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nursing theory iv a- cindy's class > Assessment and Management if Patients with Hepatic Disorders > Flashcards

Assessment and Management if Patients with Hepatic Disorders Flashcards

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1
Q

What is the metabolic functions?

A
  • Glucose metabolism
  • Ammonia conversion
  • Protein metabolism
  • Vitamin and iron storage
  • Drug metabolism
  • Bile formation
  • Bilirubin excretion
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2
Q

What are the liver function studies?

A

bilirubin and PT
- ALT, ALK

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3
Q

What are some additional diagnostic studies for hepatic disorders?

A
  • Liver biopsy, Ultrasonography
  • CT, MRI
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4
Q

What is jaundice?

A

Yellow- or green-tinged body tissues, sclerae, and skin caused by increased serum bilirubin levels

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5
Q

What is the S&S of jaundice?

A
  • Lack of appetite, nausea, weight loss
  • Malaise, fatigue, weakness
  • Headache, chills, and fever if infectious in origin
    -Dark orange-brown urine and light clay-colored stools
  • Dyspepsia and intolerance of fats, impaired digestion
    Pruritus
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6
Q

What is hepatitis?

A

Inflammation of the liver
two types: acute viral (spread through viruses) and non viral (spread through toxic and drug induced)

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7
Q

What is hepatitis A?

A
  • spread through fecal contamination
  • incubation: 15-45 days
  • anti-hav antibody serum after symptoms appear
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8
Q

What is the S&S of hepatitis A?

A

mild flulike symptoms, low-grade fever, anorexia, later jaundice and dark urine, indigestion and epigastric distress, enlargement of liver and spleen

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9
Q

What is the management of hepatitis A?

A

-prevention: vaccine
- WASH HANDS
- no effective treatment
- recover in 4-6 weeks

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10
Q

What is hepatitis B?

A
  • transmitted through blood and bodily fluids
  • incubation period is 1-6 months
  • symptom are similar to hep A
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11
Q

What is the management of hepatitis B?

A
  • prevention is vaccine
  • treated with interferon
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12
Q

What is Hepatitis C?

A
  • transmitted through percutaneous
  • commonly through people who share needles
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13
Q

What is the S&S of hepatitis C?

A
  • N&V, loss of appetite, jaundice, fatigue, itching, pain in URQ
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14
Q

What is the management of Hepatitis C?

A
  • no prevention
  • Prevention of needle sticks for health care workers & measures to reduce spread of infection
  • treated with pegylated interferon and ribavirin
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15
Q

What is Hepatitis D?

A
  • Only persons with hepatitis B are at risk for hepatitis D
  • Transmission is percutaneously
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16
Q

What is hepatitis E?

A

Transmitted by fecal-oral route (contaminated water)
- rare

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17
Q

What is hepatitis G?

A

Transmitted parenterally and sexually

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18
Q

What is toxic and drug induced hepatitis?

A

Agents producing toxic hepatitis are generally systemic poisons

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19
Q

What is cirrhosis of the liver?

A
  • Liver serves as a reservoir for a large amount of venous blood that the failing heart is unable to pump into circulation
  • Liver becomes anoxic
  • Resulting in liver cell necrosis and fibrosis
20
Q

What are the S&S of cirrhosis?

A
  • jaundice, ascites, hepatomegaly, edema, anemia, spider angiomas
  • changes in mental responsiveness and memory
21
Q

What are tar three types of cirrhosis?

A
  1. alcohol
  2. post necrotic
  3. biliary
22
Q

What is alcoholic cirrhosis?

A
  • alcohol induced cirrhosis
  • makes fatty liver which can be reverses if person stops drinking
  • if continues, causes scar formation
23
Q

What is post necrotic cirrhosis?

A
  • Occurs after massive liver cell necrosis
  • complication of acute viral hepatitis or after exposure to industrial or chemical hepatotoxins
    -Broad bands of scar tissue cause destruction of liver lobules and entire lobes
24
Q

What is biliary cirrhosis?

A
  • Develops from chronic biliary obstruction, bile stasis, inflammation
  • Diffuse fibrosis of the liver with jaundice as the main feature.
25
Q

What is the complications of cirrhosis?

