Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
126 Cards in this Set
- Front
- Back
|
What is the largest internal organ in the body weighing approximately 3lbs. in an adult and is essential for life?
|
The liver
|
|
|
About one-fourth of the liver's blood supply comes from the...
|
Hepatic artery
|
|
|
Three-fourths of the liver's blood supply comes from the...
|
Portal vein
|
|
|
The portal circulatory system brings blood to the liver from the...
|
Stomach
Intestines Spleen Pancreas |
|
|
Where does blood enter the liver?
|
through the portal vein
|
|
|
What are the functions of the liver?
|
Metabolic functions
Bile synthesis Storage Mononuclear phagocyte system |
|
|
Metabolic functions of the liver includes...
|
Carbohydrate metabolism
Protein metabolism Fat metabolism Detoxification Steroid metabolism |
|
|
Bile synthesis of the liver includes...
|
Bile production
Bile excretion |
|
|
What does the liver store?
|
Glucose in the form of glycogen
Vitamins (fat and water soluble) Fatty acids Minerals Amino acids (albumin/B-globulins) |
|
|
What is the lab value for ammonia?
|
15-45mcg N/dl
|
|
|
What is the lab value for Alkaline phosphatase (ALP)?
|
38-126 U/L
|
|
|
What is the lab value for Aspartate amino-transferase (AST)?
|
10-30 U/L
|
|
|
What is the lab value for Alanine aminotransferase (ALT)?
|
10-40 U/L
|
|
|
What is the lab value for Cholesterol?
|
140-200 mg/dl
|
|
|
What procedure is used to obatin a specimen of liver tissue?
|
Liver biopsy
|
|
|
What type of patient shouldnt get a liver biopsy?
|
One who has a bleeding disorder
|
|
|
What are some complications of a liver biopsy?
|
Pneumothorax
Peritonitis Hemorrhage |
|
|
What are some goals for a patient that undergone a liver biopsy?
|
Bilateral breath sounds
No respiratory distress Stable vitals No bleeding |
|
|
what is a chronic progressive disease of the liver, that causes extensive degeneration and destruction of liver cells?
|
Cirrhosis
|
|
|
What is cirrhosis of the liver caused by?
|
Long term liver disease
Excessive alcohol intake Alcohol vs. malnutrition Nonalcoholic fatty liver disease Primary biliary cirrhosis Primary sclerosing cholangitis Cardiac cirrhosis |
|
|
What are some early signs and symptoms of cirrhosis?
|
Nausea and vomiting
Anorexia Dyspepsia Flatulence Diarrhea or constipation Abdominal pain Fever Slight weight loss Enlargement of liver and spleen |
|
|
What are some late signs and symptoms of cirrhosis?
|
Jaundice
Perpherial edema Ascites Skin lesions Hematologic disorders Endocrine disturbances Perpherial neuropathies Liver size decreased and nodular |
|
|
The compression of bile ducts by connective tissue overgrowth causes?
|
Jaundice
|
|
|
What color stools does a person with jaundice have?
|
Light or clay colored
|
|
|
What are the two kinds of skin lesions associated with cirrhosis?
|
Spider angiomas
Palmar erythema |
|
|
What are small dilated blood vessels with a bright red center point and spider like branches?
|
Spider angiomas
|
|
|
What is a reddened area that blanches with pressure?
|
Palmar erythema
|
|
|
What are some hemtologic problems thats are associated with cirrhosis?
|
Thrombocytopenia
Leukopenia Anemia Coagulation disorders Splenomegly |
|
|
What are some endocrine problems associated with cirrhosis?
|
Hyperaldosteronism
|
|
|
What are some signs and symptoms of hyperaldosteronism in men?
|
Gynecomastia
Loss of axillary and pubic hair Testicular atrophy Impotence Loss if libido |
|
|
What are some signs and symptoms of hyperaldosteronism in women?
|
Younger women: amenorrhea
Older women: vaginal bleeding |
|
|
What are enlarged and swollen veins at the end of the esophagus as a result in portal hypertension?
