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Test 4 > Chapter 58 > Flashcards

Chapter 58 Flashcards

1
Q

Effects of portal hypertension on the body?

A

ascities
esophageal varices
prominent abdominal veins
hemorrhoids

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2
Q

Early symptoms of lover disease?

A

fatigue
change in weight
nausea/vomiting
RUQ abdominal pain

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3
Q

Late symptoms of liver disease?

A 
GI bleeds
jaundice
Pruritus 
Ascites 
Spontaneous Bruising
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4
Q

AST

UP or DOWN?

A

UP

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5
Q

ALT

UP or DOWN?

A

UP

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6
Q

LDH

UP or DOWN?

A

UP

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7
Q

GGT

UP or DOWN?

A

UP

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8
Q

Alkaline phosphate

UP or DOWN?

A

UP

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9
Q

Direct bilirubin

UP or DOWN?

A

UP

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10
Q

Indirect bilirubin

UP or DOWN?

A

UP

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11
Q

Urine bilirubin

UP or DOWN?

A

UP

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12
Q

Urine urobilinogen

UP or DOWN?

A

UP

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13
Q

PT/IRN

UP or DOWN?

A

prolonged, so UP

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14
Q

Fecal urobilinogen

UP or DOWN?

A

Down

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15
Q

Albumin

UP or DOWN?

A

Down

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16
Q

Protein

UP or DOWN?

A

Down

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17
Q

Nursing care after Liver biopsy?

A

Immediately after
 turn patient on right side with pillow under costal margin
 Remain in that position for several hours
 Do not cough or strain
 Vitals taper – Q15x4, Q30x2
 No heavy lifting for one week

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18
Q

What does the patient need to do prior to a Abdominal Paracentesis?

A

Void before procedure

Vitals prior to procedure

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19
Q

Risk from a Abdominal Paracentesis?

A
  • May cause respiratory distress called hepatopulmonary syndrome
  • Dyspnea, intra-abdominal pressure, crackles in lungs
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20
Q

Drugs to help prevent esophageal varices?

A

 Beta-Blockers (propranolol) to decrease heart rate and hepatic venous pressure

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21
Q

What is a Sengstaken-Blakemore tube used for?

A

applys pressure to bleeding via a balloon on a stick

22
Q

Risk of Sengstaken-Blakemore tube?

A

Risk for aspiration, asphyxia, and esophageal perforation

23
Q

Drugs used to decrease bleeding and portal pressure?

A 
Vasopressin
Nitro
Somatostatin
Octreotide
Propanolol 
Nadolol
24
Q

What does a EVL endoscopic variceal ligation accomplish?

A

Stops the bleeding by applying rubber bands

25
Q

Risk of TIPS?

A

stenosis of the stent and thrombosis

26
Q

Indication for TIPS procedure?

A

hemmorhage or chronic ascites

27
Q

Diet for hepatic encephalopathy?

A

High carb
High protein
low fat

28
Q

What are the symptoms of hepatic encephalophathy?

A

sleep disturbance
mood disturbance
mental status changes
speech problems

29
Q

Drugs to avoid for a patient with a history of hepatic encephalophathy?

A

opiods
sedatives
barbiturates

30
Q

Drugs to reduce ammonia levels?

A

Lactulose

non absorable antibiotics

31
Q

Why give lactulose?

A

promote excretion of ammonia in the stool
reduce confusion
2 to 3 soft stools per day

32
Q

Why give nonabsorbable antibiotics?

A

acts as an intestinal antiseptic

destroys normal flora to decrease protein breakdown which reduces the ammonia produced

33
Q

Drugs in the nonabsorbable antibiotics catagory?

A

Rifaximin

Neomycin

34
Q

HAV transmission?

A

Ass to mouth

35
Q

Incubation period for HAV?

A

15 - 30 days

36
Q

Vaccine for HAV?

A

YEs

37
Q

HBV transmission?

A

Blood, saliva, semen, vaginal secretions

38
Q

HBV incubation period?

A

1 to 6 months

39
Q

Symptoms of HBV?

A 
nausea/vomiting 
fever
fatigue 
RUQ pain
Dark urine
Light stool 
joint pain
jaundice
40
Q

Treatments for HBV

A

antivirals
immunomodulators
rest to reduce strain on liver

41
Q

HCV transmission?

A

injection drug use
sexual
transfusions

42
Q

Teaching for HBV and HCV???

A
  • Cannot donate blood, body organs, tissue, semen
  • Do not share tooth brushes or razors
  • No illegal drugs and no sharing of needles
  • No alcohol
  • Cover open wounds and sores
  • Transmission rare in monogamous sexual partners
43
Q

What heps are there vaccines for?

A

HAV and HBV

44
Q

WHich heps are chronic carriers?

A

HBV and HCV

45
Q

contraindication for liver transplant?

A 
cardiovascular disease
pulmonary disease
active alcoholism 
metastatic disease
non-compliant
46
Q

What does MELD determine?

A

severity of liver disease for ranking on transplant list.

47
Q

Primary rejection timeframe

A

within 30 days

48
Q

Secondary rejection timeframe

A

after 30 days

49
Q

symptoms of liver transplant rejection

A 
Fever
Decreased quality/quantity bile (should be viscous like motor oil)
Elevated liver function tests
Malaise/fatigue/confusion
Increased ascites
RUQ tender
Urine dark/Stool clay colored
Jaundice
rise in ALT and AST
elevated alkaline phosphatase 
prolonged PT/INR
50
Q

indications for infection from liver transplant

A 
Fever/chills
Decreased quality/quantity bile 
Elevated liver function tests
Malaise
Nausea/vomiting/diarrhea
Swelling or redness of any area

Test 4 (8 decks)

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