liver will become enlarged and firm

severe abdominal pain, N/V, absent bowel sounds, Cullen or Grey Turner's sign

these complications of cirrhosis can rupture easy with coughing, swallowing, or bearing down

bluish or purple discoloration around the sides of abdomen (along flank)

free fluid in the peritoneal cavity that makes the abdomen hard

bluish or purple discoloration around the umbilicus

fever, chills, and abdominal pain due to bacterial migration

give medications to suppress gastric acid

bacterial peritonitis needs

NPO for acute pancreatitis

spleen enlargement and itching due to this complication of cirrhosis

neurological changes caused due to ammonia build up

the pain bores from front to back and is worse when they lay flat

ammonia toxicity gets lactulose

cirrhosis needs

in what position do we want a patient with acute pancreatitis

restrict sodium with

saclike structure that resolves spontaneously most of the time

avoid alcohol, aspirin, and irritating foods with varices

collection of pus that requires surgical drainage

what is drug of choice for varices

don't sedate patients with hepatic encephalopathy because the liver can't metabolize

transmitter oral-anal activity or poor hygiene

progressive, prolonged, destructive disease of the pancreas

transmitted by blood, maternal-fetal, sexual intercourse, and sharing of needles

avoid what with acute pancreatitis

transmitted blood to blood

pain will be less bothersome as this disease progresses

only occurs with Hep B

will have edema, mild jaundice, and dark urine

usually only in tropical areas with heavy rains

a diagnostic may be getting a stool sample

virus is only killed by chlorine and high temperatures

do not let pancreatic enzyme replacement therapy touch

blood tests confirm this and presents N/V, dark urine, RUQ pain

give small frequent meals and antiemetics

Ribavirin treats

with chronic pancreatitis, how do we take the pancreatic enzyme

monitor for decreased bile pigment, tachycardia, and fever

treat aggressively with immunosuppressive drugs to avoid what after liver transplant

dark urine, sclera, and weight lost are the first signs of

may place this with pancreatic cancer

sit the patient straight up and place an NG tube

fluid filled thyroid

solid thyroid

if you can see the thyroid gland, do you palpate it

if doing a thyroid exam with two hands

increase fluid intake for 24-48 hours after

if doing a thyroid exam with one hand

if giving PO radioactive iodine for a thyroid scan

if giving oral radioactive iodine

hot area on a scan (black)

cold area on scan (white)

contraindications of radioactive iodine

Graves, Adenoma, Goiter, and Hyperthyroidism

thyroiditis, hypothyroidism, and increased hormone replacement therapy

excessive thyroid and hormone secretion

is related to hyperthyroidism

protruding eyes

everything speeds up

hyper, hot, and skinny

tremors, tachycardia, and hypertension

T3 and T4 will be elevated with

need a diet high in calories and protein

a 1 degree increase in temperature can equal

thyroid storm

drug of choice for hyperthyroidism

radioactive iodine precautions

hoarseness is common for 1-2 days after

put patient in which position after a thyroidectomy to prevent incision stress

low calcium causes the face to draw up when touched

low calcium will cause the arm to contract if taking BP on it

after a thyroidectomy, you need to assess for

numbness,, tingling around lips, muscle spasms, and Chvostek's

uncontrolled hyperthyroidism with fever and tachycardia

give tapazole for

cool room and cooling blankets for

what type of thyroid replacement is needed for hyperthyroidism after surgery

eye drops, sunglasses, elevating HOB, and taping eyelids shut

insufficient thyroid hormone

cold, overweight, slow, and dry

hypotension, bradycardia, and low RR

thick tongue

is associated with hypothyroidism

need a low calorie, high-fiber diet

keep them warm

drug of choice for hypothyroidism

start a ____ synthroid dose for hypothyroidism

poorly treated hypothyroidism

characterized by hypothermia, hypotension, hypoventilation, bradycardia, and hypoglycemia

