OBJECTIVES
OBJ 1: Analyze physiological, psychological, developmental, socio-cultural, and spiritual
concepts as they relate to the delivery of effective nursing care to the adult client and family.
OBJ 2 : Explain the etiology, risk factors, assessment methods and complications of select
alterations in health.
OBJ: 3 Use clinical judgment for assessing, planning, implementing, and evaluating delivery of
safe, quality client-centered care for adults with alterations in health.
OBJ 4: Apply knowledge of clinical reasoning and prioritization using evidenced based practice
in the care of the adult client.
OBJ 5: Exhibit effective teaching strategies with clients and families in regard to
inter-disciplinary care of the adult client
OBJ 6: Choose effective and therapeutic communication skills for collaboration with clients,
families, and members of the inter-disciplinary healthcare team.
OBJ 7: Demonstrate behaviors consistent with the professional nursing role in the delivery of
client care.
OBJ 8: Demonstrate the use of patient care technological resources, information systems, and
communication devices that support safe nursing practice.
GI CONTENT 5 Qs
Liver Disease/Cirrhosis :
Explain the etiology, risk factors, assessment methods and complications of select alterations in
health.
PATHO chronic disease; replacements of normal liver cells by diffuse fibrosis=
hardned/non-flexible
● Dirsupts structure and function
● Liver becomes nodular; blood & lymph flow are impaired; leads to portal HTN; blood
backs up→ esophgeal varices→ acites
● Affects MEN more (40-60 years old)
TYPES
● Alcoholic cirrhosis
○ MOST COMMON
● Post-necrotic cirrhosis
○ Late result acute viral hepatitis
● Biliary cirrhosis
○ Scarring occurs around bile ducts
DX
● Albumin decreased→ causes edema
● gobulin increased
, ● Liver function tests
○ Alkaline phosphatase
○ AST/LT and bilirubin increased (clay colored stool and dark urine result)
○ CT/MRI/US for obstructions and thickening/enlarging
○ Liver biopsy os confirmation of diagnosis
MED/TX
● Antacids
● Potassium sparing diuretics
○ Spironolactone; decreases ascites; watch for elevated potassium→ Cardiac
and muscle issues
● Statins; antifibrotic activity
● Herb milk thistle
Use clinical judgment for assessing, planning, implementing, and evaluating delivery of safe,
quality client-centered care for adults with alterations in health.
Risk assessment
● Exposure to ETOH/herbs/meds/chemicals
● Needle stick injury
● Health care workers/firefighters/officers
● Sex/family/medical hx
CM
● pallor /jaundice
● Muslce atrophy; large central trunks thin arms
● Edema esp in abd
● Skin excoriation/scratching
● petechiae/spider angiomas
● Enlarged liver or small/hard
● Gynecomastia and teste atrophy
● Cognitive status/weakness
COMPS with progression
● Esophageal varcies/ascites; build up of fluid
● Portal HTN
● Hepatic encephalopathy; build up of ammonia
● Vitamin deficiecnies
, Bile Duct Pancreatitis
Explain the etiology, risk factors, assessment methods and complications of select alterations in
health.
PATHO inflammation of the pancreas, self digestion of the organ: amylsae and lipase are
digestive enzymes that are elevated which causes the digestion of the pancreas
RF
● Gallstones→ obstruction
● ETOH
● Immune disease
CM J.A.N.E H.R.F.
● abdominal/back pain
● Rigid abd.--> guarding→peritonitis
● N/V
● Ecchymosis in the flank or around the umbilicus
● Fever
● Jaundice
● Hypotension
● Hypovolemic shock
DX
● HX of abd pain and drinking
● CBC→ see increased WBC, H/H (bleeding)
● Serum amylase/liapse elevated within 24 hr sof s/s beginning
● Hyperglycemia; failure to make enough insulin (pancreas) and increase bilirubin
● ABD XRAY
● Ultrasound
MED/TX
● NPO
● TPN
● NG to suction
● Pain management
● Resp care
● Biliary drainage
● Surgery
● ICU
OBJ 1: Analyze physiological, psychological, developmental, socio-cultural, and spiritual
concepts as they relate to the delivery of effective nursing care to the adult client and family.
