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Disorders of the accessory organs of the digestion: liver and pancreas…
Disorders of the accessory organs of the digestion: liver and pancreas
Assessment
Abdominal distention, tenderness or rigidity related to ascites.
Oedema and rebound tenderness
Patient may report abdominal pain.
Anorexia, nausea and vomiting.
On palpation may experience guarding and hepatomegaly may be palpated.
diagnostic test including blood test, liver biopsy, radiological and endoscopic procedures.
Aetiology
Excessive use of over-counter drugs or contraceptives
Alcoholic liver disease.
Lifestyle : behavior
Drugs effects.
Hormonal changes during pregnancy
Pathophysiology
Pancreatitis: pancreatic duct obstruction>edema>compression of blood vessels>ischemia>acinar cell injury.
Acinar cell injury>release of pancreatic and lysosomal enzymes>activation of enzymes>auto digestion of pancreas.
Defective intracellular transport of enzymes within acinar cells.
Risk factors
Exposure to hepatotoxic substances such as industrial chemicals.
Exposure to blood and blood contaminated with viruses such as hepatitis.
Excessive use of certain prescribed over-counter medication.
Critical illnesses such as trauma may cause stress ulcers.
Lifestyle behavior such as consumption of alcohol excessive.
Clinical manifestation
Cholestasis
Portal hypotension
Hepatic coma
Nursing care
Promote rest to the patient.
Vital sins should be monitored.
Nasogastric tube may be used to drain abdominal contents to a patient with distended abdomen
Encourage the patient to stay away from over-counter drugs
Nurse the patient in a comfortable condition .
Nursing management
Vital signs should be monitored and to detect deterioration.
Monitor blood pH level as well as amonea.
Fluid intake should be monitored and recorded.
Educate patient about the correct diet and medication that should be taken and avoided.