|
Esophageal varies
|
|
|
What kind of varies are located in the upper portion of the stomach?
|
Gastric varies
|
|
|
What are some factors that produce ulcerations such as Esophageal and gastric varies?
|
Alcohol ingested
Swallowing of poorly masticated food Ingested or coarse food Acid regurgitation from the stomach Straining at stool Coughing or sneezing Lifting heavy objects |
|
|
What results from collodial pressure from impaired liver synthesis of albumin and portcaval pressure from portal hypertension?
|
Peripheral edema
|
|
|
What is the most common manifestation of cirrhosis?
|
Ascites
|
|
|
What is the accumulation of serous fluid in the peritoneal or abdominal cavity?
|
Ascites
|
|
|
Due to ascites, the lymphatic system is not able to...
|
Carry off the excess protein and water
|
|
|
What position should a person with ascites be in?
|
High-folwers
|
|
|
What signs and symptoms will a person have with ascites?
|
Dehydration:
Dry tongue and skin Sucken eyeballs Muscle weakness Decrease in urinary output Hypokalemia Abdominal distention |
|
|
What is hepatic encephalopathy?
|
When ammonia crosses the blood brain barrier and produces neurotoxic manifestation.
|
|
|
In hepatic encephalopathy the liver is unable to convert ammonia into...
|
Urea
|
|
|
What are some signs and symptoms of hepatic encephalopathy?
|
Changes in neurologic and mental responsiveness
Sleep disturbances Lethargy Coma Asterixis (Flapping tremors) Fetor hepaticus (musty, sweet, odor of the patient's breath) |
|
|
What is functional renal failure with azotemia, obliguria, and intractable ascites?
|
Hepatorenal syndrome
|
|
|
What type of renal failure can be reversed by a liver transplantation?
|
Hepatorenal syndrome
|
|
|
What happens to liver enzymes (alkaline phosphatase, AST, ALT, and GGT) when it is cirrhosis?
|
They all increase
|
|
|
In compensated or end stage liver disease what happens to the liver enzymes AST and ALT?
|
They may be normal
|
|
|
In compensated or end stage liver disease what happens to the protein, albumin, serum billirubin, globulin and cholesterol levels? and What happens to the prothrombin time?
|
Protein, albumin, and cholesterol levels are decreases
Billirubin and globulin levels are increased Prothrombin time is prolonged |
|
|
What are some nursing interventions for a person with ascites?
|
Sodium restriction
Diuretics (spironolactone, amiloride, triamterene, furosemide, and hydrochlorothiazide) Fluid removal (paracentesis and perioneovenous shunt) |
|
|
What are some interventions for a person with varices?
|
Endoscopic ligation (banding of varices, fewer complications than sclerotherapy)
Balloon tamponade (controls hemorrhage by compression of varices and uses Sengstaken-Blakemore tube) |
|
|
What should someone with esophageal and gastric varices avoid?
|
Alcohol
Asprin Irritating foods |
|
|
What is the main goal for a person with esophageal and gastric varices?
|
Airway
Avoid bleeding/Hemorrhage Treat respiratory infections promptly |
|
|
What is the most common type of hepatitis?
|
Viral Hepatitis
|
|
|
What is inflammation and necrosis of hepatic cells?
|
Viral hepatitis
|
|
|
What are types of viral hepatitis?
|
Hepatitis A,B,C,D, and E
|
|
|
What is also known as "infectious hepatitis"?
|
Hepatitis A
|
|
|
What is the mode of transmisson for hepatitis A?
|
Fecal- oral route, poor sanitation
|
|
|
How long is the incubation period for hepatitis A?
|
15-50 days
|
|
|
The preicteric phase of hepatitis A includes what signs and symptoms?
|
Headache
Anorexia Fever |
|
|
The icteric phase of hepatitis A includes what signs and symptoms?