OBJ 2 : Explain the etiology, risk factors, assessment methods and complications of select
alterations in health.
OBJ: 3 Use clinical judgment for assessing, planning, implementing, and evaluating delivery of
safe, quality client-centered care for adults with alterations in health.
OBJ 4: Apply knowledge of clinical reasoning and prioritization using evidenced based practice
in the care of the adult client.
OBJ 5: Exhibit effective teaching strategies with clients and families in regard to
inter-disciplinary care of the adult client
OBJ 6: Choose effective and therapeutic communication skills for collaboration with clients,
families, and members of the inter-disciplinary healthcare team.
OBJ 7: Demonstrate behaviors consistent with the professional nursing role in the delivery of
client care.
OBJ 8: Demonstrate the use of patient care technological resources, information systems, and
communication devices that support safe nursing practice.
GI CONTENT 5 Qs
Liver Disease/Cirrhosis :
Explain the etiology, risk factors, assessment methods and complications of select alterations in
health.
PATHO chronic disease; replacements of normal liver cells by diffuse fibrosis=
hardned/non-flexible
● Dirsupts structure and function
● Liver becomes nodular; blood & lymph flow are impaired; leads to portal HTN; blood
backs up→ esophgeal varices→ acites
● Affects MEN more (40-60 years old)
TYPES
● Alcoholic cirrhosis
○ MOST COMMON
● Post-necrotic cirrhosis
○ Late result acute viral hepatitis
● Biliary cirrhosis
○ Scarring occurs around bile ducts
DX
● Albumin decreased→ causes edema
● gobulin increased
, ● Liver function tests
○ Alkaline phosphatase
○ AST/LT and bilirubin increased (clay colored stool and dark urine result)
○ CT/MRI/US for obstructions and thickening/enlarging
○ Liver biopsy os confirmation of diagnosis
MED/TX
● Antacids
● Potassium sparing diuretics
○ Spironolactone; decreases ascites; watch for elevated potassium→ Cardiac
and muscle issues
● Statins; antifibrotic activity
● Herb milk thistle
Use clinical judgment for assessing, planning, implementing, and evaluating delivery of safe,
quality client-centered care for adults with alterations in health.
Risk assessment
● Exposure to ETOH/herbs/meds/chemicals
● Needle stick injury
● Health care workers/firefighters/officers
● Sex/family/medical hx
CM
● pallor /jaundice
● Muslce atrophy; large central trunks thin arms
● Edema esp in abd
● Skin excoriation/scratching
● petechiae/spider angiomas
● Enlarged liver or small/hard
● Gynecomastia and teste atrophy
● Cognitive status/weakness
COMPS with progression
● Esophageal varcies/ascites; build up of fluid
● Portal HTN
● Hepatic encephalopathy; build up of ammonia
● Vitamin deficiecnies
, Bile Duct Pancreatitis
Explain the etiology, risk factors, assessment methods and complications of select alterations in
health.
PATHO inflammation of the pancreas, self digestion of the organ: amylsae and lipase are
digestive enzymes that are elevated which causes the digestion of the pancreas
RF
● Gallstones→ obstruction
● ETOH
● Immune disease
CM J.A.N.E H.R.F.
● abdominal/back pain
● Rigid abd.--> guarding→peritonitis
● N/V
● Ecchymosis in the flank or around the umbilicus
● Fever
● Jaundice
● Hypotension
● Hypovolemic shock
DX
● HX of abd pain and drinking
● CBC→ see increased WBC, H/H (bleeding)
● Serum amylase/liapse elevated within 24 hr sof s/s beginning
● Hyperglycemia; failure to make enough insulin (pancreas) and increase bilirubin
● ABD XRAY
● Ultrasound
MED/TX
● NPO
● TPN
● NG to suction
● Pain management
● Resp care
● Biliary drainage
● Surgery
● ICU
