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16 Cards in this Set
- Front
- Back
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What are the manifestations of cirrhosis?
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chronic indigestion
weight loss spleenomegally spider telangiectasis varices-d/t portal HTN decrease in albumin vitamin deficiency gastritis ascites caput medusae-enlarged vessels ATC belly button anemia coma encephalopathy bleeding |
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What are the different types of cirrhosis?
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Laennac's-chronic ETOH
Post necrotic-viral infection Biliary-scarring in bile duct Cardiac-CHF r/t engaged liver Early-liver large, cells loaded with fat LATE-liver size decreased as scar tissue contracts |
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What do you assess?
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chief complaint
GI-pain, anorexia, nausea, vomiting, wt. change, indigestion, fat intolerance, eructation, bowel changes, melena, clay colored stools, steatorrhea Neurologic-drowsiness, clouded sensorium, irritability, change in mental status GU-change in urine color (orange) Skin-jaundice, petechiae, dilate abdominal veins, unexplaine punctures CV-nosebleeds, bruising, hemorrhoids, ascites, edema |
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Past Health HX
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major illness, hospitalizations
procedures causing skin, membrane disruption medications |
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What are the functions of the liver?
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glucose metabolism
lipid metabolism protein metabolism vitamins and mineral levels drug metabolism and detoxification bile formation billirubin excretion blood volume reservoir blood filter blood clotting hormone detoxification |
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What do radiologic exams tell you?
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structure
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What are the complications of paracentisis?
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hypovolemia and shock
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What are the interventions used to treat ascites?
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d/c meds that dec. prostaglandins
diuretics, esp. aldactone IV albumin low na diet restrict fluids paracentisis pertioneovenous shunt |
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What is ascites?
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sequel to portal HTN
fluid accumulation in peritoneal cavity chronic problem-liver sweats |
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What are the contraindications of a liver biopsy? What are some complications?
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CONTRAINDICATIONS:
thrombocytopenia prolonged PT peritonitis mass axcites enlarged gallbladder cancer COMPLICATIONS: hemorrhage pneumothorax infections peritonitis |
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What are some nursing intervetions used in treating ascites?
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daily weights
girth measurements strict I&O small frequent feedings limit protein and fluids teach to read food labels-NA skin care |
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What is hepatic encephalopathy?
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results from accumulation of ammonia and other toxic metabolites in blood
damaged liver cells fail to detoxify and convert to urea the ammonia that is constantly entering bloodstream |
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Diagnostic Exams
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ALT (SGPT)-liver specific
AST ALP LDH-#4&5 Billirubin-conjugated vs onjugated PT-prolonged in liver failure Serum ammonia-inc. r/t no breakdown and elimination Serum albumin-r/t dec. urea production globulins-dec. related to dec. production except with cirrhosis initially |
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What are the causes that result in damage to liver parenchymal cells?
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infectious agents
toxins nutritional deficiency cirrhosis anoxia medications hypersensitivity |
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Medical management Hepatitis?
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bedrest
diet of high CHO and low fat frequent small feedings IV if indicated |
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What are the clinical manifestations of hepatic encephalopathy?
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minor mental and motor changes
slight confusion, alteration in mood asterixis (hand flapping) handwriting changes LATE-frank coma |
