Cirrhosis Flashcards
What are the 4 major functions of the liver?
Detoxify body
Help blood clot
Help metabolize drugs
Synthesizes albumin
Patho?
Liver cells destroyed and replaced with CT/scar tissue which alters circulation w/in liver and BP in liver goes up—Portal HTN
S/s
How is liver
Firm, nodular
S/s
Pain
Abdominal pain–liver capsule has stretched
S/s
GI
Chronic dyspepsia
Change in bowel habits
S/s
Abdomen
Ascites
Splenomegaly
S/s
Albumin
Decreased
S/s
ALT and AST
Increase
If liver is sick, what is #1 concern?
Bleeding
If liver is sick, what about meds?
Decrease the dose by 1/2
Never give what with liver problems?
Acetaminophen
Antidote for acetaminophen?
Acetylycsteine
When spleen is enlarged, what is involved?
Immune system
Liver patients need to ___ because so full of toxins
Rest
S/s
Blood
Anemia (often bleed with liver disease)
S/s
Can progress to ?
Hepatic encephalopathy/coma
Diagnosis?
US, CT, MRI
Liver biopsy
Liver biopsy
What pre-procedure?
Clotting studies (PT, INR, and aPTT) VS
Liver biopsy
Position
Right arm up behind the head
Liver biopsy
Tell them to do what?
Exhale and hold breath (to get diaphragm out of the way)
Liver biopsy
Post-procedure position
Lie on right side (put pressure on liver)
Get VS!!–worried about bleeding/hemorrhage
Treatment
What drugs?
Antacids
Vitamins
Diuretics
Treatment
No more ___
Alcohol
Treatment
Any time you have ascites, you have a fluid volume problem…need to do what?
I&O and daily weights
Treatment
Toxins in body so need to
Rest
Treatment
Prevent?
Bleeding
*bleeding precautions
Treatment
Measure?
Abdominal girth to know degree of ascites
Treatment
Removal of fluid from peritoneal cavity
Paracentesis
Paracentesis
Void or full bladder?
Void
*dont want to puncture bladder
Paracentesis
Position?
Sit up so fluids can drain
Paracentesis
Take VS because worried they will go into ___ with all fluid removal
Shock
Anytime fluids pulled, pt can go into __
Shock
With “shocky” clients, the BP goes ___ and pulse goes __
BP down
Pulse up
Treatment
Skin
Monitor jaundice
*first place to see it= sclera
Treatment
Avoid what drugs?
Narcotics–liver can’t metabolize drugs well when sick; give 1/2 doses
Treatment
Diet
Decrease protein!!! (too much protein with liver problem= ammonia build up which can cross BBB and cause hepatic coma)
Low NA
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!!!
