Liver Disease Flashcards
What are the functions of the liver?
Bile production, Carbohydrate metabolism, fat metabolism, protein metabolism, vitamin storage and protection
How much bile can be produced by the liver a day?
1 liter
What does bile do?
Digests fats then is excreted out of the body or resorbed by the liver
What 3 things are involved in carbohydrate metabolism?
Glycogenesis, Glycogenolysis, Gluconeogenesis
What is glycogenesis?
Conversion of glucose to glycogen
What is glycogenolysis?
Breakdown of glycogen back to glucose
What is gluconeogenesis?
Conversion of amino acids to glucose
What proteins are metabolized in the liver?
Ammonia conversion, plasma proteins: albumin, prothrombin, fibrinogen, clotting factors
What vitamins are stored in the liver?
Fat soluble: A, D, E, K
And vitamin B; copper and iron too
What type of protection does the liver offer?
Blood reservoir, Kupffer cells, and conjugation
In emergency situations the liver can supply up to how much blood?
1 liter
What are Kupffer cells?
Cells that filter out debris, foreign bodies, and bacteria for a clean blood supply
What is conjugation of the liver?
Transforming things that aren’t water soluble to water soluble to get rid of them like meds and bilirubin
What is direct hepatocyte (liver cells) damage?
Primary liver diseases like cancer
What is indirect hepatocyte (liver cells) damage?
Obstruction of bile duct
When hepatocytes become inflamed what happens?
Hypoxia, sclerosis and fibrosis
Pathophysiology of liver disease?
Hepatocyte damage -> hepatocytes become inflamed -> death of hepatocytes
What’s the physical exam for liver disease?
Palpate the RUQ (if palpable=enlarged), assess size of liver of palpable and check for tenderness
If 75% of the liver is damaged what does that cause?
Signs and symptoms will appear
Alkaline phosphatase; lactic dehydrogenase (LDH); Serum transaminases: ALT and AST; proteins; bilirubin; ammonia; clotting factors; and lipids are all what?
Liver function tests
What does the Alanine Aminotransferase (ALT) measure?
Liver damage (elevated)
What does the Aspartate Aminotransferase measure?
High metabolic activity (not liver specific)
Ultrasounds, CT scan, MRI, Laparoscopy, and a Liver biopsy are what?
Other diagnostics
What is the biggest complication of a liver biopsy?
Hemorrhage
What are clinical manifestations of jaundice?
Yellowed skin, mucous membranes, sclerae, tea-colored urine, light, clay-colored stools, pruritis, bleeding, GI distress and fatigue
What is the nursing care for pruritis?
Antihistamines, soak baths, sedatives, mits if keep scratching. Anything that prevents scratching
What is the nursing care for bleeding tendencies?
Bleeding precautions and monitor coagulation studies, apply pressure after injections especially biopsy
What is the nursing care to prevent injuries?
Clear walkway path, adequate assistance w/ movement, use padding appropriately, avoid valsalva maneuvers
What is the nursing care for GI distress?
Inappropriate bile production/excretion, low fat diet, antacids and H2 receptor blockers
