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AH III - chapter 53
| Question | Answer |
|---|---|
| Liver functions | - removes toxic byproducts of meds - metabolizes nutrients to produce energy - removes bacteria from the blood - produces substances that regulate blood clotting - stores vitamins, minerals, & sugar - produces protein - produces bile |
| 3 reasons why there’s bleeding | 1) reduced bile (vitamin k) 2) thrombocytopenia 3) clotting factors |
| Albumin | Protein produced by the liver; keeps fluid/plasma in the blood vessels to give us a BP; when it is not being produced -> fluid seeps into the tissue -> edema & ascites (drops BP) |
| Ascites | Huge belly of fluid; can be caused by either portal hypertension or lack of albumin |
| Paracentesis | Solution for ascites; pulling fluid out of belly -> drops BP even more -> give albumin before & maybe after procedure to pull fluid back into vascular space to raise BP |
| Bile | Compound needed to digest fat & to absorb vitamins A, D, E, & K |
| Portal vein | Blood from abdominal organs goes to the liver first vs. the heart (to filter out filth - mcdonald’s scenario) |
| Liver | Sterilization factor for the abdominal organs |
| Cirrhosis | Extensive scarring of the liver, usually caused by a chronic reaction to inflammation & necrosis; scarring -> nodules -> block bile ducts & blood vessels |
| Causes of cirrhosis | Chronic alcoholism, hepatitis, nonalcoholic steatohepatitis (NASH), drugs & toxins, bile duct disease, & genetic diseases |
| Compensated cirrhosis | The liver has significant scarring, but performs essential functions without significant symptoms |
| Decompensated cirrhosis | Liver failure |
| Portal hypertension | Increase in pressure within the portal vein from increased resistance or obstruction of the flow of blood; blood backs up into the spleen -> splenomegaly (spleen enlargement) |
| Spleen | Immune organ & holds a unit of blood & platelets (thrombocytes); on left-side |
| Esophageal varices | Like hemorrhoids (outpouching due to pressure); can bleed (life-threatening) |
| Third spacing | Edema where it’s not expected |
| Splenomegaly | Spleen enlargement from the backup of blood; destroys platelets, causing thrombocytopenia & increased risk of bleeding -> may be the first clinical sign of liver dysfunction |
| What can cause the varices to pop? | Coughing, vomiting, pooping, straining…(Give stool softener) |
| Jaundice | Develops when the liver cells cannot effectively excrete bilirubin; caused from either disease or obstruction (hepatocellular or intrahepatic obstructive); itching is common (*teaching about scratching because of bleeding) |
| Hepatic encephalopathy | Brain fog from liver probs; why? toxins aren’t being taken out & ammonia accumulation because the liver isn’t able to excrete by conversion; causes: high protein diet, infection, hypovolemia & hypokalemia, constipation, GI bleed & drugs |
| Ammonia | Liver breaks down protein into this -> urea -> we pee this out |
| Lactulose | Laxative; used to pull ammonia out |
| Hepatorenal Syndrome | End stage liver -> end stage kidney -> usually endgame; s/s: oliguria & elevated BUN & creatinine |
| Spontaneous bacterial peritonitis (SBP) | Bacteria from bowel wall seeps into the fluid from the ascites; the diagnosis is made from a sample of this ascitic fluid |
| Hepatitis A | Fecal-oral (ex: everyone ate a restaurant & now has it) |
| Hepatitis B, C, D, & E | Blood |
| Hepatitis | The widespread inflammation & infection of liver cells; s/s: abdominal pain, yellowish sclera (icterus), arthralgia, myalgia, diarrhea/constipation, clay-colored stools, dark yellow - brownish urine, jaundice, fatigue, anorexia, nausea, and itching |
| Hepatitis patient teaching | Diet: high is carbohydrates & calories, frequent meals are more preferable than 3 meals a day, & high-calorie snacks may be needed; fatigue: adequate resting periods; avoid crowds & people who are infected |
| Preventing Hepatitis | Hand-washing, avoiding contaminated food or water, receiving immunoglobulin within 14 days if exposed to the virus, avoiding large crowds, & vaccination (A & B) |
Created by:
tatianalopez03
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