Chapter 43 Flashcards
The largest gland of the body is what?
Liver
What is considered a chemical factory that manufactures, stores, alters, and excretes a large number of substances involved in metabolism?
Liver
What does the liver receive?
Nutrient rich blood from the GI tract and then stores it
The liver is essentially important in what?
Important in the regulation of glucose and protein metabolism
The bile produced by the liver is stored where?
Gallbladder
Where is the liver located?
Behind ribs in the URQ
What is the major importance of liver function?
Circulation of blood into and out of the liver
What vitamins are stores in large amounts in the liver?
A,B, and D
Chronic liver disorder characterized by fibrotic change
Loss of functional liver tissue
Cirrhosis
What is a major symptom of liver disease/ hepatic dysfunction
Jaundice
Involuntary flapping movements of the hands
Asterixis
The patient may observe for signs of associated liver dysfunction when they see what?
Obesity
High alcohol intake
A liver with cirrhosis might feel?
Small and hard
A liver with acute hepatitis may feel?
Soft
Enlargement of the liver is what type of finding?
Abnormal
Removal of small amount of liver tissue usually through needle aspiration
Liver biopsy
Familial disorder characterized an increased level of unconjugated bilirubin that causes jaundice
Gilbert syndrome
What is a chronic idiopathic jaundice, with pigment in the liver?
Rubin-Johnson syndrome
Increased pressure throughout the portal venous system that results in obstruction of blood flow into and through the damaged liver
Portal hypertension
What med is the first line therapy in patients with ascites from cirrhosis
Spironolactone
Removal of fluid from the peritoneal cavity
Paracentesis
A method of treating ascites in which a cannula is threaded into the portal vein by the trans jugular route
Trans jugular intrahepatic portosystemic shunt (TIPS)
What is life-threatening and can result in hemorrhagic shock that produces decreased cerebral, hepatic, and renal perfusion?
Bleeding esophageal varices 
Which medication should not be used with coronary artery disease, because it may precipitate in MI 
Vasopressin
What medications decreases portal pressure and prevents a first bleeding episode in patients with varices
Beta blockers (-olol)
What is a therapy that is used to temporarily control hemorrhage and to stabilize a patient with massive bleeding?
Balloon Tamponade 
A patient under treatment of a balloon tamponade should what? 
Be observed in the ICU for serious complication such as aspiration, esophageal ulcer formation, and perforation
When would you see asterixis, which is involuntary flapping of the hands
Stage II encephalopathy
What is a sweet slightly fecal odor to the breath? May be described as freshly mowed grass, acetone, or old wine
Fector hepaticus
With hepatic dysfunction many patients develop what? that is caused by hypoalbuminemia do to decrease hepatic production of albumin
edema
Patients with liver dysfunction resulting from biliary obstructions commonly develop what? due to retention of bile salts
Pruritis
What is the most common cause of acute liver failure?
Drug induced liver disease
What meds may be indicated to decrease ascites? 
Potassium sparing diruretic agents
(Spironolactone or triamterene
What may help minimize bleeding gums?
Soft bristled toothbrush
Primary liver tumors are usually associated with what?
Liver disease
hepatitis B+C 
cirrhosis
What are early manifestations of malignancy of the liver?
Dull ache in the RUQ or back
Weight loss
Anorexia
Anemia

What is the most common surgical procedure for getting rid of a liver tumor?
Lobectomy 
What is the leading cause of death after liver transplantation
Infection
Vitamin deficiency leading to beriberi
Thiamine deficiency
Vitamin deficiency resulting in scurvy
Vitamin C
Vitamin deficiency resulting in macrolytic anemia
Folic acid
Nurses will expect to see asterixis with what?
Hepatic encephalopathy
Hepatitis A is transmitted how?
Fecal-oral route
Hepatitis B is transmitted how?
Through blood, saliva, semen
With the a balloon tamponade from a hemorrhage what is your main goal?
Maintaining the airway
Hepatitis A symptoms include?
Anorexia
Nausea/vomiting
What procedure would you use to diagnose cirrhosis?
Liver biopsy
What medication helps with elevated ammonia due to cirrhosis
Lactulose
What medication is administered with acute liver failure?
N-Acetylcysteine
What color stool will a patient have who is diagnosed with cirrhosis
Clay colored or whitish
Where can you palpate the liver?
RUQ
Diuretic that spares potassium and prevents hypokalemia
Spironolactone
What increases the risk for liver cancer?
Hepatitis C
Symptoms of hypovolemia include?
Cool clammy skin
Tachycardia
Hypotension
Decreased urine output
Type of jaundice
An adult experiencing transfusion reaction
Hemolytic
When is the 2nd and 3rd hepatitis B vaccine given after the 1st
2nd in 1 month
3rd in 6 months
What color stool indicated obstructive jaundice?
Clay colored stool
