Nursing Care of Clients with Gallbladder, Liver and Pancreatic Disorders Chapter 24
Liver, Gallbladder and Pancreas
Gallbladder Disorders <ul><li>Cholelithiasis and Cholecystitis </li></ul><ul><li>Patho  </li></ul><ul><ul><li>gallstones f...
Gallbladder Disorders Cholelithiasis asymptomatic epigastric fullness after fatty meal biliary colic jaundice Acute cholec...
 
Gallbladder Disorders <ul><li>Treatment </li></ul><ul><ul><li>laparoscopic cholecystectomy </li></ul></ul><ul><li>Nursing ...
Let’s Review
 
 
Liver
Hepatitis
 
Liver Disorders <ul><li>Hepatitis </li></ul><ul><ul><li>inflammation of the liver due to virus, ETOH, drugs, toxins, may b...
Liver Disorders <ul><li>Hepatitis B  </li></ul><ul><ul><li>transmission - infected blood and body fluids </li></ul></ul><u...
Hepatitis Worldwide
Liver Disorders <ul><li>Disease pattern </li></ul><ul><ul><li>incubation </li></ul></ul><ul><ul><li>prodromal </li></ul></...
Liver Disorders <ul><li>Nursing Care </li></ul><ul><ul><li>teaching </li></ul></ul><ul><ul><ul><li>handwashing </li></ul><...
Advanced Cirrhosis
Liver Disorders <ul><li>Cirrhosis </li></ul><ul><ul><li>end state of chronic liver disease, progressive and irreversible <...
Liver Disorders <ul><li>Complications </li></ul><ul><ul><li>portal hypertension </li></ul></ul><ul><ul><li>splenomegaly </...
What are your assessments, interventions? What are your goals? How would you chart this?
Systemic effects of Cirrhosis
Liver Disorders <ul><li>Liver Cancer </li></ul><ul><ul><li>usually poor outcomes </li></ul></ul><ul><li>Liver Trauma </li>...
Hepatitis Nursing Care? Teaching needs? Complications?
 
Pancreatitis
Pancreatitis <ul><li>Pancreatitis </li></ul><ul><ul><li>inflammation of pancreas characterized by release of pancreatic en...
Pancreatitis <ul><li>Manifestations </li></ul><ul><ul><li>abrupt onset of severe epigastric/abdominal pain </li></ul></ul>...
Pancreatitis
Pancreatitis <ul><li>Diagnostic tests </li></ul><ul><ul><li>labs - amylase and lipase </li></ul></ul><ul><ul><li>Ultra sou...
Pancreatic Cancer
Pancreatic Cancer <ul><li>Very lethal </li></ul><ul><li>Risk factors </li></ul><ul><ul><li>smoking, chemical or environmen...
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B75 chapter 24 gallbladder, liver and pancreatic disorder

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B75 chapter 24 gallbladder, liver and pancreatic disorder