treat myxedema coma with

treat hypothermia and hypoglycemia of hypothyroidism with

bacterial infection

viral infection

hypothyroidism

hypothyroidism

will be a painful gland with a fever and dysphagia

treatment of subacute thyroiditis

treatment of acute thyroiditis

treatment of chronic thyroiditis

symptoms of hyperthyroidism can be controlled with

post op priority of thyroidectomy

there will be an increased thyroglobulin (Tg) level with

when parathyroid levels drop, they pull calcium from bones and kidneys for more

calcium is going up, and phosphorus is going down

decreases bone density so there's an increased risk for osteoporosis

moans, bones, stones, groans, and psychic overtones

anorexia, lethargy, osteoporosis, renal stones, fractures, and anemia

hyperparathyroidism labs

hyperparathyroidism labs

hyperparathyroidism labs

hyperparathyroidism labs

increase fluid intake to avoid kidney stones with hyperparathyroidism

drug of choice for hyperparathyroidism

oral phosphates and calcitonin help with hyperparathyroidism

if parathyroidectomy for hyperparathyroidism took the whole gland

check for hypocalcemia after a parathyroidectomy

results from a lack of PTH to maintain serum calcium levels; hypocalcemia

most common cause of hypoparathyroidism

fatigue, depression, constipation, tingling, numbness, cramps

hypoparathyroidism labs

hypoparathyroidism labs

hypoparathyroidism labs

hypoparathyroidism labs

low calcium and increased phosphorus

can treat hypoparathyroidism with

decreased Ca, decreased Mag, and increased phosphorus

increased Ca, increased Mag, and decreased Phosphorus

deficient in one or more anterior pituitary hormones

tumors are most common cause of

can cause HA and vision changes

dwarfism in children

adults have osteoporosis

perform a stimulation test (won't produce) with

need to remove the adenoma

give synthetic growth hormones for hypopituitarism

overstimulates growth of bones and soft tissue

need potassium supplements, and potassium sparing diuretics

gigantism in children

post op adenoma removal, give hydrocortisone

acromegaly in adults

elevated blood glucose

if surgery is contraindicated in hyperaldosteronism

enlargement of hands, joint pain, deeper voice, enlargement of organs

in this suppression test, GH levels won't fall

rare tumor of the adrenal medulla

shrinks a tumor in hyperpituitarism

intermittent HTN and severe HA are signs of

replace hormones as treatment with

diagnosed with a 24 hour urine and blood test

perform hypophysectomy

check anterior and posterior visual fields

monitor for increased ICP after hypophysectomy

common teaching after hypophysectomy

deficiency in vasopressin (ADH)

have an excess of vasopressin (ADH)

extreme dehydration, tachycardia, hypovolemia

diabetes insipidus will have a urine output of

drug of choice for diabetes insipidus

monitor daily weights

can give vasopressin IM or IV for

will have extreme water retention and low sodium

N/V, crackles, edema, HA, lethargy, altered LOC

will be put on a fluid restriction of 500-1000 mL/24 hours

reduce noise and environmental stimuli

adrenal hypofunction

often caused by cessation of steroid therapy

wasted appearance with bronze skin

cortisone, hydrocortisone, prednisone, and fludrocortisone

replace 2/3 of cortisol in morning and 1/3 in afternoon for addison's

hypotension, tachycardia, dehydration, and low glucose

treat hyperkalemia of addisonian crisis with

check glucose levels every hour with addisonian crisis

people with addisonian crisis or adrenal hypofunction can't handle stress because they have no cortisol

increase hydrocortisone dose if in a stressful time

excess cortisol

will see skin changes such as stretch marks, striae, bruising, or petechiae

will have delayed wound healing

cortisol and glucose will be increased

adrenal gland hyperfunction

drug therapy for cushing's

need to restrict fluids and nutrition with

cushing's may need

give proteins for what to promote wound healing

administer what before an adrenalectomy

hallmark is HTN and hypokalemia

excessive aldosterone secretion