Liver: Cirrhosis and Fulminant hepatic Failure Flashcards
What is cirrhosis?
Irreversible, inflammatory disease of the liver
Cirrhosis is extensive scarring of the liver caused by _____ or chronic reaction to ____ over a long period of time
Necrotic injury or a chronic reaction to inflammation over a prolonged period of time
Cirrhosis
What is normal tissue replaced with?
Fibrotic tissue that lacks function
Cirrhosis
Teaching
Stay current on immunizations
Encourage client to avoid drinking alcohol
Cirrhosis
Nonsurgical tx? (3)
- Parcentesis
- Endoscopic variceal ligation/endoscopic sclerotherapy (EST)
- Transjugular intrahepatic oortosystemic shunt (TIPS)
Cirrhosis
Why do parcentesis?
To relieve ascites
Cirrhosis
Why do EVL/EST?
To band varies and decreased risk of hemorrhage
Cirrhosis
Why do TIPS?
An interventional radiology for clients who require further intervention with ascites or hemorrhage
Cirrhosis
Surgical tx?
- Surgical bypass shunting
2. Liver transplant
Cirrhosis
Who gets surgical bypass shunting?
Last resort for those with portal HTN and esophageal varies
Cirrhosis
What to know about the liver and giving meds?
Liver is main metabolism source so if liver is hurt then meds need to be administered sparingly
*esp. opioids, sedatives, and barbiturates
Cirrhosis
Why give diuretic?
Decrease excessive fluid in the body
Cirrhosis
Why give BB?
Used for clients who have varies to prevent bleeding
Cirrhosis
Why give lactulose?
To promote excretion of ammonia from the body through stool
Cirrhosis
Why give non absorbable antibiotic?
To be used in place of lactulose
Fulminant hepatic failure
What are the management goals?
- Decrease ammonia levels
- Control bleeding
- Prevent infection
- Protect from injury
- Prepare for transplant
- Survey for complications
Fulminant hepatic failure
How to decrease ammonia levels?
- Remove nitrogenous wastes
- DRUG: Neomycin: prevents ammonia production in intestines
- Drug: Lactulose: Keeps ammonia in intestines and instead expelled from colon via BM
- Decrease protein intake
Fulminant hepatic failure
What does neomycin do?
Prevents ammonia productive in intestines
Fulminant hepatic failure
What does lactulose do?
Keeps ammonia in intestines and is expelled through BM
Fulminant hepatic failure
How to control bleeding?
Stress ulcer prophylaxis
Vitamin K, FFP, Plts
Fulminant hepatic failure
Protect from what injury?
Bleeding
Fulminant hepatic failure
Survey for complications..what complications?
Cerebral edema Renal failure ARF Electrolyte imbalance HYPOglycemia
