Interventions forInterventions for
clients with liver,clients with liver,
galdbladder andgaldbladder and
pancreaspancreas
...
HepatitisHepatitis
 Widespread viral inflammation of liver cellsWidespread viral inflammation of liver cells
 Hepatitis ...
Clinical ManifestationsClinical Manifestations
 Abdominal painAbdominal pain
 Changes in skin or eye colorChanges in ski...
Fatty LiverFatty Liver
(Steatohepatitis)(Steatohepatitis)
 Fatty liver is caused by the accumulation of fats in andFatty ...
Hepatic AbscessHepatic Abscess
 Liver invaded by bacteria or protozoa causing abscessLiver invaded by bacteria or protozo...
Liver TraumaLiver Trauma
 The liver is the most common organ injured in clients withThe liver is the most common organ in...
CirrhosisCirrhosis
 Cirrhosis is extensive scarring of the liver, usually caused byCirrhosis is extensive scarring of the...
ComplicationsComplications
 Portal hypertensionPortal hypertension
 AscitesAscites
 Bleeding esophageal varicesBleeding...
EtiologyEtiology
 Known causes of liver disease include:Known causes of liver disease include:
 AlcoholAlcohol
 Viral h...
Clinical ManifestationsClinical Manifestations
 In early stages, signs of liver diseaseIn early stages, signs of liver di...
Clinical ManifestationsClinical Manifestations
Abdominal AssessmentAbdominal Assessment
 Massive ascitesMassive ascites
 Umbilicus protrusionUmbilicus protrusion
 Cap...
Cancer of the LiverCancer of the Liver
 One of the most common tumors inOne of the most common tumors in
the worldthe wor...
Liver TransplantationLiver Transplantation
 Used in the treatment of end-stage liver disease,Used in the treatment of end...
ComplicationsComplications
 Acute, chronic graft rejectionAcute, chronic graft rejection
 InfectionInfection
 Hemorrhag...
Acute CholecystitisAcute Cholecystitis
 Acute cholecystitis isAcute cholecystitis is
the inflammation of thethe inflammat...
Chronic CholecystitisChronic Cholecystitis
 Repeated episodes of cystic ductRepeated episodes of cystic duct
obstruction ...
Clinical ManifestationsClinical Manifestations
 Flatulence, dyspepsia, eructation,Flatulence, dyspepsia, eructation,
anor...
Surgical ManagementSurgical Management
 Laparoscopic cholecystectomyLaparoscopic cholecystectomy
 Standard preoperative ...
TraditionalTraditional
CholecystectomyCholecystectomy
 Standard preoperative careStandard preoperative care
 Operative p...
Cancer of the GallbladderCancer of the Gallbladder
 Anorexia, weight loss, nausea, vomiting, general malaise,Anorexia, we...
Acute PancreatitisAcute Pancreatitis
 Serious and possibly life-threatening inflammatory processSerious and possibly life...
Complications of AcuteComplications of Acute
PancreatitisPancreatitis
 HypovolemiaHypovolemia
 HemorrhageHemorrhage
 Ac...
Clinical ManifestationsClinical Manifestations
 Generalized jaundiceGeneralized jaundice
 Bowel soundsBowel sounds
 Abd...
Clinical ManifestationsClinical Manifestations
 Cullen’s signCullen’s sign
Turner’s signTurner’s sign
Chronic PancreatitisChronic Pancreatitis
 Progressive destructive disease of theProgressive destructive disease of the
pa...
Pancreatic AbscessPancreatic Abscess
 Most serious complication ofMost serious complication of
pancreatitis; always fatal...
Pancreatic CarcinomaPancreatic Carcinoma
 Nonsurgical managementNonsurgical management
 Drug therapyDrug therapy
 Radia...
Interventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disorders
Upcoming SlideShare
Loading in …5
×

