NUR 202 Test 2 Questions With Complete Solutions
Normal ammonia levels
15-45 mg/dL
Higher ammonia=
squirrelly in bed
Abundant ammonia=
completely unarousable
Compensated cirrhosis
organ can still perform
Decompensated cirrhosis
liver function is impaired
Fatty liver...
turns into liver fibrosis which then turns into cirrhosis
Is recovery possible in cirrhosis?
It is possible but scar tissue remains
Early manifestations of liver disease
anorexia, dyspepsia, flatulence, N/V, bowel changes (grey
colored stools), abdominal pain, malaise
Late manifestations of liver disease
,jaundice, skin lesions, hematologic issues (high clotting times,
bruising, thrombocytopenia), endocrine tissues, ascites, vitamin
deficiencies
Is jaundice a disease or a symptom?
It is a symptom NOT a disease
Other symptoms of liver disease
skin lesions (spider angiomas, palmar erythema), endocrine
issues, vitamin deficiencies
Spinder angiomas
open sores (face, abdomen, neck)
Palmar erythema
swollen red palms
Endocrine issues of liver disease
gynecomastia (boobs in men), loss of axillary or public hair,
impotence or loss of libido, hyperaldosteronism,
hypo/hyperglycemia, altered thyroid function
Vitamin deficiencies of liver disease
vitamin A, vitamin B, thiamine B1, folic acid, vitamin K
Complications of liver disease
portal hypertension, splenomegaly, esophageal varices, ascites,
hepatic encephalopathy, hepato-renal syndrome, coma, death
Hepato-renal syndrome
,poor diagnosis (death), sudden decrease urinary output/flow,
very high BUN/creatinine (azotemia)
Splenomegaly
enlarged spleen
Ascites
accumulation of plasma rich fluid in the abdominal cavity from
capillary leakage and decreased colloidal osmotic pressure
Enlarged varices
swollen veins in lower esophagus, hemorrhoids in the throat
(huge hemorrhage= pt in shock)
Enlarged varices priority
maintain airway, sit them up/oral suction, turn to side, call rapid
response
Enlarged varices cause
portal hypertension
Enlarged varices treatment
PPI, non-selective beta blockers, vasopressin, ballon therapy,
shunt, esophageal bonding
Manifestations of ascites
weight gain, abdominal distention, hypovolemia
Ascites treatment
, high carb and low protein diet, IV albumin, listen for crackles,
no raw or undercooked foods, strict I&Os, measure abdominal
girth, weight daily
Paracentesis
need to void first to prevent urine perforation, high fowlers,
done w ultrasound, remove 100-1500mL initially, vital signs
(q15 min for 1 hr, q30 min for 2 hr, q60 min for 4 hr)
Pancreatitis
inflammation inside the pancreas
Manifestations of pancreatitis
epigastric of LUQ, radiating to back left, abdominal guarding,
N/V, weight loss, usually lie in fetal position, steatorrhea (fat
content visible in stool)
Pancreatitis inital treatment
NPO (rest the gut), high IV fluids
Pancreatitis treatment
Low fat diet, blank and small meals (no alcohol/no caffeine)
Left ventricle=
powerhouse of heart
Single EKG: small square
1 mm in length and represent 0.04 seconds
Single EKG: large square
5 mm in length and represent 0.20 seconds
Normal ammonia levels
15-45 mg/dL
Higher ammonia=
squirrelly in bed
Abundant ammonia=
completely unarousable
Compensated cirrhosis
organ can still perform
Decompensated cirrhosis
liver function is impaired
Fatty liver...
turns into liver fibrosis which then turns into cirrhosis
Is recovery possible in cirrhosis?
It is possible but scar tissue remains
Early manifestations of liver disease
anorexia, dyspepsia, flatulence, N/V, bowel changes (grey
colored stools), abdominal pain, malaise
Late manifestations of liver disease
,jaundice, skin lesions, hematologic issues (high clotting times,
bruising, thrombocytopenia), endocrine tissues, ascites, vitamin
deficiencies
Is jaundice a disease or a symptom?
It is a symptom NOT a disease
Other symptoms of liver disease
skin lesions (spider angiomas, palmar erythema), endocrine
issues, vitamin deficiencies
Spinder angiomas
open sores (face, abdomen, neck)
Palmar erythema
swollen red palms
Endocrine issues of liver disease
gynecomastia (boobs in men), loss of axillary or public hair,
impotence or loss of libido, hyperaldosteronism,
hypo/hyperglycemia, altered thyroid function
Vitamin deficiencies of liver disease
vitamin A, vitamin B, thiamine B1, folic acid, vitamin K
Complications of liver disease
portal hypertension, splenomegaly, esophageal varices, ascites,
hepatic encephalopathy, hepato-renal syndrome, coma, death
Hepato-renal syndrome
,poor diagnosis (death), sudden decrease urinary output/flow,
very high BUN/creatinine (azotemia)
Splenomegaly
enlarged spleen
Ascites
accumulation of plasma rich fluid in the abdominal cavity from
capillary leakage and decreased colloidal osmotic pressure
Enlarged varices
swollen veins in lower esophagus, hemorrhoids in the throat
(huge hemorrhage= pt in shock)
Enlarged varices priority
maintain airway, sit them up/oral suction, turn to side, call rapid
response
Enlarged varices cause
portal hypertension
Enlarged varices treatment
PPI, non-selective beta blockers, vasopressin, ballon therapy,
shunt, esophageal bonding
Manifestations of ascites
weight gain, abdominal distention, hypovolemia
Ascites treatment
, high carb and low protein diet, IV albumin, listen for crackles,
no raw or undercooked foods, strict I&Os, measure abdominal
girth, weight daily
Paracentesis
need to void first to prevent urine perforation, high fowlers,
done w ultrasound, remove 100-1500mL initially, vital signs
(q15 min for 1 hr, q30 min for 2 hr, q60 min for 4 hr)
Pancreatitis
inflammation inside the pancreas
Manifestations of pancreatitis
epigastric of LUQ, radiating to back left, abdominal guarding,
N/V, weight loss, usually lie in fetal position, steatorrhea (fat
content visible in stool)
Pancreatitis inital treatment
NPO (rest the gut), high IV fluids
Pancreatitis treatment
Low fat diet, blank and small meals (no alcohol/no caffeine)
Left ventricle=
powerhouse of heart
Single EKG: small square
1 mm in length and represent 0.04 seconds
Single EKG: large square
5 mm in length and represent 0.20 seconds
