Cirrhosis Flashcards
What are 4 major functions of the liver?
- Detoxifying the body
- Helps blood to clot
- Metabolize drugs
- Liver synthesizes albumin
What is the pathophysiology or cirrhosis? (142)
What are s/s of cirrhosis?
- Firm, nodular liver; jaundice
- Abd pain (liver capsule has stretched)
- Chronic dyspepsia (GI upset)
- Change in bowel habits
- Ascites
- Splenomegaly
- Peripheral edema
- Anemia
Can cirrhosis progress to hepatic encephalopathy/coma?
Yes
Does ammonia act like a sedative?
Yes
If liver is sick what is number one concern?
Bleeding
If liver is sick should medication levels be decreased?
Yes
Should you give people with liver problems acetaminophen?
NO
What is the antidote for acetaminophen?
acetylcysteine
When the spleen is enlarged is the immune system involved?
Yes
Will serum albumin go down or up?
down
Will ALT and AST go up or down?
up
What else can be used to diagnose cirrhosis?
- CT/MRI
- US
- Liver biopsy
Does a liver biopsy confirm a diagnosis?
Yes
What will you do before a liver biopsy?
- Clotting studies (PT, INR, aPTT)
- VS
- Position supine with right arm behind head
Why should the client exhale and hold breath during a liver biopsy?
To get diaphragm out of the way
After a liver biopsy how should client lay?
-On right side
What should you monitor after a liver biopsy?
- VS
- Worried about signs of hemorrhage
Will people with cirrhosis need antacids, vitamins, and diuretics?
Yes
Should they drink alcohol anymore?
NO
Should intake/output and daily weights be monitored? why?
Yes, if ascites
Do they need to rest?
Yes
How do you prevent bleeding?
Bleeding precautions (no IM)
Why should abdominal girth be measured?
Ascites
What is a paracentesis?
Removal of fluid from the peritoneal cavity (ascites)
Should you have the client void before a paracentesis?
YEs
How should client be positioned during a paracentesis?
Sitting up
Why should VS be monitored/for what?
-With “shock” clients, bp goes down and pulse goes up
Should skin be monitored for jaundice?
Yes
Anytime you are pulling fluids from someone can they go into shock?
Yes
Why should they avoid narcotics?
Liver can’t metabolize drugs when its sick
How should their diet be modified?
- Decrease protein (too much causes increased ammonia)
- Low sodium
What is the process of protein breakdown and excretion?
- Protein to ammonia
- liver converts ammonia to urea
- Kidneys excrete urea