Interventions for clients with liver, gallbladder and pancreas disorders

624 views

Published on

Disorders in patients with liver, biliary and pancreatic problems

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
624
On SlideShare
0
From Embeds
0
Number of Embeds
7
Actions
Shares
0
Downloads
5
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Interventions for clients with liver, gallbladder and pancreas disorders

  1. 1. Interventions forInterventions for clients with liver,clients with liver, galdbladder andgaldbladder and pancreaspancreas disorders. Clientsdisorders. Clients with malnutritionwith malnutrition and obesity.and obesity. ..
  2. 2. HepatitisHepatitis  Widespread viral inflammation of liver cellsWidespread viral inflammation of liver cells  Hepatitis AHepatitis A  Hepatitis BHepatitis B  Hepatitis CHepatitis C  Hepatitis DHepatitis D  Hepatitis EHepatitis E  Hepatitis F and G are uncommonHepatitis F and G are uncommon
  3. 3. Clinical ManifestationsClinical Manifestations  Abdominal painAbdominal pain  Changes in skin or eye colorChanges in skin or eye color  Arthralgia (joint pain)Arthralgia (joint pain)  Myalgia (muscle pain)Myalgia (muscle pain)  Diarrhea/constipationDiarrhea/constipation  FeverFever  LethargyLethargy  MalaiseMalaise  Nausea/vomitingNausea/vomiting  PruritusPruritus
  4. 4. Fatty LiverFatty Liver (Steatohepatitis)(Steatohepatitis)  Fatty liver is caused by the accumulation of fats in andFatty liver is caused by the accumulation of fats in and around the hepatic cells.around the hepatic cells.  Causes include:Causes include:  Diabetes mellitusDiabetes mellitus  ObesityObesity  Elevated lipid profileElevated lipid profile  Many clients are asymptomaticMany clients are asymptomatic
  5. 5. Hepatic AbscessHepatic Abscess  Liver invaded by bacteria or protozoa causing abscessLiver invaded by bacteria or protozoa causing abscess  Pyrogenic liver abscess; amebic hepatic abscessPyrogenic liver abscess; amebic hepatic abscess  Treatment usually involves:Treatment usually involves:  Drainage with ultrasound guidanceDrainage with ultrasound guidance  Antibiotic therapyAntibiotic therapy
  6. 6. Liver TraumaLiver Trauma  The liver is the most common organ injured in clients withThe liver is the most common organ injured in clients with penetrating trauma of the abdomen, such as gunshot woundspenetrating trauma of the abdomen, such as gunshot wounds and stab wounds.and stab wounds.  Clinical manifestations include abdominal tenderness,Clinical manifestations include abdominal tenderness, distention, guarding, rigidity.distention, guarding, rigidity.  Treatment involves surgery, multiple blood products.Treatment involves surgery, multiple blood products.
  7. 7. CirrhosisCirrhosis  Cirrhosis is extensive scarring of the liver, usually caused byCirrhosis is extensive scarring of the liver, usually caused by a chronic irreversible reaction to hepatic inflammation anda chronic irreversible reaction to hepatic inflammation and necrosis.necrosis.  Complications depend on the amount of damage sustainedComplications depend on the amount of damage sustained by the liver.by the liver.  In compensated cirrhosis, liver has significant scarring butIn compensated cirrhosis, liver has significant scarring but performs essential functions without causing significantperforms essential functions without causing significant symptoms.symptoms.
  8. 8. ComplicationsComplications  Portal hypertensionPortal hypertension  AscitesAscites  Bleeding esophageal varicesBleeding esophageal varices  Coagulation defectsCoagulation defects  JaundiceJaundice  Portal-systemic encephalopathy withPortal-systemic encephalopathy with hepatic comahepatic coma  Hepatorenal syndromeHepatorenal syndrome  Spontaneous bacterial peritonitisSpontaneous bacterial peritonitis
