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15 Cards in this Set

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What are the causes that result in damage to liver parenchymal cells?
infectious agents

toxins

nutritional deficiency

cirrhosis

anoxia

medications

hypersensitivity
What are the manifestations of cirrhosis?
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
What are the interventions used to treat ascites?
d/c meds that dec. prostaglandins

diuretics, esp. aldactone

IV albumin

low na diet

restrict fluids

paracentisis

pertioneovenous shunt
What are the functions of the liver?
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
What are the clinical manifestations of hepatic encephalopathy?
minor mental and motor changes

slight confusion, alteration in mood

asterixis (hand flapping)

handwriting changes

LATE-frank coma
What is hepatic encephalopathy?
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
What do radiologic exams tell you?
structure
Past Health HX
major illness, hospitalizations

procedures causing skin, membrane disruption

medications
Medical management for Hepatitis?
bedrest

diet of high CHO and low fat

frequent small feedings

IV if indicated
What are the contraindications of a liver biopsy? What are some complications?
CONTRAINDICATIONS:
thrombocytopenia
prolonged PT
peritonitis
mass axcites
enlarged gallbladder
cancer

COMPLICATIONS:
hemorrhage
pneumothorax
infections
peritonitis
What are the complications of paracentisis?
hypovolemia and shock
What is ascites?
sequel to portal HTN

fluid accumulation in peritoneal cavity

chronic problem-liver sweats
Diagnostic Exams
ALT (SGPT)-liver specific

AST

ALP
LDH-#4&5
Billirubin-conjugated vs unconjugated
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
What are some nursing intervetions used in treating ascites?
daily weights

girth measurements

strict I&O

small frequent feedings

limit protein and fluids

teach to read food labels-NA

skin care
What do you assess?
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