Liver Disorders and Cirrhosis Flashcards

1
Q

Liver

A
  • complex organ
  • multiple metabolic, regulatory functions
  • metabolism of proteins, carbs
  • vital to digestion, metabolism of nutrients
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2
Q

Cirrhosis

A
  • end stage chronic liver disease
  • progressive
  • irreversible
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3
Q

Alcoholic cirrhosis

A

most common form

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4
Q

Liver Disease

A

impaired liver cells has multiple effects:

-impaired protein metabolism with decreased production of albumin and clotting factors

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5
Q

Low albumin levels

A

edema in peripheral tissues and ascites

  • glucose alterations (hypo/hyper)
  • inadequate Vit K, affects clotting factors, leads to bleeding tendency
  • feminization in men and irregular menses in women
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6
Q

Cirrhosis Etiology

A
  • most common cause of liver dz in the US
  • end stage chronic liver dz
  • progressive, irreversible, leads to liver failure
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7
Q

Cirrhosis may result from..

A
  • chronic Hep B or C
  • prolonged biliary obstruction
  • long term, severe HF
  • other liver dz’s
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8
Q

Cirrhosis Patho

A
  • functional liver tissue replaced by fibrous scar tissue
  • hepatocytes and liver lobules are destroyed, metabolic functions are lost
  • structurally abnormal nodules encircled by connective tissue form
  • restricted blood flow leads to portal HTN
  • incidence and mortality vary greatly among populations
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9
Q

Alcohol causes…

A

metabolic changes in liver

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10
Q

Biliary cirrhosis

A

bile flow obstructed within liver, biliary system

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11
Q

Post-hepatic cirrhosis

A

-results from chronic hepatitis or unknown cause

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12
Q

Risk factors..

A

alcohol use, injection drug use

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13
Q

Early stage Clinical Manifestation

A
  • liver enlarged, may be tender

- weight loss, weakness, anorexia

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14
Q

As disease progresses…

A

manifestations related to liver cell failure

-portal HTN

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15
Q

Cirrhosis Tx

A
  • supportive

- slowing progression to liver failure

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16
Q

Portal HTN

A

causes blood to be rerouted to adjoining vessels

17
Q

Splenomegaly

A
  • blood shunted to splenic vein

- greater destruction of RBCs, WBCs, platelets

18
Q

Ascites

A
  • plasma-rich fluid in abdominal cavity

- hypoalbuminemia and hyperaldosteronism

19
Q

Esophageal varices

A
  • enlarged, thin-walled veins form in submucosa of esophagus
  • from portal HTN
  • may rupture leads to massive hemorrhage
20
Q

Portal systemic encephalopathy

A
  • hepatic encephalopathy
  • asterixis
  • changes in personality, mentation
21
Q

asterixis

A

tremor of the hand when the wrist is extended, sometimes said to resemble a bird flapping its wings

22
Q

Hepatorenal syndrome

A
  • renal failure with:
  • azotemia
  • sodium retention
  • oliguria
  • hypotension

-result of imbalanced blood flow

23
Q

Spontaneous bacterial peritonitis

A

inflammatory response to peritonitis

24
Q

Holistic approach

A
  • psych needs
  • psychosocial needs
  • spiritual needs
25
Q

Pharm Tx

A
  • used to treat complications and effects

- will not reverse or slow process

26
Q

Diuretics

A

reduce fluid retention, ascites

27
Q

Lactulose, Neomycin

A

reduce nitrogen load, lower serum ammonia

28
Q

Beta Blockers

A

prevent rebleeding of esophageal varices

29
Q

Ferrous sulfate, folic acid

A

treats anemia

30
Q

Oxazepam (Serax)

A

treats acute agitation

31
Q

Nutritional Therapy

A
  • Sodium intake restricted to less than 2g per day
  • fluid restrictions
  • protein restricted/eliminated
  • high calorie, moderate fat intake
  • vitamin, mineral supplements
32
Q

Transplantation indications

A
  • functional decline
  • increasing bilirubin
  • decreasing albumin
  • increasing problems with complications
33
Q

Contraindications

A
  • malignancy
  • active alcohol or drug abuse
  • poor surgical risk
34
Q

Nursing Process

A
  • reduce further liver damage
  • teach client to make healthier lifestyle choices
  • minimizing symptoms of disease
35
Q

Physical Assessment

A
  • VS
  • Mental status
  • condition of skin and MM
  • peripheral pulses, edema
  • abdominal assessment
36
Q

Nursing diagnoses

A
  • excess fluid volume
  • risk for acute confusion
  • ineffective protection
  • impaired skin integrity
  • imbalanced nutrition: less than body requirements
37
Q

Planning

A

goals may include that client will:

  • maintain proper hydration levels as indicated by urine specific gravity
  • appro diet
  • VS normal limits
  • report regular bowel elimination
  • be oriented to person, place, time
  • avoid alcohol
38
Q

Interventions

A
  • stress relationship between alcohol, drug abuse, and disease
  • balance fluid volume:
  • maintain mental status
  • minimize bleeding

maintain skin integrity

  • promote balanced nutrition
  • manage complications
39
Q

Expected Outcomes

A
  • improved labs
  • VS improvement
  • absence of bruising or bleeding
  • adequate urinary and bowel elimination
  • decreasing ascites
  • restorative sleep and decreased discomfort