar erythema.
,Labs for Cirrhosis ↑ AST, ALT (liver cell injury); ↑ Bilirubin (cholestasis); ↓
Albumin (poor protein synthesis); ↑ INR/PT (clotting
issues); ↑ Ammonia (encephalopathy risk).
Symptomatic Management for Ascites Spironolactone (K+-sparing diuretic), low-sodium diet,
possible paracentesis.
Symptomatic Management for Lactulose (traps ammonia in stool), Rifaximin (kills
Encephalopathy ammonia-producing bacteria).
Symptomatic Management for Varices Non-selective beta-blockers (propranolol) to lower
bleeding risk.
Anticipated Complications of Cirrhosis Variceal hemorrhage (life-threatening bleeding);
Hepatic encephalopathy (confusion ➔ coma);
Hepatorenal syndrome (acute kidney injury).
Addressing Underlying Causes of Alcohol cessation programs (biggest priority);
Cirrhosis Hepatitis management if viral; Monitor nutrition
(protein needs to be restricted if encephalopathy
present).
Acute Pancreatitis Trigger Alcoholism.
Pathophysiology of Acute Pancreatitis Pancreatic enzymes are activated inside pancreas ➔
autodigestion ➔ inflammation and tissue death.
Symptoms of Acute Pancreatitis Severe LUQ abdominal pain radiating to back; Fever;
Nausea/vomiting; Tachycardia; Abdominal distension.
Labs for Acute Pancreatitis ↑ Amylase and Lipase (especially Lipase—gold
standard); Hypocalcemia (fat necrosis binds calcium);
Hyperglycemia (islet cell injury).
, Treatment for Acute Pancreatitis NPO (no oral intake to rest pancreas); Aggressive IV
fluids (prevent hypovolemic shock); IV opioids
(morphine, dilaudid); Correct electrolytes.
Septic Shock Definition Life-threatening infection ➔ widespread vasodilation
➔ hypotension ➔ organ failure.
Symptoms of Septic Shock Hypotension unresponsive to fluids; Tachycardia;
Confusion (brain not perfused); High serum lactate (>2
mmol/L); Oliguria; Hypothermia or fever.
Pathophysiology of Septic Shock Severe infection ➔ cytokine storm ➔ systemic
vasodilation ➔ capillary leak ➔ hypoperfusion.
Labs for Septic Shock ↑ Lactate; ↓ Platelets (sepsis uses them up—DIC risk); ↑
Creatinine (AKI); ABG: Metabolic acidosis (lactic
acidosis).
Treatment for Septic Shock Immediate broad-spectrum antibiotics; 30 mL/kg NS
bolus; Norepinephrine (vasopressor of choice);
Oxygen to maintain tissue perfusion.
Fluid Challenge for Septic Shock 30 mL/kg bolus (adult standard); For 80kg patient:
30×80 = 2,400mL NS over first hour; Pediatrics: much
more cautious — 10-20 mL/kg.
Vasopressors for Septic Shock Norepinephrine to maintain MAP >65 mmHg.
MODS Definition Progressive dysfunction of 2 or more organ systems
due to uncontrolled inflammatory response.
Symptoms of Hepatitis A Dark urine; Pale stools; RUQ tenderness; Icteric
sclera; Fatigue.