  1. 1. Nursing Care of Clients with Gallbladder, Liver and Pancreatic Disorders Chapter 24
  2. 2. Liver, Gallbladder and Pancreas
  3. 3. Gallbladder Disorders <ul><li>Cholelithiasis and Cholecystitis </li></ul><ul><li>Patho </li></ul><ul><ul><li>gallstones form due to </li></ul></ul><ul><ul><ul><li>abnormal bile composition </li></ul></ul></ul><ul><ul><ul><li>biliary statis </li></ul></ul></ul><ul><ul><ul><li>inflammation of gallbladder </li></ul></ul></ul><ul><li>Risk factors </li></ul><ul><ul><li>age, family hx., females - oral contraceptive </li></ul></ul>
  4. 4. Gallbladder Disorders Cholelithiasis asymptomatic epigastric fullness after fatty meal biliary colic jaundice Acute cholecystitis RUQ pain - back a/n/v fever with chills
  5. 6. Gallbladder Disorders <ul><li>Treatment </li></ul><ul><ul><li>laparoscopic cholecystectomy </li></ul></ul><ul><li>Nursing Diagnoses </li></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><li>Imbalanced Nutrition </li></ul></ul><ul><ul><li>Risk for Infection </li></ul></ul>
  6. 7. Let’s Review
  7. 10. Liver
  8. 11. Hepatitis
  9. 13. Liver Disorders <ul><li>Hepatitis </li></ul><ul><ul><li>inflammation of the liver due to virus, ETOH, drugs, toxins, may be acute or chronic </li></ul></ul><ul><li>Viral Hepatitis </li></ul><ul><li>Hepatitis A - infectious hepatitis </li></ul><ul><ul><li>fecal-oral route </li></ul></ul><ul><ul><li>benign, self-limiting </li></ul></ul>
  10. 14. Liver Disorders <ul><li>Hepatitis B </li></ul><ul><ul><li>transmission - infected blood and body fluids </li></ul></ul><ul><ul><ul><li>at risk - healthcare workers, drug users, multiple sexual partners, hemodialysis clients </li></ul></ul></ul><ul><li>Hepatitis C </li></ul><ul><ul><li>transmission - infected blood and body fluids </li></ul></ul><ul><ul><li>manifestations - mild, non-specific </li></ul></ul><ul><ul><li>world wide cause of chronic hepatitis </li></ul></ul>
  11. 15. Hepatitis Worldwide
  12. 16. Liver Disorders <ul><li>Disease pattern </li></ul><ul><ul><li>incubation </li></ul></ul><ul><ul><li>prodromal </li></ul></ul><ul><ul><li>icteric </li></ul></ul><ul><ul><li>convalescent </li></ul></ul>
  13. 17. Liver Disorders <ul><li>Nursing Care </li></ul><ul><ul><li>teaching </li></ul></ul><ul><ul><ul><li>handwashing </li></ul></ul></ul><ul><ul><ul><li>blood and body fluid precautions </li></ul></ul></ul><ul><ul><ul><li>vaccines for persons at high risk </li></ul></ul></ul>
  14. 18. Advanced Cirrhosis
  15. 19. Liver Disorders <ul><li>Cirrhosis </li></ul><ul><ul><li>end state of chronic liver disease, progressive and irreversible </li></ul></ul><ul><ul><ul><li>alcoholic cirrhosis, biliary, or secondary to hepatitis </li></ul></ul></ul><ul><ul><li>Manifestations </li></ul></ul><ul><ul><ul><li>liver enlg. Tender, wt loss, weakness, anorexia </li></ul></ul></ul><ul><ul><ul><li>ascites, gynecomastia, jaundice, edema, anemia, pancytopenia </li></ul></ul></ul>
  16. 20. Liver Disorders <ul><li>Complications </li></ul><ul><ul><li>portal hypertension </li></ul></ul><ul><ul><li>splenomegaly </li></ul></ul><ul><ul><li>ascites </li></ul></ul><ul><ul><li>esophageal varices </li></ul></ul><ul><ul><li>hepatic encephalopathy </li></ul></ul><ul><ul><li>hepatorenal syndrome </li></ul></ul>
  17. 21. What are your assessments, interventions? What are your goals? How would you chart this?
  18. 22. Systemic effects of Cirrhosis
  19. 23. Liver Disorders <ul><li>Liver Cancer </li></ul><ul><ul><li>usually poor outcomes </li></ul></ul><ul><li>Liver Trauma </li></ul><ul><ul><li>blunt or penetrating - hemorrhage </li></ul></ul><ul><li>Liver Abscess </li></ul>
  20. 24. Hepatitis Nursing Care? Teaching needs? Complications?
  21. 26. Pancreatitis
  22. 27. Pancreatitis <ul><li>Pancreatitis </li></ul><ul><ul><li>inflammation of pancreas characterized by release of pancreatic enzymes into pancreatic tissue itself leading to hemorrhage and necrosis </li></ul></ul><ul><li>Risk factors </li></ul><ul><ul><li>alcoholism, gallstones </li></ul></ul>
  23. 28. Pancreatitis <ul><li>Manifestations </li></ul><ul><ul><li>abrupt onset of severe epigastric/abdominal pain </li></ul></ul><ul><ul><ul><li>relieved by leaning forward, sitting up </li></ul></ul></ul><ul><ul><ul><li>initiated by fatty meal or alcohol intake </li></ul></ul></ul><ul><ul><li>n/v </li></ul></ul><ul><ul><li>abd. distention and rigidity, decreased b.s. </li></ul></ul><ul><ul><li>fever, 24 hours later jaundice </li></ul></ul>
  24. 29. Pancreatitis
  25. 30. Pancreatitis <ul><li>Diagnostic tests </li></ul><ul><ul><li>labs - amylase and lipase </li></ul></ul><ul><ul><li>Ultra sound, ERCP, C-T scan, needle bx </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>hydration, pain control and antibiotics </li></ul></ul>
  26. 31. Pancreatic Cancer
  27. 32. Pancreatic Cancer <ul><li>Very lethal </li></ul><ul><li>Risk factors </li></ul><ul><ul><li>smoking, chemical or environmental toxins </li></ul></ul><ul><li>Manifestations </li></ul><ul><ul><li>non-specific, a/n, wt. loss, dull epigastric pain </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>surgery - Whipple, radiation and chemotherapy </li></ul></ul>

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