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NUR 210-Exam 1 > Cirrhosis > Flashcards

Cirrhosis Flashcards

1
Q

What is Laennec’s (Alcoholic) portal cirrhosis?

A

Scar tissue out #’s normal cells and the liver is unfunctional; results of alcohol or nutritional probs

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2
Q

Postnecrotic cirrhosis is what?

A

Complication of hepatitis/hepatoxins

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3
Q

What is biliary cirrhosis?

A

Chronic biliary obstruction/infection and scarring from diseases of the bile duct

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4
Q

What is cardiac cirrhosis?

A

From long standing right CHF

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5
Q

What is the primary risk factor for cirrhosis?

A

Alcohol consumption

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6
Q

What are other risk factors?

A

Malnutrition: low protein intake, high phosphate intake; occupation exposure; men between ages 40-60

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7
Q

What are the early clinical manifestations of?

A

Liver enlargement/fatty liver, vascular changes, abnormal labs: Tiny increases in ALT/AST/LDH/PT and decreased albumin

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8
Q

How do you get rid of a enlarged/fatty liver?

A

Quit drinking, exercise and maintain a healthy diet

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9
Q

What are the advanced stages severe complications?

A

Ascities, GI varices, encephalopathy and portal HTN

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10
Q

Where are the 3 main places ascities can accumulate?

A

Esophagus, rectum and stomach

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11
Q

What is encephalopathy caused by? And some s/s?

A

Ammonia; Confusion, mental deterioration, somnalence

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12
Q

What is portal HTN?

A

Increase pressure of blood flow around the liver

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13
Q

What of the liver cannot be reversed?

A

Fibrosis (thickening/scarring of CT)

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14
Q

What anti-inflammatory is often used for the pharmacological management of cirrhosis?

A

Colchicine

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15
Q

What potassium sparing diuretic is used for the pharmacological management of cirrhosis?

A

Aldactone

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16
Q

What meds can cause liver damage?

A

Barbiturates, tylenol and sedatives

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17
Q

What other meds can be used for the pharmacological management of cirrhosis?

A

Vit. K, antacids and H2 receptor blockers

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18
Q

What is the nutritional therapy for cirrhosis?

A

Protein, high calories, moderate fat, decrease sodium, limit fluids and vit/mineral supplements

19
Q

How much salt can a person w/ cirrhosis intake?

A

2g/day

20
Q

What vitamin/mineral supplements can be used for nutritional therapy?

A

B complex, fat soluble vitamins and Mg

21
Q

What other supportive therapy is used in the treatment for cirrhosis?

A

Rest: semi-fowlers position, O2 therapy and actions to prevent immobility

22
Q

What’s the major risk factor of portal HTN?

A

Hemorrhage

23
Q

What is the non-surgical managements of portal HTN?

A

Endoscopic screening, non-selective beta blockers

24
Q

If a pt is a high risk for bleeding what non-selective beta blocker is used?

A

Propanolol Hydrochloride (Inderal)

25
Q

What other common non-selective beta blocker is used to treat portal HTN?

A

Nadolol (Cogard)

26
Q

What is ascities?

A

Accumulation of fluid in the peritoneal cavity

27
Q

What surgical procedure can be used for portal HTN?

A

Transjugular intrahepatic portosystemic shunt (TIPS)

28
Q

What is TIPS?

A

Stent placed b/t hepatic and portal vein to decrease pressure and prolong life

29
Q

Frequent complication of portal HTN, fluid leaks from GI organs, fluid leaks from vascular system and sodium and water retention are all causes of what?

A

Ascities

30
Q

What are the dietary modifications to manage ascities?

A

Low sodium diet and the use of salt substitutes w/o ammonia

31
Q

What diuretics are used to manage ascities?

A

Spirnalactone (Aldactone)

32
Q

What nursing care is done to measure salt-poor albumin?

A

Daily weights, monitor F/E, I/O, measuring abd girths

33
Q

What surgical procedure can be performed to manage ascities?

A

LaVeen shunt

34
Q

What is a LaVeen Shunt?

A

A tube inserted from the liver to the heart to help blood flow when you breathe

35
Q

What are complications of a LaVeen Shunt?

A

CHF, infection, repeated clotting

36
Q

What should be monitored in a pt w/ ascities?

A

H/H and coagulation studies

37
Q

What is the most advanced stage of hepatic encephalopathy?

A

Hepatic coma

38
Q

What is the management for heaptic encephalopathy?

A

Remove offending agent, reduce/restrict protein intake, reduce intestinal bacteria, and reduce serum ammonia levels

39
Q

What is admin. to reduce intestinal bacteria in hepatic encephalopathy?

A

Flagyl, enemas, neomycin, sulfasuxidine, sulfathaladine

40
Q

What is admin. to reduce ammonia levels?

A

Lactulose: flushes out ammonia through diarrhea

41
Q

What are the side effects of Lactulose?

A

Intestinal bloating and cramping

42
Q

What should you dilute lactulose w/ if given PO?

A

Fruit juice

43
Q

What are varices?

A

Enlarged, thin-walled veins that form and may rupture or cause massive hemorrhage

NUR 210-Exam 1 (9 decks)

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