HEPATIC COMS

Question 1

explain HEPATIC COMA

Answer 1

● Protein in your diet is broken down into ammonia.
● Liver is supposed to convert the ammonia into urea.
○ Kidneys can excrete urea.
● When there is inflammation of the liver due to hepatitis, the ammonia builds
up instead of being converted to urea
● Increased ammonia levels can cause a hepatic coma.

Question 2

—— can cause hepatic coma?

Answer 2

increase ammonia levels

Question 3

assessment for hepatic coma

Answer 3

● Altered level of
consciousness
● Difficult to
awake
● Hyperreflexia
● Asterixis
● Fetor

Question 4

problem increase by (hepatic coma):

Answer 4

• †Protein
• Infection
• Hypovolemia
• Hypokalemia (IK)
• GI Bleeding

Question 5

treatment for hepatic coma

Answer 5

● Lactulose
● Cleansing enema
● Decreased protein
● Monitor serum ammonia

Question 6

mechanism of action of lactulose

Answer 6

○ Bacteria in the colon digest lactulose into chemicals that bind ammonia
○ The binding of ammonia prevents ammonia from moving from the colon into the blood
○ Allows the ammonia to be excreted decreasing serum ammonia