NSG 210 Test 3 Study Guide

Vasopressin is contraindicated in pts w hx of cad

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Unformatted text preview: & check w/ physician before taking new meds & take daily weights. Carlton Notes  ­Retention of Na & H20 also causes dilutional hypernatremia (more H20 than Na). This may cause pt to lose K & become hypokalemic. Pt will show s/s of dehydration  ­Also could ax pt’s respiratory status, gait & if orthopenia or splenomegaly is present.  ­SBP is an infection in the abdominal cavity. It may occur in pt w/ a GI or esophageal bleed. SBP s/s include rigid abdomen, low grade fever, tachycardia, pain, loss of appetite, N/V, changes in mental status. Dx made through paracentesis. Esophageal Varices Disease Process: varices develop from portal HTN; they are dilated veins usually found in the submucosa of the lower esophagus. Once formed, varices increase in size & eventually hemorrhage. They are life ­threatening & are a major cause of death in pt’s w/ cirrhosis.  ­Factors that contribute to hemorrhage: muscular exertion from lifting heavy objects, straining at stool, sneezing, coughing, vomiting, esophagitis, irritation of vessels by poorly chewed foods or irritating fluids, reflux of stomach contents (esp alcohol). Blood clotting abnormalities also increase the likelihood of hemorrhage. S/S: Hematemesis, melena, deterioration in mental/physical status, hx of alcohol abuse; pt may exhibit s/s of shock from massive blood loss that include cool clammy skin, hypotension, tachycardia Ax & Dx: includes endoscopy, portal HTN measurements & lab tests  ­Endoscopy: used to identify the bleeding site, along w/ barium swallow, ultrasonography, CT & angiography. Preventative endoscopy screening for pts w/ cirrhosis is recommended q2 years in an effort to treat large varices prior to hemorrhage.  ­Lab...
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This document was uploaded on 03/29/2014.

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