|
Dark urine
Jaundice of skin and sclera |
|
|
(TRUE OR FALSE)
Hepatitis A is not a chronic carrier |
True
|
|
|
Nursing management for hepatitis A includes:
|
Stressing good hygiene
Environmental sanitation |
|
|
What is also known as "serum hepatitis"
|
Hepatitis B
|
|
|
Nursing management for hepatitis A includes:
|
Stressing good hygiene
Environmental sanitation |
|
|
What is the mode of transmission of hepatitis B?
|
Blood and body fluids
Through mucous membranes and breaks in the skin. |
|
|
What is also known as "serum hepatitis"
|
Hepatitis B
|
|
|
Who are at the greatest risk for contracting hepatitis B?
|
Health care workers (#1)
IV drug abusers Homosexual activity |
|
|
What is the mode of transmission of hepatitis B?
|
Blood and body fluids
Through mucous membranes and breaks in the skin. |
|
|
How long is the incubation period of hepatitis B?
|
1-6 months
|
|
|
Who are at the greatest risk for contracting hepatitis B?
|
Health care workers (#1)
IV drug abusers Homosexual activity |
|
|
How long is the incubation period of hepatitis B?
|
1-6 months
|
|
|
How long can hepatitis B live on dry surfaces?
|
7 days
|
|
|
This vaccine provides active immuinty...
|
Hepatitis B
|
|
|
How does one recieve passive immunity for hepatitis B?
|
Through hepatitis B immune globulin
|
|
|
Nursing considerations for hepatitis B includes:
|
Teaching patient proper nutrition
Rest Prevention of spread |
|
|
(TRUE OF FALSE)
HBV can be a carrier state |
TRUE
|
|
|
People who have hepatitis B are at and increased risk for
|
Cirrhosis
Chronic hepatitis Hepatic cancer |
|
|
How is hepatitis C transmitted?
|
Blood transfusion
Exposure to blood Contaminated equiptment or drug paraphernalia Sexual contact |
|
|
What is the incubation period hepatitis C?
|
15-160 day
|
|
|
(TRUE OR FALSE)
Chronic carrier state is usually occurs with hepatitis C? |
TRUE
|
|
|
What medications are used to treat hepatitis C?
|
Interferon
Ribavirin |
|
|
Who are at risk for getting hepatitis D?
|
only people who have hepatitis b
|
|
|
How is hepatitis D transmitted?
|
Sexual contact
IV drug use |
|
|
Which hepatitis will likely progress to chronic hepatitis and cirrhosis?
|
hepatitis D
|
|
|
How is hepatitis E transmitted?
|
Fecal-oral route
|
|
|
What is the incubation peroid for hepatitis E?
|
15-65 days
|
|
|
What symptom is usually present with hepatitis E?
|
Jaundice
|
|
|
Does hepatitis E have a chronic state?
|
NO
|
|
|
What is an inflammatory condition caused by ingestion or inhalation of certian substances?
|
Toxic hepatitis
|
|
|
Inhalation or ingesting what substances can cause toxic hepatitis?
|
Dry cleaning fluid
Glue Insecticides Pesticides Poisonous mushrooms Rat poison |
|
|
What medications can cause toxic hepatitis?
|
Tylenol
Asprin Thorazine INH Valium |
|
|
What are some symptoms of toxic and drug induced hepatitis?
|
GI and flu type symptoms
Jaundice Hepatomegaly (may take days to months for symptoms to appear) |
|
|
What are twos kinds of gallbladder diseases?
|
Cholelithiasis
Cholecystitis |
|
|
What is Cholelithiasis?
|
Stones in the gallbladder
|
|
|
What is the most common disorder of the biliary system?
|
Cholelithiasis
|
|
|
What is Cholecystitis?
|
Inflammation of the gallbladder
|
|
|
What are some risk factors of Cholelithiasis?
|
Estrogen therapy
Sedentary lifestyle Familial tendency Obesity |
|
|
What gall bladder disease is most commonly associated with obstruction(gallstones or biliary sludge)?
