a MCPHS- Provider I- Ch 39- Assessment & Management of Pts w/Hepatic Disorders
Help!
|
|
||||
|---|---|---|---|---|---|
| 75% of liver's blood supply comes from | Portal vein
🗑
|
||||
| Supplies liver with oxygen | Hepatic artery
🗑
|
||||
| Most common phagocyte in human body | Kupffer cells
🗑
|
||||
| Main function r/t Kupffer cells | Engulf particulate matter
🗑
|
||||
| End product r/t gluconeogenesis | Ammonia
🗑
|
||||
| Liver converts ammonia to | Urea
🗑
|
||||
| Examples r/t Protein metabolism of liver | Synthesizes almost all plasma proteins including albumin, alpha & beta globulins, blood clotting factors
🗑
|
||||
| Required for synthesis of prothrombin | Vitamin K
🗑
|
||||
| Vitmains stored in large amounts in liver | A, B-complex and D
🗑
|
||||
| Fraction of an administered medication that actually reaches systemic circulation | Bioavailability
🗑
|
||||
| Bioavailability is decreased if medication is metabolized to a great extent by liver before it reaches systemic circulation | First-pass effect
🗑
|
||||
| Enteropathic circulation | Pathway from hepatocytes to bile to intestines and back to hepatocytes
🗑
|
||||
| Amount of bile salts excreted in feces | Small fraction
🗑
|
||||
| Route r/t bilirubin elimination | Excreted to bile
🗑
|
||||
| Most common changes to liver r/t Aging | Decreases in size, weight and total hepatic blood flow
🗑
|
||||
| Abnormal liver function tests r/t Aging process | Abnormal results indicate abnormal liver function and are not result of aging
🗑
|
||||
| Alcohol consumption r/t High risk for cirrhosis | Men:60-80 g/day or 4 cocktails, Women: 40-60 g/day
🗑
|
||||
| Viral hepatitis vs. Alcoholic hepatitis r/t Liver tenderness | VH:tender, AH:nontender
🗑
|
||||
| Amount of liver damage before liver function tests may become abnormal | 70%+
🗑
|
||||
| ALT level increase vs. AST level increase vs. GGT level increase r/t Liver function | ALT:primarily d/t liver disorders, AST:damage/death to organ tissues, GGT:cholestasis or alcoholic liver disease
🗑
|
||||
| Acute vs. Chronic r/t More common liver dysfunction | Chronic
🗑
|
||||
| Most common and significant symptoms r/t liver disease | Jaundice, Portal hypertension, Ascites, Varices, Nutritional deficiencies, Hepatic encephalopathy
🗑
|
||||
| Hemolytic vs. Hepatocellular vs. Obstructive jaundice | Hemo:increased destruction of RBC's, Hepato:inability of damaged liver cells to clear normal amounts of bilirubin, O:extrahepatic obstruction from occulsion of bile duct
🗑
|
||||
| Extrahepatic vs. Intrahepatic obstruction | I:obstruction involves small bile ducts w/in liver, E:occlusion of bile duct
🗑
|
||||
| Urine & Stool r/t Obstructive jaundice | U:deep orange and foamy, S:light/clay-colored
🗑
|
||||
| Pathophysiology r/t Varices | Develop d/t elevated pressure in veins
🗑
|
||||
| Treatment goal r/t Pt w/ascites | Negative Na balance to reduce fluid retention
🗑
|
||||
| Commercial salt substitutes r/t Physician approval | May contain ammonia which could cause hepatic coma, May also contain K
🗑
|
||||
| Second treatment option r/t Ascites | Diuretic therapy
🗑
|
||||
| Pathophysiology r/t Esophageal varices | Almost always d/t portal hypertension
🗑
|
||||
| Factors contributing to hemorrhage r/t Esophageal varices | Muscular exertion, Straining at stool, Sneezing, Coughing, Vomiting, Esophagitis, Irritation of vessels d/t poorly chewed food, Reflux of stomach contents
🗑
|
||||
| Signs r/t Potential hypovolemia | Cold clammy skin, Tachycardia, Drop in BP, Decreased urine output, Weak peripheral pulses
🗑
|
||||
| Order to removing Balloon tamponade | Esophageal balloon deflated first, Pt monitored for recurrent bleeding, Gastric balloon deflated, Monitor for recurrent bleeding, Remove balloon tamponade
🗑
|
||||
| Treatment of choice r/t Esophageal varices | Esophageal band ligation
🗑
|
||||
| Surgical decompression prevents variceal bleeding | Decompression of portal circulation
🗑
|
||||
| Precipating factors r/t Hepatic encephalopathy | Profound liver failure, Accumulation of ammonia and other toxic metabolites
🗑
|
||||
| Earliest symptoms r/t Hepatic encephalopathy | Minor mental changes & motor disturbances
🗑
|
||||
| Medication used to decrease serum ammonia levels | Lactulose
🗑
|
||||
| Pathophysiology r/t Generalized edema | Hypoalbuminemia d/t decreased hepatic production of albumin
🗑
|
||||
| Bleeding r/t Hepatic impairment | Production of clotting factors is reduced, Increased bruising and bleeding from wounds
🗑
|
||||
| Hep A vs. Hep B r/t Transmission route | A:fecal-oral, B:blood
🗑
|
||||
| Active vs. Passive immunity | Active acquire immunity:develop by own body, Passive acquired immunity:obtained from source outside of body like immune globulin, antiserum, or mother to baby
🗑
|
||||
| Most frequent side effect r/t Hep C treatment | Hemolytic anemia
🗑
|
||||
| Only risk factor r/t Hep D | Those w/Hep B
🗑
|
||||
| Almost always present w/Hep E | Jaundice
🗑
|
||||
| Common chemicals r/t Nonviral hepatitis | Carbon tet, Phosphorus, Chloroform & gold compounds
🗑
|
||||
| Common med that leads to hepatitis | Acetaminophen
🗑
|
||||
| Most common cause of acute liver failure | Drug-induced liver disease
🗑
|
||||
| Sudden/severe impaired liver function in previously healthy Pt | Fulminant hepatic failure
🗑
|
||||
| Common causes r/t Fulminant hepatic failure | Viral hepatitis, Toxic meds, Toxic chemicals, Metabolic disturbances, Structural changes
🗑
|
||||
| Replacement of normal tissue w/diffuse fibrosis that disrupts liver function | Cirrhosis
🗑
|
||||
| Alcoholic vs. Postnecrotic vs. Biliary cirrhosis | A:scar tissue surrounds portal areas, P:result of acute viral hepatitis, B:scar tissue around bile ducts
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
rpclothier
Popular Nursing sets