  9. 9. EtiologyEtiology  Known causes of liver disease include:Known causes of liver disease include:  AlcoholAlcohol  Viral hepatitisViral hepatitis  Autoimmune hepatitisAutoimmune hepatitis  SteatohepatitisSteatohepatitis  Drugs and toxinsDrugs and toxins  Biliary diseaseBiliary disease  Metabolic/genetic causesMetabolic/genetic causes  Cardiovascular diseaseCardiovascular disease
  10. 10. Clinical ManifestationsClinical Manifestations  In early stages, signs of liver diseaseIn early stages, signs of liver disease include:include:  FatigueFatigue  Significant change in weightSignificant change in weight  Gastrointestinal symptomsGastrointestinal symptoms  Abdominal pain and liver tendernessAbdominal pain and liver tenderness  PruritusPruritus
  11. 11. Clinical ManifestationsClinical Manifestations
  12. 12. Abdominal AssessmentAbdominal Assessment  Massive ascitesMassive ascites  Umbilicus protrusionUmbilicus protrusion  Caput medusae (dilated abdominal veins)Caput medusae (dilated abdominal veins)  Hepatomegaly (liver enlargementHepatomegaly (liver enlargement
  13. 13. Cancer of the LiverCancer of the Liver  One of the most common tumors inOne of the most common tumors in the worldthe world  Most common complaint: abdominalMost common complaint: abdominal discomfortdiscomfort  Treatment includes:Treatment includes:  ChemotherapyChemotherapy  SurgerySurgery
  14. 14. Liver TransplantationLiver Transplantation  Used in the treatment of end-stage liver disease,Used in the treatment of end-stage liver disease, primary malignant neoplasm of the liverprimary malignant neoplasm of the liver  Donor livers obtained primarily from trauma victimsDonor livers obtained primarily from trauma victims who have not had liver damagewho have not had liver damage  Donor liver transported to the surgery center in aDonor liver transported to the surgery center in a cooled saline solution that preserves the organ for up tocooled saline solution that preserves the organ for up to 8 hours8 hours
  15. 15. ComplicationsComplications  Acute, chronic graft rejectionAcute, chronic graft rejection  InfectionInfection  HemorrhageHemorrhage  Hepatic artery thrombosisHepatic artery thrombosis  Fluid and electrolyte imbalancesFluid and electrolyte imbalances  Pulmonary atelectasisPulmonary atelectasis  Acute renal failureAcute renal failure  Psychological maladjustmentPsychological maladjustment
  16. 16. Acute CholecystitisAcute Cholecystitis  Acute cholecystitis isAcute cholecystitis is the inflammation of thethe inflammation of the gallbladder.gallbladder.  CholelithiasisCholelithiasis (gallstones) usually(gallstones) usually accompaniesaccompanies cholecystitis.cholecystitis.  AcalculousAcalculous cholecystitischolecystitis inflammation can occurinflammation can occur in the absence ofin the absence of gallstones.gallstones.  Calculous cholecystitisCalculous cholecystitis is the obstruction of theis the obstruction of the cystic duct by a stone,cystic duct by a stone, which creates anwhich creates an inflammatory response.inflammatory response.
  17. 17. Chronic CholecystitisChronic Cholecystitis  Repeated episodes of cystic ductRepeated episodes of cystic duct obstruction result in chronicobstruction result in chronic inflammationinflammation  Pancreatitis, cholangitisPancreatitis, cholangitis  JaundiceJaundice  IcterusIcterus  Obstructive jaundiceObstructive jaundice  PruritusPruritus
  18. 18. Clinical ManifestationsClinical Manifestations  Flatulence, dyspepsia, eructation,Flatulence, dyspepsia, eructation, anorexia, nausea and vomiting,anorexia, nausea and vomiting, abdominal painabdominal pain  Biliary colicBiliary colic  Murphy’s signMurphy’s sign  Blumberg’s signBlumberg’s sign  Rebound tendernessRebound tenderness  SteatorrheaSteatorrhea
