What are the labs associated with CRC? - Precise Answer ✔✔-Hgb &
Hct are *decreased* due to intermittent bleeding associated with the
tumor (may be the *first indication of a tumor* in some patients)
-if spread to liver, *liver enzymes are elevated*
-FOBT (if positive = GI bleeding)
-*CEA* elevated in CRC (tumor marker - may be elevated in other
benign or malignant diseases & in smokers as well, so is *not a
diagnosis*) (normal value = *<5 ng/mL*)
---> CEA often used to evaluate treatment effectiveness & to identify
recurrence (repeat every year)
How should albumin 20% be administered? - Precise Answer ✔✔for
hypovolemic shock --> 1 mL/min
for normal blood volume --> 2-3 mL/min
*comes in grams, and is administered by gravity (drops/min)
,True or False:
As ascites increases, pts complain of SOB - Precise Answer ✔✔true
True or False:
Esophageal varices are a life-threatening medical emergency; severe
blood loss may occur and result in shock from hypovolemia - Precise
Answer ✔✔true (anything that increases IAP or irritates the lining can
increase risk for bleeding)
all patients with cirrhosis should be screened for then by *endoscopy* to
detect them *before* they bleed
*propanolol to prevent bleeding*
What is often the first clinical sign that a patient has liver dysfunction? -
Precise Answer ✔✔thrombcytopenia
Hepatic cell damage may lead to what common complications? - Precise
Answer ✔✔-portal hypertension
---> *ascites* & esophageal varices
--coagulation defects
-jaundice
-portal-systemic encephalopathy w/ hepatic coma
A patient can be prescribed Ketoralac for a maximum of _______ days
for relief of pain associated with cholecystitis - Precise Answer ✔✔10
days
How does the aging process affect the expected findings with the
*liver*? - Precise Answer ✔✔-liver cells *decrease in number & size*
which results in a *smaller* liver
-*decreased* enzyme activity*
-*decreased* cholesterol synthesis
-*DECREASED DRUG METABOLISM* = increased risk for toxicity
(monitor for adverse effects)
How does the aging process affect the *large intestine*? - Precise
Answer ✔✔-*decreased* sensation to defecate (nerve impulse are
dulled)
-peristalsis *decreases*
= constipation / impaction
(encourage increased fluids & high-fiber diet and encourage as much
activity as tolerated)
, How does the aging process affect the *pancreas*? - Precise Answer
✔✔-duct changes (distention/dilation)
-calcification of pancreatic vessels = *decreased lipase production*
-*decreased lipase levels* = *decreased* fat absorption & *decreased*
digestion ---> steatorrhea (fat in stools)
(encourage small, frequent feedings and assess for diarrhea)
What is the pathway of bile from its originating organ to the exiting
point? - Precise Answer ✔✔liver --> L& R hepatic ducts --> common
hepatic duct --> cystic duct from gallbladder --> common bile duct -->
pancreatic duct --> duodenum
(if sphincter to common bile duct is closed, it goes to gallbladder for
*storage*)
Which labs are *elevated* with hepatitis? - Precise Answer ✔✔ALT,
AST, CEA
Which labs are *elevated* with cirrhosis? Which labs are *decreased*? -
Precise Answer ✔✔*elevated* = ALT, AST, alkaline phosphatase,
CEA, ammonia
*serum albumin is decreased* but there is an increase in albumin in the
abdominal cavity due to *ascites* (liver dysfunction = fluid shifts to
abdominal cavity)
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