Exam 2 Flashcards
What does Serum Bilirubin include?
Direct (0.1-0.3 mg/dL)
Indirect (0/2-0/8 mg/dL
Total (0.1-1.0 mg/dL)
What is a blood test for Liver Disease?
Serum Bilirubin Test
What serum bilirubin causes jaundice?
Total Serum Bilirubin >2.5 mg/dL
What are the main Liver Tests?
AST and ALT
What is albumin?
The most abundant protein
Liver disease impairs what enzyme?
Albumin
Low protein levels may cause what in the body?
Edema
What is Gamma-glutamyl Transferase (GTT)?
A serum blood test for an enzyme that occurs in the liver
What is asterixis?
When a patient’s wrists and fingers are observed to “flap”
What is hepatitis?
An acute or chronic condition of liver inflammation
How is hepatitis A spread?
Fecal or oral material. Oral and anal sex as well.
How is hepatitis B spread?
Blood
How is hepatitis C spread?
Blood to Blood
Three ways Hep B is transmitted:
- Infected blood, blood products, needles
- Sexual transmission in semen or saliva
- Infected mothers to child at birth
Discuss Hep A treatment:
Self limiting. Clients generally recover in 4-6 weeks acquiring lifelong immunity.
Hep B at risk for what?
Risk of liver cancer. Chronic hepatitis.
Hep B vaccines?
Is recommended for infants, children, adolescents, and adults.
Who has the greatest risk of developing Hep C?
Individuals who are IV drug users
Hep C carriers can develop what?
50% develop chronic disease, 20% develop cirrhosis. Increased risk of liver cancer.
Incubation period for Hep C?
5 - 12 weeks
Incubation period of Hep B?
6 - 24 weeks
Hepatitis treatments
- Immunoglobulin
- Peginterferon
- Interferon
- Antivirals
Nursing considerations for Hepatitis
Private room, PPI (gown, gloves, goggles), disposable equipment, needless system, hand washing, screen blood donors, stool precautions for A, and test all pregnant women for B. No sharing toothbrushes.
Diet for hepatitis
Provide high carbs, high calorie, low to moderate fat, low to moderate protein to promote healing. Small, frequent meals
Liver abscess is what?
Caused by the spread of infection from some part of the intestinal tract
Liver abscess S/S
chills, intermittent fever, extreme weight loss, nausea, vomiting, abdominal distention, right sided pain in abdomen and shoulder, jaundice
Liver abscess Tx
antibiotics, percutaneous incision and drainage (I&D).
Trauma S/S and Tx
orthostatic hypotension, low BP, tachycardia, shock. Surgery to control the bleeding.
Trauma nursing considerations
Monitor VS, assess abdomen, treat shock, sterile technique, monitor drainage
When is liver transplant necessary?
With life-threatening, end-stage liver diseases. May be total or a piece of the liver
What is bile used for?
The digestion of fats.
Where is bile produced?
In the liver
Where is bile stored?
The gallbladder
What is cholecystitis?
Inflammation of the bladder wall
What is cholecysitits usually caused by?
Gallstones (cholelithiasis) that block the common bile ducts. Bile backs up and the gallbladder becomes inflammed.
Disease prevention for cholecystitis:
Low fat diet rich in HDL sources (seafood, nuts, olive oil). Don’t smoke. Participate in regular exercise program.
Physical assessment findings:
jaundice, clay colored stool, steatorrhea (fatty stool), and pruritus
incubation period for Hep A
2-6 weeks
What is a cholecystectomy?
Removal of the gallbladder with a laparoscopic or open approach
What is the drug Ursodiol used for?
Helps break up gallstones
What is pancreatitis?
The enzymes activate prematurely before reaching the intestines. Results in inflammation, necrosis, and hemorrhage.
