Hepatic Coma Flashcards
1
Q
When you eat protein, what does it get broken down to?
A
Ammonia
2
Q
What does the liver convert ammonia to?
A
Urea
3
Q
Where is urea excreted?
A
Kidneys
4
Q
When liver is impaired, can it convert ammonia?
A
No, so ammonia level increases.
5
Q
What does ammonia do to the LOC?
A
decreases it
6
Q
What are s/s of a hepatic coma?
A
- Minor mental changes/motor problems
- Difficult to awaken
- Asterixis (hand flapping)
- Hand writing changes
- Reflexes will decrease
- EEG will be slow
- Fetor (breath smells like ammonia)
- GI bleeding is common
7
Q
What is the treatment for cirrhosis?
A
- Lactulose (to decrease ammonia)
- Enemas (rid blood from GI)
- Decrease protein in diet
- Monitor serum ammonia
8
Q
Explain the pathophysiology of hepatic coma.
A
Protein ➜ ammonia ➜ liver converts ammonia to urea ➜ urea get excreted by the kidneys
If liver is impaired ➜ ✗ convert ammonia to urea ➜ ↑ ammonia ➜ ↓ LOC
