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Pancreatitis, Cirrhosis, and Liver failureMedical-Surgical Nursing-7th edition

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What causes the skin lesions of cirrhosis to form?
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Increased estrogen coupled with the liver's inability to metabolize steroid hormones.
What hematologic problems can occur with cirrhosis?
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Thrombocytopenia, leukopenia, anemia which are caused by splenomegaly. Coagulation disorders are also included.
What should you do if an esophageal balloon slips up and obstructs the airway?
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Cut it (scissors must be kept bedside) or deflate it.
Esophageal varices are located in the _______ part of the esophagus. Gastric varices are located in the _______ part of the stomach.
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esophageal = lower; gastric = upper (cardia/fundus)
_______ is the most life threatening complication of cirrhosis.
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Esophageal varices
Why does a patient with cirrhosis develop peripheral edema?
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Liver synthesis of albumin is impaired, decreases oncotic pressure and increases pressure. Proteins moved from blood vessels into the lymph space which then leaks into the peritoneum.
_______ is a terminal complication of cirrhosis caused by ammonia build-up.
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Hepatic encephalopathy
After receiving one unit of blood, the hemoglobin should increase by _______.
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1 gram
How are varices diagnosed?
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Endoscopy
_______ is a chronic, progressive disease of the liver caused by degeneration and destruction of parenchymal liver cells.
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Cirrhosis
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_______ should be used cautiously in older adults with an active varices bleed because it increases the risk of cardiac ischemia.
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Vasopressin
_______ cirrhosis is reversible. The 1st sign is an accumulation of fat in the liver cells. As it progresses widespread scarring occurs.
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Alcoholic
What is the agent used during endoscopic sclerotherapy to thrombose and obliterate distended veins?
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Scleromate/morrhuate
_______ cirrhosis can be caused by right-side heart failure, cor pulmonale, pericarditis or tricuspid insufficiency.
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Cardiac
_______ controls bleeding varices by compressing them. It is used when varices aren't well controlled with other treatments.
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Balloon tamponade
What is the major reason peripheral neuropathy develops in patients with cirrhosis?
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Dietary deficiencies (thiamine, folic acid, and cobalamin).
Why does cirrhosis lead to water retention, edema, and ascites?
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The liver can no longer metabolize aldosterone which leads to Na+ and H20 retention and K+ loss.
What are common causes of cirrhosis?
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Alcohol, malnutrition, hepatitis, biliary obstruction, and right side heart failure.
How frequently should neuro checks be done on a patient with hepatic encephalopathy?
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Every 2 hours.
What are the 3 contraindications for TIPS?
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Encephalopathy, hepatic carcinoma, and portal vein stenosis.
How is ascites associated with cirrhosis treated?
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Sodium restriction (2q/day), if severe, 250-500 mg/day; Bed rest; Diuretics (spironolactone, Amiloride, Triamterene, furosemide); and Paracentesis or Peritoneovenous shunt.
  
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