Cirrhosis

Question 1

What are the 4 major functions of the liver?

Answer 1

Detoxify body
Help blood clot
Help metabolize drugs
Synthesizes albumin

Question 2

Patho?

Answer 2

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

Question 3

S/s

How is liver

Answer 3

Firm, nodular

Question 4

S/s

Pain

Answer 4

Abdominal pain–liver capsule has stretched

Question 5

S/s

GI

Answer 5

Chronic dyspepsia

Change in bowel habits

Question 6

S/s

Abdomen

Answer 6

Ascites

Splenomegaly

Question 7

S/s

Albumin

Answer 7

Decreased

Question 8

S/s

ALT and AST

Answer 8

Increase

Question 9

If liver is sick, what is #1 concern?

Answer 9

Bleeding

Question 10

If liver is sick, what about meds?

Answer 10

Decrease the dose by 1/2

Question 11

Never give what with liver problems?

Answer 11

Acetaminophen

Question 12

Antidote for acetaminophen?

Answer 12

Acetylycsteine

Question 13

When spleen is enlarged, what is involved?

Answer 13

Immune system

Question 14

Liver patients need to ___ because so full of toxins

Answer 14

Rest

Question 15

S/s

Blood

Answer 15

Anemia (often bleed with liver disease)

Question 16

S/s

Can progress to ?

Answer 16

Hepatic encephalopathy/coma

Question 17

Diagnosis?

Answer 17

US, CT, MRI

Liver biopsy

Question 18

Liver biopsy

What pre-procedure?

Answer 18

Clotting studies (PT, INR, and aPTT)
VS

Question 19

Liver biopsy

Position

Answer 19

Right arm up behind the head

Question 20

Liver biopsy

Tell them to do what?

Answer 20

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

Question 21

Liver biopsy

Post-procedure position

Answer 21

Lie on right side (put pressure on liver)

Get VS!!–worried about bleeding/hemorrhage

Question 22

Treatment

What drugs?

Answer 22

Antacids
Vitamins
Diuretics

Question 23

Treatment

No more ___

Answer 23

Alcohol

Question 24

Treatment

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

Answer 24

I&O and daily weights

Question 25

Treatment

Toxins in body so need to

Answer 25

Rest

Question 26

Treatment

Prevent?

Answer 26

Bleeding

*bleeding precautions

Question 27

Treatment

Measure?

Answer 27

Abdominal girth to know degree of ascites

Question 28

Treatment

Removal of fluid from peritoneal cavity

Answer 28

Paracentesis

Question 29

Paracentesis

Void or full bladder?

Answer 29

Void

*dont want to puncture bladder

Question 30

Paracentesis

Position?

Answer 30

Sit up so fluids can drain

Question 31

Paracentesis

Take VS because worried they will go into ___ with all fluid removal

Answer 31

Shock

Question 32

Anytime fluids pulled, pt can go into __

Answer 32

Shock

Question 33

With “shocky” clients, the BP goes ___ and pulse goes __

Answer 33

BP down

Pulse up

Question 34

Treatment

Skin

Answer 34

Monitor jaundice

*first place to see it= sclera

Question 35

Treatment

Avoid what drugs?

Answer 35

Narcotics–liver can’t metabolize drugs well when sick; give 1/2 doses

Question 36

Treatment

Diet

Answer 36

Decrease protein!!! (too much protein with liver problem= ammonia build up which can cross BBB and cause hepatic coma)

Low NA

Question 37

Protein breaks down into _____. The liver converts ammonia to ____….___ excrete urea.

Answer 37

Ammonia; urea; kidneys

So if liver is sick then decrease protein bc liver will convert it to ammonia and ammonia can cross BBB!!!