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Acute Inflammatory Disorders
     Disturbances in Metabolism
HEPATITIS
Hepatitis
• Marked by:
  – Hepatocellular destruction
  – Necrosis
  – Autolysis


• Prognosis is poor if edema and end-stage
  liver disease develops
Hepatitis         A              B               C           D           E
            Infectious     Serum           Non-A, Non-
A.K.A
            Hepatitis      Hepatitis       B Hepatitis
Cause       HAV            HBV             HCV            HDV        HEV
            Fecal-oral;                    Blood
            food-borne;                    transfusions
Mode of     Water-         Parenteral;     and
                                                           Same as   Fecal-
Transmis-   bourne;        sexual;         parapher-
                                                           HBV       oral
sion        person-to-     perinatal       nalia; sex with
            person                         infected
            contact                        partner
            Flu-like
                                           Similar to                Similar
            (Pre-Icteric   With or
                                           HBV; less      Similar    to HAV;
S/Sx        Phase;         without
                                           severe and     to HBV     severe in
            Icteric        symptoms
                                           anicteric                 pregant
            Phase)
                           may be          Risk for
            Mild with                                     Similar    Similar
Prognosis                  severe; Risk    hepatic
            recovery                                      to HBV     to HAV
                           for cirrhosis   cancer
Virus infect liver-interlobular infiltration



Necrosis and hyperplasia of kuffer cells


 Failure of the bile to reach intestine in normal
                      amount


               Obstructed jaundice
       s/sx: dark urine, pale feces, itchness




               Liver cell damage
       Necrosis and autolytic type destroy
                  parenchyma
VIRAL HEPATITIS
• Assessment : s/sx
    • Prodromal / Preicteric
           »S – symptoms of URTI
           »W – weight loss
           »A – anorexia , chills , fever
           »R – right upper quadrant pain
           »M – malaise
    • Icteric
           »J – jaundice
           »A – acholic stool
           »B – bile colored urine ( tea colored)
APPENDICITIS
VIRAL HEPATITIS
• Nursing Mgt
    • Isolation of patient ( enteric isolation)
    • Standard precaution
    • Patient should be encouraged to rest during acute
      or symptomatic phase
    • Improved nutritional status
    • Utilize appropriate measures to minimize spread of
      the disease
VIRAL HEPATITIS
• Nursing Mgt
        • Observe patient for Melena and check stool for the
          presence of blood
        • Provide optimum eye and oral care
        • Increase in ability to carry out activities
            – Encourage the patient to limit activity when fatigued
            – Assist the client in planning period of rest and activity
            – Encourage gradual resumption of activities and mild exercise during recovery
• PREVENTION AND CONTROL
   – Handwashing every after use of toilet
   – Travelers should avoid water and ice if unsure of their purity
   – Educate on the mode of transmission of the disease.
Special Considerations
• Monitor patient’s weight daily, and record
  fluid intake and output

• Observe stools for consistency and
  amount and record bowel movement

• Tell the client not to consume alcohol or
  use nonprescription drugs for 1 year
Pathophysiology:
   Lumen of appendix - obstructed

            Inflammation

  Mucosa continues to secrete fluid

   Increased pressure in lumen of
             appendix

        Restricted blood flow

 Hypoxia       Infection        Gangrene

    PERITONITIS                 Perforation
PANCREATITIS
PANCREATITIS
ACUTE PANCREATITIS

PATHOPHYSIOLOGY
• Spasm, edema or block in the
  Ampulla of Vater reflux of
  proteolytic enzymes auto
  digestion of the pancreas
  inflammation
PANCREATITIS
PANCREATITIS
CHOLECYSTITIS
CHOLECYSTITIS




   Colleen C. Flores, RN
CHOLECYSTITIS
CHOLECYSTITIS
15   gi inflam disorders

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15 gi inflam disorders

  • 1. Acute Inflammatory Disorders Disturbances in Metabolism
  • 3. Hepatitis • Marked by: – Hepatocellular destruction – Necrosis – Autolysis • Prognosis is poor if edema and end-stage liver disease develops
  • 4. Hepatitis A B C D E Infectious Serum Non-A, Non- A.K.A Hepatitis Hepatitis B Hepatitis Cause HAV HBV HCV HDV HEV Fecal-oral; Blood food-borne; transfusions Mode of Water- Parenteral; and Same as Fecal- Transmis- bourne; sexual; parapher- HBV oral sion person-to- perinatal nalia; sex with person infected contact partner Flu-like Similar to Similar (Pre-Icteric With or HBV; less Similar to HAV; S/Sx Phase; without severe and to HBV severe in Icteric symptoms anicteric pregant Phase) may be Risk for Mild with Similar Similar Prognosis severe; Risk hepatic recovery to HBV to HAV for cirrhosis cancer
  • 5. Virus infect liver-interlobular infiltration Necrosis and hyperplasia of kuffer cells Failure of the bile to reach intestine in normal amount Obstructed jaundice s/sx: dark urine, pale feces, itchness Liver cell damage Necrosis and autolytic type destroy parenchyma
  • 6. VIRAL HEPATITIS • Assessment : s/sx • Prodromal / Preicteric »S – symptoms of URTI »W – weight loss »A – anorexia , chills , fever »R – right upper quadrant pain »M – malaise • Icteric »J – jaundice »A – acholic stool »B – bile colored urine ( tea colored)
  • 8. VIRAL HEPATITIS • Nursing Mgt • Isolation of patient ( enteric isolation) • Standard precaution • Patient should be encouraged to rest during acute or symptomatic phase • Improved nutritional status • Utilize appropriate measures to minimize spread of the disease
  • 9. VIRAL HEPATITIS • Nursing Mgt • Observe patient for Melena and check stool for the presence of blood • Provide optimum eye and oral care • Increase in ability to carry out activities – Encourage the patient to limit activity when fatigued – Assist the client in planning period of rest and activity – Encourage gradual resumption of activities and mild exercise during recovery • PREVENTION AND CONTROL – Handwashing every after use of toilet – Travelers should avoid water and ice if unsure of their purity – Educate on the mode of transmission of the disease.
  • 10. Special Considerations • Monitor patient’s weight daily, and record fluid intake and output • Observe stools for consistency and amount and record bowel movement • Tell the client not to consume alcohol or use nonprescription drugs for 1 year
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  • 12. Pathophysiology: Lumen of appendix - obstructed Inflammation Mucosa continues to secrete fluid Increased pressure in lumen of appendix Restricted blood flow Hypoxia Infection Gangrene PERITONITIS Perforation
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  • 21. ACUTE PANCREATITIS PATHOPHYSIOLOGY • Spasm, edema or block in the Ampulla of Vater reflux of proteolytic enzymes auto digestion of the pancreas inflammation
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  • 27. CHOLECYSTITIS Colleen C. Flores, RN

Notas del editor

  1. Rovsing's signContinuous deep palpation starting from the left iliac fossa upwards (counterclockwise along the colon) may cause pain in the right iliac fossa, by pushing bowel contents towards the ileocaecal valve and thus increasing pressure around the appendixPsoas sign or "Obraztsova's sign" is right lower-quadrant pain that is produced with either the passive extension of the patient's right hip (patient lying on left side, with knee in flexion) or by the patient's active flexion of the right hip while supine. The pain elicited is due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves. Straightening out the leg causes pain because it stretches these muscles, while flexing the hip activates the iliopsoas and therefore also causes pain.Obturator signIf an inflamed appendix is in contact with the obturatorinternus, spasm of the muscle can be demonstrated by flexing and internal rotation of the hip. This maneuver will cause pain in the hypogastrium