Cirrhosis Flashcards

1
Q

What are the 4 major functions of the liver?

A

Detoxify body
Help blood clot
Help metabolize drugs
Synthesizes albumin

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2
Q

Patho?

A

Liver cells destroyed and replaced with CT/scar tissue which alters circulation w/in liver and BP in liver goes up—Portal HTN

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3
Q

S/s

How is liver

A

Firm, nodular

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4
Q

S/s

Pain

A

Abdominal pain–liver capsule has stretched

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5
Q

S/s

GI

A

Chronic dyspepsia

Change in bowel habits

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6
Q

S/s

Abdomen

A

Ascites

Splenomegaly

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7
Q

S/s

Albumin

A

Decreased

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8
Q

S/s

ALT and AST

A

Increase

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9
Q

If liver is sick, what is #1 concern?

A

Bleeding

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10
Q

If liver is sick, what about meds?

A

Decrease the dose by 1/2

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11
Q

Never give what with liver problems?

A

Acetaminophen

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12
Q

Antidote for acetaminophen?

A

Acetylycsteine

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13
Q

When spleen is enlarged, what is involved?

A

Immune system

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14
Q

Liver patients need to ___ because so full of toxins

A

Rest

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15
Q

S/s

Blood

A

Anemia (often bleed with liver disease)

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16
Q

S/s

Can progress to ?

A

Hepatic encephalopathy/coma

17
Q

Diagnosis?

A

US, CT, MRI

Liver biopsy

18
Q

Liver biopsy

What pre-procedure?

A
Clotting studies (PT, INR, and aPTT)
VS
19
Q

Liver biopsy

Position

A

Right arm up behind the head

20
Q

Liver biopsy

Tell them to do what?

A

Exhale and hold breath (to get diaphragm out of the way)

21
Q

Liver biopsy

Post-procedure position

A

Lie on right side (put pressure on liver)

Get VS!!–worried about bleeding/hemorrhage

22
Q

Treatment

What drugs?

A

Antacids
Vitamins
Diuretics

23
Q

Treatment

No more ___

24
Q

Treatment

Any time you have ascites, you have a fluid volume problem…need to do what?

A

I&O and daily weights

25
Treatment Toxins in body so need to
Rest
26
Treatment Prevent?
Bleeding *bleeding precautions
27
Treatment Measure?
Abdominal girth to know degree of ascites
28
Treatment Removal of fluid from peritoneal cavity
Paracentesis
29
Paracentesis Void or full bladder?
Void *dont want to puncture bladder
30
Paracentesis Position?
Sit up so fluids can drain
31
Paracentesis Take VS because worried they will go into ___ with all fluid removal
Shock
32
Anytime fluids pulled, pt can go into __
Shock
33
With "shocky" clients, the BP goes ___ and pulse goes __
BP down | Pulse up
34
Treatment Skin
Monitor jaundice *first place to see it= sclera
35
Treatment Avoid what drugs?
Narcotics--liver can't metabolize drugs well when sick; give 1/2 doses
36
Treatment Diet
Decrease protein!!! (too much protein with liver problem= ammonia build up which can cross BBB and cause hepatic coma) Low NA
37
Protein breaks down into _____. The liver converts ammonia to ____....___ excrete urea.
Ammonia; urea; kidneys So if liver is sick then decrease protein bc liver will convert it to ammonia and ammonia can cross BBB!!!