Liver Disease

Question 1

What are the functions of the liver?

Answer 1

Bile production, Carbohydrate metabolism, fat metabolism, protein metabolism, vitamin storage and protection

Question 2

How much bile can be produced by the liver a day?

Answer 2

1 liter

Question 3

What does bile do?

Answer 3

Digests fats then is excreted out of the body or resorbed by the liver

Question 4

What 3 things are involved in carbohydrate metabolism?

Answer 4

Glycogenesis, Glycogenolysis, Gluconeogenesis

Question 5

What is glycogenesis?

Answer 5

Conversion of glucose to glycogen

Question 6

What is glycogenolysis?

Answer 6

Breakdown of glycogen back to glucose

Question 7

What is gluconeogenesis?

Answer 7

Conversion of amino acids to glucose

Question 8

What proteins are metabolized in the liver?

Answer 8

Ammonia conversion, plasma proteins: albumin, prothrombin, fibrinogen, clotting factors

Question 9

What vitamins are stored in the liver?

Answer 9

Fat soluble: A, D, E, K

And vitamin B; copper and iron too

Question 10

What type of protection does the liver offer?

Answer 10

Blood reservoir, Kupffer cells, and conjugation

Question 11

In emergency situations the liver can supply up to how much blood?

Answer 11

1 liter

Question 12

What are Kupffer cells?

Answer 12

Cells that filter out debris, foreign bodies, and bacteria for a clean blood supply

Question 13

What is conjugation of the liver?

Answer 13

Transforming things that aren’t water soluble to water soluble to get rid of them like meds and bilirubin

Question 14

What is direct hepatocyte (liver cells) damage?

Answer 14

Primary liver diseases like cancer

Question 15

What is indirect hepatocyte (liver cells) damage?

Answer 15

Obstruction of bile duct

Question 16

When hepatocytes become inflamed what happens?

Answer 16

Hypoxia, sclerosis and fibrosis

Question 17

Pathophysiology of liver disease?

Answer 17

Hepatocyte damage -> hepatocytes become inflamed -> death of hepatocytes

Question 18

What’s the physical exam for liver disease?

Answer 18

Palpate the RUQ (if palpable=enlarged), assess size of liver of palpable and check for tenderness

Question 19

If 75% of the liver is damaged what does that cause?

Answer 19

Signs and symptoms will appear

Question 20

Alkaline phosphatase; lactic dehydrogenase (LDH); Serum transaminases: ALT and AST; proteins; bilirubin; ammonia; clotting factors; and lipids are all what?

Answer 20

Liver function tests

Question 21

What does the Alanine Aminotransferase (ALT) measure?

Answer 21

Liver damage (elevated)

Question 22

What does the Aspartate Aminotransferase measure?

Answer 22

High metabolic activity (not liver specific)

Question 23

Ultrasounds, CT scan, MRI, Laparoscopy, and a Liver biopsy are what?

Answer 23

Other diagnostics

Question 24

What is the biggest complication of a liver biopsy?

Answer 24

Hemorrhage

Question 25

What are clinical manifestations of jaundice?

Answer 25

Yellowed skin, mucous membranes, sclerae, tea-colored urine, light, clay-colored stools, pruritis, bleeding, GI distress and fatigue

Question 26

What is the nursing care for pruritis?

Answer 26

Antihistamines, soak baths, sedatives, mits if keep scratching. Anything that prevents scratching

Question 27

What is the nursing care for bleeding tendencies?

Answer 27

Bleeding precautions and monitor coagulation studies, apply pressure after injections especially biopsy

Question 28

What is the nursing care to prevent injuries?

Answer 28

Clear walkway path, adequate assistance w/ movement, use padding appropriately, avoid valsalva maneuvers

Question 29

What is the nursing care for GI distress?

Answer 29

Inappropriate bile production/excretion, low fat diet, antacids and H2 receptor blockers