Liver Flashcards
_________ and ________ are initial indications of hepatic dysfucntion
fatigue and dark urine
___________ and __________ indicates the possibility of internal bleeding (a life threatening problem)
distended abdomen and splenomegaly
3 things to know about cholecystitis:
- can cause nausea
- frequent belching
- right upper abdominal pain
2 things a T-Tube is used for:
- to allow drainage of bile
2. to allow the introduction of media
2 things to avoid when having a T-Tube:
- strenuous exercise
2. do not immerse T-Tube in water
What is the expected drainage of a T-Tube?
500 - 1000 mL/day initially, will gradually decrease
What do you do following a cholecystectomy?
ensure the pt has help at home the first 24 - 48 hours
What should the pt do prior to an abdominal cholecystectomy?
place a pillow against the abdomen, take 3 deep breaths, hold the breath and the cough 2 - 3 times; this should be done every 2 hrs to prevent respiratory complications
_________can prevent abdominal jarring.
splinting
If a pt complains of severe abdominal pain in the right upper quadrant, it could indicate…
peritonitis or wound infection
Sources of Vitamin K:
- Green salad (most green vegetables), pork
If a pt has vitamin K deficiency, it means that ____________
they can bleed easily, check arm after BP for any bruising
What position should a pt be in after a liver biopsy?
lying on the right side for several hours to promote hemostasis and prevent hemorrhage and bile leakage
How should the nurse position the pt in preparation of a liver biopsy?
supine with the arms raised above the head to allow access to the liver.
Where is the needle inserted when doing a liver biopsy?
between two of the lower ribs or below the right rib cage
In Asians, signs of early jaundice are best observed on __________
the posterior hard palate; involved with taking Isoniazid
Jaundice may signal ____________
metastatic disease
Jaundice may also indicate a possible ___________
stone in the bile duct causing obstruction
8 signs of alcohol withdrawal symptoms:
- increase in pulse
- anxiety
- tremors
- insomnia
- hallucinations
- restless
- agitated
- irritable
3 early symptoms of alcohol withdrawal:
- hyperalert
- easily startled
- anorexia
When does alcohol withdrawal peak?
24 - 48 hours after the last drink
What is a good indicator of the pt’s progress through alcohol withdrawal?
an elevated pulse rate
How do you know if a pt in alcohol withdrawal is approaching delirium tremens (the most severe expression of alcohol withdrawal syndrome?
a steady increase in vital signs
How can delirium tremens be avoided in pt’s with alcohol withdrawal?
with additional sedation
Chronic alcohol use is the most common cause of _____________
hypomagnesium (less than 1.5)
4 Clinical manifestations of hypo magnesium include:
increase neuromuscular irritability
tremors
tetany
seizures
The best way to identify possible physical of alcohol dependency is through ___________
a complete physical assessment
What is hepatic toxicity?
a serious complication resulting from an acute Tylenol overdose that manifests 1 to 3 days after initial ingestion. ALT and AST will be increased.
3 symptoms of hepatitis A:
- Fatigue
- Anorexia
- intolerance to odors
3 recommendations for pts with hepatitis A:
- eat small meals and snacks
- eat protein from milk, meat and eggs
- increase calories 2000 - 3000 per day to meet energy needs
When is hepatitis A not infectious?
within a week or so after the onset of jaundice
What kind of precaution is needed for hepatitis A?
Standard precaution
What supplements do pts with chronic alcoholism need?
all B vitamins, especially thiamine (vitamin B1)
___________ is the primary cause of alcohol related changes such as _________ and ___________
Thiamine deficiency
Wernicke’s encephalopathy and Korsakoff’s syndrome
Side effects of Disulfiram (Antabuse):
- helps to minimize complications from the sedative effects of the drug
- the longer the pt takes the drug, the more sensitive they will be to alcohol.
- ANY contact with alcohol will cause alcohol-disulfiram reaction which may lead to shock and cardiac dysrhythmias
In the event of ascites, ___________ is given to _____________
albumin; pull fluid back into the blood vessel; then a diuretic is given to remove the excess fluids
In cirrhosis, a __________ is need to relieve portal hypertension.
a shunt
What kind of diet would a pt need in the early stages of cirrhosis?
High protein, high carbohydrate diet
Later in the disease process a pt with cirrhosis needs what kind of diet?
low fiber, protein, fat and sodium
What is an early symptom of chronic cirrhosis?
impaired thought process
3 Nursing interventions for a pt with cirrhosis:
- monitor for bleeding; administer blood
- measure abdominal girth; weight pt daily
- assess for respiratory difficulties
