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NSG 210 Test 3 Study Guide

Develop in the head body or tail of the pancreas 8085

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Unformatted text preview: fats & high in carbs/proteins immediately after surgery; fat restriction is normally lifted after 4 ­6 weeks Pt may feel pain btwn shoulders b/c of CO2 from surgery. Cold/hot packs, movement & OTC drugs will help Traditional cholecystectomy: similar to laparoscopic but more invasive & more complications. Some pts have a drain inserted & brought out through a puncture wound if there is a bile leak. Drug therapy is also used. Advance diet quickly from clear liquids to low fat diet as soon as bs return. T ­tubes: are only used if there is a serious complication. They are inserted into the common bile duct & ensure patency of the duct & allow excess bile to drain. They may/may not have a drainage bag attached. Nursing care for t ­tubes includes keep pt in semi ­fowlers position; positioning drainage system below the level of the gallbladder & observing/recording drainage. Never irrigate, aspirate or clamp a T ­tube w/o a physician’s order. Jackson ­Pratt drains: are the most common. They are placed in the gallbladder bed to prevent fluid accumulation Monitor amt & character of drainage; it should be serosanguineous Notify physician if the drainage suddenly increases or becomes bright red Usually taken out w/in 24 ­48 hours post ­op Drug Therapy: includes opioids (morphine) & anti ­emetics. A PCA pump may be used to help w/ pain control. PANCREATIC DISORDERS Acute Pancreatitis Disease Process: self ­digestion of the pancreas by its own enzymes, usually trypsin, causes this. Most affected pts have biliary tract disease (involving gallstones) or hx of long ­term alcohol abuse. Toxic enzymes that are normally inactivated in the pancreas become activated & autodigest in the pancreas due to an obstruction that keeps them from moving on to the duodenum (where they should activate).  ­Renal failure, hyperparathyroidism, ulcers & increasing age all increase the risk of pancreatitis. Complications:  ­Bile flow obstruction may jaundice, hyperglycemia & type I diabetes (if bg isn’t controlled)  ­Left lung pleural effusionspneumonia, atelectasis  ­Multi ­system organ failureacute respiratory distress syndrome (ARDS)  ­Coagulation defectsdisseminated intravascular coagulation (DIC) S/S: severe abdominal pain occur...
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