A
  • Portal hypertension
  • Ascites
  • Bleeding esophageal varices
  • Coagulation defects
  • Hepatic encephalopathy
  • Hepatorenal syndrome
  • Jaundice
26
Q

What is portal hypertension?

A

Obstructed blood flow through the liver results in increased pressure throughout the portal venous system.
- this can potentially result in ascites and esophageal varices

27
Q

What is ascites?

A

Accumulation of free fluid containing almost pure plasma within peritoneal cavity

28
Q

What is the treatment of ascites?

A
  • low sodium diet, bed rest, Paracentesis, TIPS
29
Q

What is paracentesis?

A

procedure that uses a hollow needle or plastic tube (catheter) to remove fluid from the abdominal cavity
- used for treatment of ascites

30
Q

What is bleeding of esophageal varies?

A

Fragile, thin-walled, distended esophageal veins that are irritated and rupture

31
Q

What is coagulation defects?

A
  • Decreased synthesis of bile fats in the liver that prevent absorption of fat-soluble vitamins
  • Without vitamin k and clotting factors client is susceptible to bleed
32
Q

What is the treatment of bleeding varices?

A
  • Treatment of shock, Oxygen, IV fluids, electrolytes, and volume expanders, Blood and blood products
  • meds to decrease bleeding, improve cardiac circulation and decrease portal pressure
33
Q

What is hepatic encephalopathy and coma?

A

A life-threatening complication of liver disease. May result from the accumulation of ammonia and other toxic metabolites in the blood.
End-stage hepatic failure and cirrhosis

33
Q

What is asterixis?

A

(liver flap) a coarse tremor characterized by rapid, nonrhythmic extension and flexion in wrist and fingers

34
Q

What is hepatorenal syndrome?

A
  • Progressive oliguric renal failure
  • Associated with hepatic failure
  • impaired kidneys and portal hypertension
35
Q

What is the S&S of hepatorenal syndrome?

A

Sudden ↓ urinary flow, ↑ BUN and Creatinine, Abnormally ↓ urine sodium excretion, Increase urine osmolarity, patients may require temporary hemodialysis.

36
Q

What is the lab and diagnostic tests for hepatorenal syndrome?

A
  • Elevated serum liver enzymes and serum bilirubin
  • Prolonged PT time
  • Enlarged liver on X-ray
37
Q

What is pancreatitis?

A

A severe disorder that can lead to death. Acute pancreatitis does not usually lead to chronic pancreatitis

38
Q

What is acute pancreatitis?

A

Pancreatic duct becomes obstructed and enzymes back up into the pancreatic duct, causing autodigestion and inflammation of the pancreas

39
Q

What is chronic pancreatitis?

A

inflammatory disorder with destruction of the pancreas

40
Q

What is the S&S of chronic pancreatitis?

A
  • Recurrent attacks of severe upper abdominal and back pain accompanied by vomiting
  • May be painless (20%)
  • Weight loss (75%)
  • Steatorrhea
41
Q

What is the S&S of acute pancreatitis?

A
  • Rigid/boardlike abd ominous sign
  • Nausea and vomiting
  • Fever, jaundice, confusion, and agitation may occur
  • Ecchymosis
  • acute renal failure
  • severe abdominal pain
42
Q

What is the complications of pancreatitis?

A

-Fluid and electrolyte disturbances
- Necrosis of the pancreas
- Shock
- Multiple organ dysfunction syndrome
- DIC

43
Q

What is the treatment of pancreatitis?

A
  • Management directed at symptoms an preventing complications
  • Pt usually NPO
  • Parenteral nutrition - TPN
  • NG tube – relieve nausea & vomiting
  • Medication to limit pancreatic secretions: H2 Antagonists, Proton pump inhibitors
44
Q

Why does chronic renal failure cause anemia?

A

When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells.
Kidney damage=less erythropoietin= less RBC= anemia

45
Q

What is worse, chronic or acute pancreatitis? Why?

A

acute, watch urine output
- there is symptoms with acute where chronic has none

nursing theory iv a- cindy's class (17 decks)

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