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DPT 631 > Liver And Gallbladder > Flashcards

Liver And Gallbladder Flashcards

1
Q

Where is the liver and gallbladder located in the abdomen?

A

RUQ

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2
Q

What are the fxns of the liver?

A

Metabolism and energy storage

Detox of drugs, alcohol, and toxins

Converts ammonia from protein metabolism to urea

Produces bile to digest fats in the small intestine

Helps excrete bilirubin and cholesterol

Stores vitamins and minerals (fat soluble)

Contributes to immune fxn, clotting, and hormone regulation

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3
Q

How do we palpate the liver? What should we feel?

A

Pt in supine, come across on a diagonal from the L ASIS up to the R rib cage

Find the location under the ribs and have the to take a deep breath and feel the liver come into your hands with the dorsal of you fingers in contact with the underside of the ribs

Should feel the soft area become hard the hard area of the liver

Check for pain

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4
Q

What are the hepatic s/s?

A

Jaundice/bruising; yellow sclera

CTS (carpal tunnel syndrome)

Intermittent pruritis (itching)

Weakness and fatigue

Dark urine/clay colored stools

Brain fog

Chronic fatigue

RUQ pain

Referred pain to thoracic spine

Weight change

Ascites/LE edema

White fingernails

Cold hands/feet

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5
Q

What is asterixis?

A

Liver flap of wrist or hip in pts with hepatic encephalopathy

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6
Q

How does asterixis occur in the wrist?

A

In sitting, when attempting to extend the wrist, the hand tremors like a bird flapping its wings

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7
Q

How does asterixis occur in the hips?

A

In supine, passively fox and abduct the hips with the feet on the mat

The asterixis seems to be provoked by the involuntary contraction of hip abductors against gravity

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8
Q

What causes asterixis in hepatic encephalopathy?

A

Ammonia toxicity

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9
Q

What are some interventions for managing hepatic diseases?

A

Put the pt in Fowler’s position with head 18-20” above the knees bc they likely won’t tolerate lying flat bc it makes them feel like they’re drowning

Limit fluid intake to 1.5 mL/day

Limit Na intake to <2g/day

Diuretics to remove additional fluid

Paracentesis for further fluid removal

Breathing exercises

Monitor for falls, fever, chills, pain, and fatigue

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10
Q

What is the goal of interventions with hepatic diseases?

A

To not let s/s get out of control

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11
Q

What are the two options for liver donation?

A

Live donor or deceased donor

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12
Q

How does a living donor liver transplant work?

A

The pt will get part of the living person’s liver and it grows to a normal size

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13
Q

How does a deceased donor liver transplant work?

A

The pt can either receive an entire liver or a part of the liver split bw two people

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14
Q

What is the survival rate for deceased donor liver transplant at 1 year?

A

86%

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15
Q

What is the survival rate of a deceased donor liver transplant at 3 years?

A

78%

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16
Q

What is the survival rate of a deceased donor liver transplant at 5 years?

A

72%

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17
Q

What is the survival rate of a deceased donor liver transplant at 20 years?

A

53%

18
Q

What types of hepatitis can result from contaminated water or food?

A

Hepatitis A and E

19
Q

What types of hepatitis are more blood related?

A

Hepatitis B, C, and D

20
Q

What types of hepatitis have vaccines in the US?

A

Hepatitis A, B, and D

21
Q

What is the most common cause of acute liver failure?

A

Drugs (OTC or prescription)

22
Q

What percent of heavy drinkers develop alcohol-related liver disease?

A

10-35%

23
Q

What has to be done for alcohol-related liver disease?

A

The pt must change their behaviors

The pt must eat healthy foods

24
Q

What are some foods to cleanse the liver?

A

Carrots, beets, olive oil, lemon juice, green tea, turmeric, garlic, spinach, leafy greens, avocado, and grapefruit

25
Q

What are the symptoms of hepatitis?

A

Dark urine
Stomach/abdominal pain
Jaundice
Pale or clay colored stool
Fever
Loss of appetite
Fatigue
Nausea/vomiting
Aching jts

26
Q

How do we get omega 3?

A

Fish oil

27
Q

How much fish oil should we get?

A

EPA 250-500mg
DHA 250-500mg
ALA 1600 (male) 1100 (female)

28
Q

What is the fxn of the gallbladder?

A

Important in processing and absorbing food (bile fxns)

Storage of bile
Release of bile
Regulating bile flow
Bile pH regulation
Absorption of certain vitamins in our body

29
Q

How do we palpate the gallbladder?

A

Place your fingers to the R of the rectus just below the rib cage and ask the to to take a deep breath

30
Q

What is a red flag with gallbladder palpation?

A

Sudden pain and abdominal muscle testing that ceases on inspiration is suggestive of gallbladder pathology

31
Q

What motion may cause pain with gallbladder pathology?

A

FB

32
Q

What is Murphy’s sign (of the gallbladder)?

A

Hook fingers under the costal margin and have the pt inhale

Causes sharp pain or the pt is unable to complete inspiration

33
Q

What are the risk factors for gallbladder pathology?

A

Fat
Forty
Female
Fatty foods
Fertile
Family hx
Flatulent
Fair skin

34
Q

What are gallstones make of?

A

Cholesterol and pigment

35
Q

How do we ID gallstones?

A

US

36
Q

T/f: when gallstones get to a certain size, even some meds will take a long time to work

A

True

37
Q

When do gallstones form?

A

When there is excess cholesterol and the pH of the bile is too low

38
Q

What are gallstones meds good for?

A

Only good for small stones and people who aren’t good with surgical risks

39
Q

What does the gallstone med UDCA do?

A

It can dissolve cholesterol stones

40
Q

What does the gallstone med CDCA do?

A

Works to decrease cholesterol saturation in bile

41
Q

What are the guidelines for diet after gallbladder removal?

A

Limit fat intake

Eat smaller, more frequent meals

Gradually increase more fiber

Limit caffeine, alcohol, and spicy foods

Stay hydrated

42
Q

T/f: after getting the gallbladder removed, you have to ease back into a normal diet

A

True

DPT 631 (5 decks)

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