Liver Flashcards
what are the 5 major functions of the liver?
- metabolism and storage of fats, carbs, proteins, vitamins, and minerals
- blood volume reservoir
- blood filter
- blood clotting factors (prothrombin and fibrinogen)
- drug metabolism and detox
what is the portal circulatory system?
vessels that bring blood from the stomach, intestines, spleen, and pancreas to the liver
what is the name of the vessel that brings the blood into the liver?
the portal vein
what levels will the nurse need to monitor with a patient with liver problems?
bilirubin, serum ammonia, serum protein, serum albumin, and PT
how will the serum ammonia level change with decreased liver functioning?
increase
how will the serum protein level change with decreased liver functioning?
decreased
how will the serum albumin level change with decreased liver functioning?
decreased
how will the PT level change with decreased liver functioning?
increased (LONGER TO CLOT)
what causes jaundice?
increased bilirubin levels in the bloodstream (usually greater than 2 - 2.5 mg/dL)
bilirubin is the byproduct of the breakdown of what?
hemoglobin
conjugated bilirubin is also called:
direct bilirubin
unconjugated bilirubin is also called:
indirect bilirubin
if conjugated bilirubin is elevated - what does that mean about the liver?
means the liver is working but there is something causing the bilirubin not be to able to get out - like a bile duct obstruction or gallstones
if unconjugated bilirubin is elevated - what does this mean about the liver?
means that there is either impaired liver function or an overproduction of bilirubin
jaundice causes what type of discoloration of the skin?
yellow
are liver enzymes elevated or depleted in the presence of jaundice?
elevated
what is viral hepatitis?
systemic virus that mainly affects the liver and causes inflammation
what are 2 other types of viruses (besides the hepatitis viruses) that lead to hepatitis
epstein barr, cytomegalovirus
what are other causes (non-viral) of hepatitis?
alcohol abuse, drugs, chemicals, and bacteria
what causes hepatocyte death in the case of hepatitis?
an infection causes an immune and inflammatory response which leads to lysing of the infected cells causing edema and tissue hypoxia which leads to the hepatocyte death
what are the 3 stages of hepatitis?
prodromal
icteric
recovery
what are the clinical manifestations of the prodromal stage of hepatitis?
fatigue, anorexia, malaise, n/v, headache, cough, hyperalgesia, low grade fever
the prodromal stage of hepatitis begins __________ after exposure
2 weeks
during what stage of hepatitis will the patient begin experiencing jaundice and an enlarged liver?
icteric
what are the clinical manifestations of the icteric stage of hepatitis?
jaundice, dark urine, liver enlargement, painful palpation of the liver, fatigue, abdominal pain
what are the transmission routes of hepatitis A?
fecal-oral, parenteral, sexual
what is the onset of hepatitis A like?
acute with a fever
does hepatitis A lead to chronic hepatitis?
no
what age groups does hepatitis A usually affect?
children and adults
what is the prevention of hepatitis A?
hand hygiene and hepatitis A vaccine
what is the transmission of hepatitis B?
parenteral or sexual
what is the onset of hepatitis B?
insidious, slow
does hepatitis B lead to chronic hepatitis?
yes
what is the incubation period of hepatitis B? (relative)
long
what is the age range of those affected with hepatitis B?
any
what is the prevention of hepatitis B?
hepatitis B vaccine and safe sex / hygiene
what is the transmission of hepatitis C?
parental, sexual
what is the onset of hepatitis C?
insidious, slow
can hepatitis C develop into chronic hepatitis?
yes (80%)
what types of hepatitis have vaccines?
A and B
how many doses does the hepatitis B vaccine have?
3
when does the vaccine for hepatitis B begin?
Infant
how many doses does the hepatitis B vaccine have?
3
when does the vaccine for hepatitis B start?
infant
what is cirrhosis?
irreversible, inflammatory, fibrotic liver disease
what are the causes of cirrhosis?
hepatitis B and C
excessive alcohol intake
idiopasthic
non-alcoholic fatty liver disease
when the liver is at the fatty liver stage can the damage be reversed?
yes
what is alcoholic steatohepatitis?
a precursor to cirrhosis, includes inflammation and degeneration of hepatocytes
Begins irreversible damage
is alcohol cirrhosis reversible?
no
what are the early clinical manifestations of liver cirrhosis?
-N/V
-anorexia
-flatulence
-change in bowel habits
-fever
-weight loss
-palpable liver
what are the late clinical manifestations of liver cirrhosis?
-jaundice
-peripheral edema
-decreased albumin
-ascites
-vascular lesions
-anemia / bleeding
-endocrine problems (women = amenorrhea)
-esophageal varices
-anorectal varices
-encephalopathy
what is the primary factor associated with encephalopathy r/t cirrhosis
ammonia
what does portal hypertension lead to?
varices and ascities
what is the treatment for portal hypertension?
liver transplant
what is the main concern with the development of portal hypertension?
development of varices that can then burst and cause internal bleeding
what is acute liver failure?
separate liver failure not caused by cirrhosis or other types of liver disease
what is the most common cause of acute liver failure?
acetaminophen overdose
what is the antidote to acetaminophen overdose?
acetylcysteine
how long after viral hepatitis or metabolic liver disease can acute liver failure happen?
6-8 weeks after
how long after an acetaminophen overdose can acute liver failure happen?
5 days - 8 weeks
