Hepatic Disorders Flashcards
labs that will be increased if there is an issue with the liver
AST ALT protein prothrombin time ammonia cholesterol alkaline phosphate
watch for this following liver biopsy
bleeding
signs of bleeding following liver biopsy
bruising in abd area
most common cause of hepatic dysfunction
malnutrition related to alcoholism
besides alcoholism, causes of hepatic dysfunction
infection anoxia metabolic disorders nutritional deficiencies hypersensitivity states
manifestations of hepatic dysfunction
jaundice portal htn ascites varices hepatic encephalopathy nutritional deficiencies
cause of hepatic encephalopathy/coma
increased ammonia levels
where do the varices associated with hepatic dysfunction occur
esophagus
obstructed blood flow thru the liver resulting in increased pressure throughout the portal venous system
portal HTN
what does portal HTN result in
ascites
esophageal varices
in a pt with ascites, is percussion of the abdomen heard as tympany or a dull sound
dull
T or F: the HOB should be flat in a pt with ascites
FALSE, should be elevated or pt may be sitting in chair
tx of ascites
low sodium diet diuretics bed rest paracentesis admin salt poor albumin TIPS
life threatening complication of hepatic dysfunction
hepatic encephalopathy
fetor hepaticus
breath smells like stool
asterixis
an unusual hand movement indicative of increased ammonia levels
med given to reduce serum ammonia levels
lactulose
how does lactulose work
usually given PO, acts as a laxative
given to pts with hepatic dysfunction to minimize protein catabolism
IV glucose
ways to reduce ammonia in GI tract
suction
enemas
oral antibiotics
manifestations of bleeding of esophageal varices
hematemesis
melena (black, tarry feces)
general deterioration
shock
pts with cirrhosis should undergo screening ____ every 2 years
endoscopy
meds given to decrease bleeding of esophageal varices
vasopressin
somatostatin
octretide
what med may be used in conjuction with vasopressin when bleeding of esophageal varices is occurring
nitroglycerin—reduce CA vasoconstriction
