Cirrhosis

Question 1

What are 4 major functions of the liver?

Answer 1

• Detoxifying the body
• Helps blood to clot
• Metabolize drugs
• Liver synthesizes albumin

Question 2

What is the pathophysiology or cirrhosis? (142)

Question 3

What are s/s of cirrhosis?

Answer 3

• Firm, nodular liver; jaundice
• Abd pain (liver capsule has stretched)
• Chronic dyspepsia (GI upset)
• Change in bowel habits
• Ascites
• Splenomegaly
• Peripheral edema
• Anemia

Question 4

Can cirrhosis progress to hepatic encephalopathy/coma?

Answer 4

Yes

Question 5

Does ammonia act like a sedative?

Answer 5

Yes

Question 6

If liver is sick what is number one concern?

Answer 6

Bleeding

Question 7

If liver is sick should medication levels be decreased?

Answer 7

Yes

Question 8

Should you give people with liver problems acetaminophen?

Answer 8

NO

Question 9

What is the antidote for acetaminophen?

Answer 9

acetylcysteine

Question 10

When the spleen is enlarged is the immune system involved?

Answer 10

Yes

Question 11

Will serum albumin go down or up?

Answer 11

down

Question 12

Will ALT and AST go up or down?

Answer 12

up

Question 13

What else can be used to diagnose cirrhosis?

Answer 13

• CT/MRI
• US
• Liver biopsy

Question 14

Does a liver biopsy confirm a diagnosis?

Answer 14

Yes

Question 15

What will you do before a liver biopsy?

Answer 15

• Clotting studies (PT, INR, aPTT)
• VS
• Position supine with right arm behind head

Question 16

Why should the client exhale and hold breath during a liver biopsy?

Answer 16

To get diaphragm out of the way

Question 17

After a liver biopsy how should client lay?

Answer 17

-On right side

Question 18

What should you monitor after a liver biopsy?

Answer 18

• VS

- Worried about signs of hemorrhage

Question 19

Will people with cirrhosis need antacids, vitamins, and diuretics?

Answer 19

Yes

Question 20

Should they drink alcohol anymore?

Answer 20

NO

Question 21

Should intake/output and daily weights be monitored? why?

Answer 21

Yes, if ascites

Question 22

Do they need to rest?

Answer 22

Yes

Question 23

How do you prevent bleeding?

Answer 23

Bleeding precautions (no IM)

Question 24

Why should abdominal girth be measured?

Answer 24

Ascites

Question 25

What is a paracentesis?

Answer 25

Removal of fluid from the peritoneal cavity (ascites)

Question 26

Should you have the client void before a paracentesis?

Answer 26

YEs

Question 27

How should client be positioned during a paracentesis?

Answer 27

Sitting up

Question 28

Why should VS be monitored/for what?

Answer 28

-With “shock” clients, bp goes down and pulse goes up

Question 29

Should skin be monitored for jaundice?

Answer 29

Yes

Question 30

Anytime you are pulling fluids from someone can they go into shock?

Answer 30

Yes

Question 31

Why should they avoid narcotics?

Answer 31

Liver can’t metabolize drugs when its sick

Question 32

How should their diet be modified?

Answer 32

• Decrease protein (too much causes increased ammonia)

- Low sodium

Question 33

What is the process of protein breakdown and excretion?

Answer 33

• Protein to ammonia
• liver converts ammonia to urea
• Kidneys excrete urea