Liver And Gallbladder Flashcards
Where is the liver and gallbladder located in the abdomen?
RUQ
What are the fxns of the liver?
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
How do we palpate the liver? What should we feel?
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
What are the hepatic s/s?
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
What is asterixis?
Liver flap of wrist or hip in pts with hepatic encephalopathy
How does asterixis occur in the wrist?
In sitting, when attempting to extend the wrist, the hand tremors like a bird flapping its wings
How does asterixis occur in the hips?
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
What causes asterixis in hepatic encephalopathy?
Ammonia toxicity
What are some interventions for managing hepatic diseases?
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
What is the goal of interventions with hepatic diseases?
To not let s/s get out of control
What are the two options for liver donation?
Live donor or deceased donor
How does a living donor liver transplant work?
The pt will get part of the living person’s liver and it grows to a normal size
How does a deceased donor liver transplant work?
The pt can either receive an entire liver or a part of the liver split bw two people
What is the survival rate for deceased donor liver transplant at 1 year?
86%
What is the survival rate of a deceased donor liver transplant at 3 years?
78%
What is the survival rate of a deceased donor liver transplant at 5 years?
72%
What is the survival rate of a deceased donor liver transplant at 20 years?
53%
What types of hepatitis can result from contaminated water or food?
Hepatitis A and E
What types of hepatitis are more blood related?
Hepatitis B, C, and D
What types of hepatitis have vaccines in the US?
Hepatitis A, B, and D
What is the most common cause of acute liver failure?
Drugs (OTC or prescription)
What percent of heavy drinkers develop alcohol-related liver disease?
10-35%
What has to be done for alcohol-related liver disease?
The pt must change their behaviors
The pt must eat healthy foods
What are some foods to cleanse the liver?
Carrots, beets, olive oil, lemon juice, green tea, turmeric, garlic, spinach, leafy greens, avocado, and grapefruit
