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210 Ch. 39

Liver Disorders

QuestionAnswer
What is the liver fx? regulation of glucose and protein metabolism, manufactures/secretes bile, removes waste from blood, metabolize drugs
The blood to liver comes from two sources 1.80% from portal vein draining GI tract, rich in nutrients, no O2 2.Hepatic art, rich in O2
What does liver do to ammonia and where does ammonia come from Liver converts ammonia to urea to b peed out....ammonia is breakdown from proteins or GI blood
Most of the plasma proteins are synthesized where liver Vit K needed by liver for synthesis of PT(prothrombin)
Which vit are stored in liver? A,B,D, Bcomplex, iron, copper
Portal HTN can be serious and lead to what complication in the esophagus>? esophageal varices tx: like hemorrhoids, band, balloon tamponade, ice cold lavage
What is accumulated to form ascites plasma in abd cavity with extra proteins
what are nsg mgmt for ascites measure girth same place, daily wts, diuretics(spirinolactone), bed rest, paracentesis(take 5-6L safe)*take VS b4,during,after for shock
what is nursing imperitive for pt wtih esophageal varices Never leave pt alone! give vasopressin,somatostatin,inderal,nitrates to lower pressure
Hepatic encephalopathy is build up of what and how to manage? ammonia due to liver disease....lactulose(laxative to pull out ammonia, assess for diarrhea), assess for personality changes, Babinski reflex, asterixis(hand flapping)
Normal bilirubin level? Jaundiced level? 0-0.3 2.5
three types of jaundice hemolytic: RBC breakdown too fast, flood plasma with bilirubin hepatocellular, obstructive(gray stool), hereditary
vasopressin contricts and reduces portal pressure, what contraindications are there CAD, because may start MI
Somatostatin decr bleeding from esophageal varices, but lacks what that vasopressin has vasoconstriction
Propranodol/nadolol are what kind of drugs? How do they help varices? Beta blockers prevent first bleeding, prophylaxis
How do nitrates help portal pressrue? venodilation, decr CO
What is key nsg priority wtih abd surgery Turn, cough, deep breath
Hep A? B? C? A: virus, fecal-oral route, 2-6wk incubation, vaccine B: blood borne, 28-160d, rash, vaccine, not pass to baby, nurse at risk C: No vaccine, blood born, Nurses at risk, pass to baby
vasopressin contricts and reduces portal pressure, what contraindications are there CAD, because may start MI
Somatostatin decr bleeding from esophageal varices, but lacks what that vasopressin has vasoconstriction
Propranodol/nadolol are what kind of drugs? How do they help varices? Beta blockers prevent first bleeding, prophylaxis
How do nitrates help portal pressrue? venodilation, decr CO
What is key nsg priority wtih abd surgery Turn, cough, deep breath
Hep A? B? C? A: virus, fecal-oral route, 2-6wk incubation, vaccine B: blood borne, 28-160d, rash, vaccine, not pass to baby, nurse at risk C: No vaccine, blood born, Nurses at risk, pass to baby
Regarding liver cancer, does primary or secondary tumors happen more? metastic liver tumors becuase of blood supply from all body parts
What is greatest threat to transplants? rejection and will see fever and hypotension
Created by: palmerag