|
Cholecystitis
|
|
|
What are the initial symptoms of acute cholecystitis?
|
Indigestion
Pain Tenderness in right upper quadrant |
|
|
What are some clincal manifestations on cholecystitis?
|
Pain
Inflammation Right upper quadrant tenderness Abdominal rigidity |
|
|
What are some symptoms of chronic cholecystitis?
|
History of:
Fat intolerance Dyspepsia Heartburn Flatulence |
|
|
Severity of cholelithiasis symptoms depends on...
|
Presence of obstruction
Whether stones move or not |
|
|
What are some symptoms of Cholelithiasis total obstruction?
|
Jaundice
Dark amber urine Clay-colored stools Pruritus Intolerance to fatty foods Bleeding tendencies Steatorrhea No urobilinogen in urine |
|
|
What are some complications of cholecystitis?
|
Gangrenous cholecysitis
Subphernic abscess Pancreatitis Cholangitis Biliary cirrhosis Fistulas Gallbladder rupture (bile peritonitis) |
|
|
What are some complications of cholelithiasis?
|
Cholangitis
Biliary cirrhosis Carcinoma Peritonitis Choledocholithiasis |
|
|
What type of Conservative therapy is used for cholelithiasis?
|
Mechanical Lithotripsy
|
|
|
What is Mechanical Lithotripsy used for?
|
It is used when gallstones are to large to pass, the endoscopist crushes the stones.
|
|
|
What are surgical therapy for cholelithiasis?
|
Laparoscopic cholecystectomy
Open cholecystectomy |
|
|
What is the treatment of choice for cholelithiasis?
|
Laparoscopic cholecystectomy
|
|
|
What is a Laparoscopic cholecystectomy?
|
Removal of the gallbladder through four puncture holes, minial postoperative pain with discharge for the next day or two.
|
|
|
What is the main complication with Laparoscopic cholecystectomy?
|
Injury to the common bile duct
|
|
|
What is an Open cholecystectomy?
|
Removal of the gallbladder through the right subcostal incision.
|
|
|
In an open cholecystectomy a T- tube is inserted into the common bile duct to...
|
Ensure patency of the bile duct
Allows excess bile to drain |
|
|
What are some clinical manifestations of gallbladder disease?
|
Indigestion
Moderate to severe pain Fever Jaundice |
|
|
What are some complications of cirrhosis?
|
Portal hypertension
Esophageal and gastric varices Ascites Peripheral neuropathy Hepatic encephalopathy Hepatorenal syndrome |
|
|
What is obstruction of normal blood flow to the liver?
|
Portal hypertension
|
|
|
Nursing Care for hepatic encephalopathy include...
|
Treatment
Restrict protein intake in early stages Lactulose (reduce serum ammonia through the bowel evacuation) D/C sedatives, tranquillzers, analgesics |
|
|
What are nursing interventions for hepatic encephalopathy?
|
Maintain safe enviornment
Assess (LOC, sensory and motor abnormalities, fluid and electrolytes imbalances, acid-base balance) Neurologic status q2h Prevention of constipation Limit physical activity Control hypokalemia Ensure proper nutrition |
|
|
What are some components of bile that precipitate into stones are?
|
Bile salts
Bilirubin Calcium Protein |
|
|
(TRUE OR FALSE)
The cause of gallstones in cholelithiasis is unknown. |
TRUE
|
|
|
Bile that is in the gallbladder is supersaturated with....
|
Cholesterol
|
|
|
What are the most common type of gallstones in cholelithiasis?
|
Cholesterol
|
|
|
What factors decrease bile flow?
|
Immobility
Pregnancey Inflammatory or obstructive lesions of biliary system |
|
|
Cholelithiasis gallstones stay in the gallbladder but may migrate to the...
|
Cystic or common bile duct
|
|
|
What is the most life threatening complication of cirrhosis?
|
Bleeding esophagel varices
|
|
|
With fluid removal from ascites you need to watch for...
|
A decrease in blood pressure and anticipate giving albumin
|
