Unit 2 Ch 35 liver, pancreatic, and gallbladder disorders Flashcards
Cirrhosis, chronic liver disease
Progressive irreversible replacement of healthy liver tissue with scar tissue
Often irreversible unless early treatment 
Cause of chronic liver disease and cirrhosis
Chronic alcohol use most common
Chronic HBV or HCV
Fatty liver NASH
Dietary fat
Diabetes
Obesity
Heart disease 
Cirrhosis and chronic liver disease pathophysiology
Inflammation of liver cells
Infiltration with fat and white blood cells
Fibroid scar tissue, replaces liver tissue
Abnormal regeneration
Impaired liver, blood flow perfusion
Impaired liver functioning, bilirubin increases
Oliguria
No urine or a decreasing urine
Needs to be at least 30 mL an hour
Signs and symptoms of chronic liver disease
Asites build up
Lumpy, hard margins when pate liver
Clay colored stools
Liver produces clotting factors, risk of bleeding
Jaundice
Itching
Diarrhea or constipation
Amenorrhea
An abnormal absence of menstruating
Complications of cirrhosis, chronic liver disease
Clotting defects
Portal, hypertension
Varices
Ascites
Hepatic encephalopathy
Hepatorenal syndrome
Wernicke- Korsakoff syndrome
Wernicke- Korsakoff
Alcoholics, decrease thymine, and vitamin B
Diagnosing cirrhosis
Liver enzymes
Bilirubin
Ammonia
PT
Bleeding clotting
Abnormal x-ray or ultrasound
Duodenoscopy
Liver biopsy
Reduce sodium
Paracentesis
Take fluid out of stomach
Therapeutic intervention for cirrhosis
Ascites
diuretics
Sodium restriction
Albumin infusion
Paracentesis
Transjugular, intrahepatic, shunt
Vasoconstrictor
Vasile ligation
Transfusion
Antibiotic prophylaxis
Cirrhosis of the liver therapeutic interventions, hepatic encephalopathy
Lactulose
Rifaximin. Caravan
Neomycin. Neo-Fradin
Patient education for acute liver, failure, and cirrhosis
Disease process
Signs and symptoms to report
Adequate rest
Avoid narcotics, sedatives, tranquilizers and alcohol
Follow up here
Hepatitis
Inflammation of the cells of the liver
Causes of hepatitis
Bacterial infection
Medication’s
Alcohol
Chemicals toxic to the liver
Metabolic and vascular disorders
Often caused by a virus
Types of hepatitis found in the US
Hepatitis, a b and c
Hepatitis E
Travel contamination from human feces
Hepatitis d
If you have hepatitis d you usually have hepatitis B?
How do you get hepatitis A?
Fecal oral route or from raw shellfish
How do you get hepatitis B C and D
Healthcare related from body fluids
Hepatitis prevention
Transmission precautions
Standard precautions
Hand hygiene
Vaccines
Immunoglobulin
Public health majors
What is immunoglobulin?
It’s a passive short term protection doesn’t build up protection
Hepatitis signs and symptoms
Can be asymptomatic
Prodromal stage
Flu like symptoms right upper quadrant pain
Icteric stage
Jaundice worsening symptoms
Convalescent
Returning to normal liver function
What is convalescent?
Returning to normal
Complications of hepatitis
Liver failure
Fulminant
Acute
Chronic
Chronic infection
Carrier of the virus
Puts you at risk of liver cancer
What does fulminate mean?
Sudden and severe
HBV and HCV
Chronic infection
Hepatitis diagnostic test
Serum test
Liver enzymes
Serum bilirubin
Prothrombin
Serological test
Liver biopsy
Hepatitis therapeutic interventions
Identify cause
Monitor liver function
Relieve symptoms
Prevent cirrhosis
Educate on hydration and nutrients
Rest
Avoid alcohol and liver, toxic drugs
HBV and HDV therapeutic interventions
Pegylated interferon therapy
HBV
Antivirals
Pegg related interferon therapy
Liver transplant
Can you cure hepatitis B or hepatitis C?
No
Types of antivirals that will treat hepatitis C
Albacore/grazoprevir
Sofosbivor/ledipasvir
Gallbladder disorder
Inflammation of the gallbladder called cholecystitis
Causes of gallbladder disorder
Risk increases with age
Family history
Bile stasis
High cholesterol
Fasting
Sedentary lifestyle
More often in women
Signs and symptoms of gallbladder disorder
Silent stones
Elevated vital signs
Vomiting
Jaundice
Epigastric pain
Nausea
Indigestion
Right upper quadrant tenderness
Positive Murphy sign
Biliary colic
What is a positive Murphy sign?
You can’t take a deep breath when your liver is pressed
What is biliary colic?
Pain in your right shoulder and back. You should reduce fat intake.
Complications of gallbladder disorder
Cholangitis
Necrosis perforation of the gallbladder
Empyema
Fistulas
Adenocarcinoma
Acute pancreatitis
Cholangitis
Bile duct inflamed
Empyema
Puss in plural cavity
Diagnostic test for gallbladder disorder
Endoscopic ultrasound
CT scan
MRI
ERCP
HITA scan
White blood cells elevated
Elevated direct bilirubin
Therapeutic interventions for gallbladder disorder
Analgesics
Bile acid sequestriants
Antiemetics
NPO
Low-fat diet
Cholelithiasis treatment
Cholecystectomy
Laparoscopic surgery most common
Traditional surgery, T tube
Medication to dissolve stones