  19. 19. Surgical ManagementSurgical Management  Laparoscopic cholecystectomyLaparoscopic cholecystectomy  Standard preoperative careStandard preoperative care  Operative procedureOperative procedure  Postoperative carePostoperative care  Free air pain result of carbon dioxide retention in theFree air pain result of carbon dioxide retention in the abdomenabdomen  AmbulationAmbulation  Return to activities in 1 to 3 weeksReturn to activities in 1 to 3 weeks
  20. 20. TraditionalTraditional CholecystectomyCholecystectomy  Standard preoperative careStandard preoperative care  Operative procedureOperative procedure  Postoperative carePostoperative care  Meperidine hydrochloride via patient-controlledMeperidine hydrochloride via patient-controlled analgesia pumpanalgesia pump  AntiemeticsAntiemetics  Wound careWound care  Care of the T-tubeCare of the T-tube  Nothing by mouthNothing by mouth  Diet therapyDiet therapy
  21. 21. Cancer of the GallbladderCancer of the Gallbladder  Anorexia, weight loss, nausea, vomiting, general malaise,Anorexia, weight loss, nausea, vomiting, general malaise, jaundice, hepatosplenomegaly, chronic, progressively severejaundice, hepatosplenomegaly, chronic, progressively severe epigastric or right upper quadrant painepigastric or right upper quadrant pain  Poor prognosisPoor prognosis  Surgery, radiation, chemotherapySurgery, radiation, chemotherapy
  22. 22. Acute PancreatitisAcute Pancreatitis  Serious and possibly life-threatening inflammatory processSerious and possibly life-threatening inflammatory process of the pancreasof the pancreas  Necrotizing hemorrhagic pancreatitisNecrotizing hemorrhagic pancreatitis  LipolysisLipolysis  ProteolysisProteolysis  Necrosis of blood vesselsNecrosis of blood vessels  InflammationInflammation  Theories of enzyme activationTheories of enzyme activation
  23. 23. Complications of AcuteComplications of Acute PancreatitisPancreatitis  HypovolemiaHypovolemia  HemorrhageHemorrhage  Acute renal failureAcute renal failure  Paralytic ileusParalytic ileus  Hypovolemic or septic shockHypovolemic or septic shock  Pleural effusion, respiratory distressPleural effusion, respiratory distress syndrome,pneumoniasyndrome,pneumonia  Multisystem organ failureMultisystem organ failure  Disseminated intravascular coagulationDisseminated intravascular coagulation  Diabetes mellitusDiabetes mellitus
  24. 24. Clinical ManifestationsClinical Manifestations  Generalized jaundiceGeneralized jaundice  Bowel soundsBowel sounds  Abdominal tenderness, rigidity, guardingAbdominal tenderness, rigidity, guarding  Pancreatic ascitesPancreatic ascites  Significant changes in vital signsSignificant changes in vital signs
  25. 25. Clinical ManifestationsClinical Manifestations  Cullen’s signCullen’s sign Turner’s signTurner’s sign
  26. 26. Chronic PancreatitisChronic Pancreatitis  Progressive destructive disease of theProgressive destructive disease of the pancreas, characterized bypancreas, characterized by remissions and exacerbationsremissions and exacerbations  Nonsurgical management includes:Nonsurgical management includes:  Drug therapyDrug therapy  Analgesic administrationAnalgesic administration  Enzyme replacementEnzyme replacement  Insulin therapyInsulin therapy  Diet therapyDiet therapy
  27. 27. Pancreatic AbscessPancreatic Abscess  Most serious complication ofMost serious complication of pancreatitis; always fatal if untreatedpancreatitis; always fatal if untreated  High feverHigh fever  Blood culturesBlood cultures  Drainage via the percutaneousDrainage via the percutaneous method or laparoscopymethod or laparoscopy  Antibiotic treatment alone does notAntibiotic treatment alone does not resolve abscessresolve abscess
  28. 28. Pancreatic CarcinomaPancreatic Carcinoma  Nonsurgical managementNonsurgical management  Drug therapyDrug therapy  Radiation therapyRadiation therapy  Biliary stent insertionBiliary stent insertion

×