Page 1501 - Saunders Comprehensive Review For NCLEX-RN

elastic rubber band.
2. Sloughing, followed by superficial ulceration, occurs
in the area of ligation within 3 to 7 days.
F. Shunting procedures
1. Description: Shunt blood away from the esophageal
varices
2. Portacaval shunting involves anastomosis of the portal
vein to the inferior vena cava, diverting blood from
the portal system to the systemic circulation (Fig. 48-
7).
3. Distal splenorenal shunt (see Fig. 48-7)
a. The shunt involves anastomosis of the
splenic vein to the left renal vein.
b. The spleen conducts blood from the
high-pressure varices to the low-
pressure renal vein.
4. Mesocaval shunting involves a side anastomosis of the
superior mesenteric vein to the proximal end of the
inferior vena cava.
5. Transjugular intrahepatic portosystemic shunt (TIPS)
a. This procedure uses the normal
vascular anatomy of the liver to create
a shunt with the use of a metallic stent.
b. The shunt is between the portal and
systemic venous system in the liver
and is aimed at relieving portal
hypertension.
XV. Hepatitis
A. Description
1. Inflammation of the liver caused by a virus, bacteria,
or exposure to medications or hepatotoxins
2. The goals of treatment include resting the inflamed
liver to reduce metabolic demands and increasing the
blood supply, thus promoting cellular regeneration
and preventing complications.
B. Types of hepatitis include hepatitis A virus (HAV), hepatitis B
virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV),
and hepatitis E virus (HEV).

C. Assessment and stages of viral hepatitis (Box 48-9)

XVI. Hepatitis A
A. Description: Formerly known as infectious hepatitis
B. Individuals at increased risk
1. Crowded conditions (e.g., day care, nursing home)
2. Exposure to poor sanitation

C. Transmission

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