EXAM III HEPATIC AND PANCREATIC LECTURE Flashcards
What is the largest organ in the body?
The liver
What is the function of the liver? HINT: 4 (starts w/ Stores G, Metabolizes P, Detox T’s, and Produces what?–ABC)
Is the liver the largest organ in the body? Yes or no?
The liver stores glycogen (also vitamins and mineral)
Metabolizes proteins (Ammonia)
Detox of toxins (Kupffer cells engulfs harmful stubstances)
Produces–> Albumin, Bile, Cogulation factors
Yes, the liver is the largest organ in the body `
What is (liver) Cirrhosis?
Is it reversible or irreversible?
Does it occur at the beginning or end of the disease?
What happends to normal liver tissues?
Extensive scarring of the liver caused by necrotic injury or CHRONIC inflammation over a prolonged period of time
Irreversible destruction and degeneration of liver cells
The end of disease (Cirrhosis is the end-stage liver disease
Replaced with fibrotic tissue that lacks function
How does liver failure occur?
What happens in severe cases?
From cirrhosis, scar tissue slows the flow of blood through the liver.
Over time, the liver CANNOT work properly
In severe cases, the liver becomes so damaged that it STOPS working and liver failure occurs `
What are the types of Cirrhosis?
Post-necrotic: caused by viral hepatitis, some meds, or toxins
Laennec’s: caused by chronic alcohol use (MOST COMMON)
Billiary: caused by chronic biliary obstruction or autoimmune disease
What are S/S of Cirrhosis?
N/V, Anorexia, Ascites, muscle wasting from poor nutritional status, Color of stool(gray or tan in prescence of jaundice)
Dyspnea or hyperventilation b/c of ascites, Jaundice (yellowing of skin around eyes and mouth)
Itching (accumulation of salts under the skin)
Melena or Hematemesis(d/t bleeding varices)
Assess for sweet or musty odor on client’s breath (aka hepaticus which is caused by accumulated liver byproducts)
What are examples of more serious complications of Cirrhosis?
HINT: can be medical emergencies
Esophageal and/or gastric varices (medical emergency if ruptured)
Hepatic encephalopathy(imparied consciousness)
Portal HTN (High BPs in the portal vein and results from an obstruction)
Splenomegaly(caused by backed of blood into the spleenm which can cause thrombocytopenia and platelet destruction)
Collateral Vessels (alternative routes for blood to bypass thel liver
What is the portal vein?
What is caput medusae and what causes it?
A large vein that carries blood from the digestive tract, spleen, and pancreas to the liver
Caput medusae is a network of dilated veins surrounding the umbilicus caused by increased blood flow in the umbilical and peri-umbilical veins. Caused by portal HTN (an increased in portal vein pressure
A client w/ a medical dx of cirrhosis has been admitted to a medical unit and the nurse is doing an assessment. What complaint from the client requires IMMEDIATE follow up?
A: Bloody expectorant with coughing episodes
B: Jeans cannot zip because of enlarged abdomen.
C: Swelling in the feet and lower legs.
D: Yellowing of the eyes and mucous membranes.
A: Bloody expectorant with coughing episodes
All signs listed may occur with cirrhosis, as well as anorexia, nauseas, and vomiting due to the enlarging abdomen. However, bleeding esophageal varices are a result of hepatoportal hypertension. Active bleeding may result in melena and hematemesis, and if not treated hemorrhage and shock.
What is Bile and what does it do in the body?
What is Bile primary functions? HINT: 2 functions–> carry something away and breaks down something
What does bile help w/ eliminating?
Bile is the greenish-yellow fluid that consists of waste products, cholesterol, and bile salts) that’s secreated by the liver cells
Bile has two primary functions: to carry waste away and break down fats during digestion
Bile helps eliminate certain waste products including bilirubin mainly and excess cholesterol and by-products of drugs from the body
What is Bilirubin and when is it made?
What is bilirubin bind to in the blood?
A yellow-ish pigment that’s made during the normal breakdown of RBCs
Protien (Albumin)
What is cholesterol? Why is it needed in the body?
What are the TWO types of cholesterol?
A waxy substance that’s needed to bulid cells and make vitamins and other hormones
LDL (low density lipoprotein)–> BAD ONE
HDL (high density lipoprotein)–> GOOD ONE
What is Jaundice? Where does bilirubin come from?
Where does the bilirubin level have to be for jaundice to appear?
A yellow discoloration of the skin and mucous membranes caused by an excess accumulation of bilirubin in the blood
Bilirubin is a product of RBC breakdown
Bilirubin level: 2-3 mg/dL
What are the 3 main types of jaundice?
Prehepatic (AKA Hemolytic) jaudice: occurs when RBC lysis (breakdown) exceed the liver’s capacity to conjugate bilirubin
Causes include: tranfusion reactions, sickle cell anemia, autoimmune disease
Hepatic jaundice: results from hepatocyte dysfunction which LIMITS the uptake ad conjugation of bilirubin
Causes include: hepatitis, Cancer, cirhosis, congential disorders
Post-hepatic (obstructive jaundice: occurs when gallstones, inflammation, scar tissue, or tumors block the flow of bile into the intestines
What are the liver labs and their normal ranges?
Alanine transaminase (ALT): an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damage ALT is released into the bloodstream and levels increase
NORMAL RANGE: 4-36 units/L
Alkaline phosphate (ALP): an enzyme found in the liver and bone and is important for breaking down proteins. HIGHER than normal levels may indicate liver damage or disease
NORMAL RANGE: 30-120 units/L
Aspartate transaminase (AST): an enzyme that help metabolize amino acids. An increase level may indicate liver damage, disease, or muscle damage
NORMAL RANGE: 0-35 units/L
Serum bilirubin: will be elevated d/t inability for the liver to excrete bile
Serum Protein and albumin will be decreased d/t lack of hepatic synthesis
