Hepatic PCC obj 4
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| Nutritional deficiencies are common with severe liver disease. Inadequate intake of sufficient vitamins including? | Vit A, vit c, Fat soluble vit (A,D,E,K)
Thiamine, Riboflavin, Pyridoxine, Folic Acid
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| Decreased secretion of bile salts prevents absorption of ____ _____ vitamins such as? which causes what? | -fat soluble vitamins
suck as Vit K, which causes problems with clotting factors, thus producing bleeding and bruising. also prolong PT
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| Whiat is a good nutritional diet for liver disease? | vitmain supplements, small frequent meals, PM snack of complex CHO's, may need to avoid protein loading; enteral or parenteral nutrition.
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| What is dietary modification in ascites? | Negative sodium balance d/t decrease fluid ret.
Na restriction (500 mg -2gm)
Offer alter. flavorings: lemon, vin, parsley, oregano, Thyme.
If serum Na falls - may need to restrict fluids to 1000-1500 ml/day
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| What is jaundice? | When serum bilirubin level exceeds 2.5 mg/dL, all body tissues including the sclerae and the skin become tinged yellow or greenish/yellow
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| What are the different types of jaundice? | Hemolytic, hepatocellular, obstructive jaundice, & hereditary hyperbilirubinemia
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| What 2 types are commonly associated w/ liver disease? | Hepatocellular & obstructive
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| Type of jaundice caused by RBC breakdown, bilirbuin is released, liver cannot take care of all the bilirubin floating around. then can cause pigment stones. If it gets too high (20-25 mg/dL) poses a risk for brainstem damage | Hemolytic Jaundice
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| How is jaundice made? (results from?) | Impairment of hepatic uptake
Conjugation of bilirubin, or
excretion of bilirubin into the biliary system
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| _______ is caused by the inability of damaged liver cells to clear normal amounts of bili from the blood. | Hepatocellular Jaundice
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| Cellular damage may be caused by? | Hepatitis viruses, chemical or medication toxins, or ETOH
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| In prolonged obstructive jaundice cell damage eventually develops, both types of jaundice appear together. What are they? | obstructive & hepatocellular jaundice
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| Patient w/ hepatocellular jaundice may appear w/ what S&S? | Mildly/severly ill w/
Lack of appetite, nausea, melaise, fatigue, weakness, & possible wt. loss.
(pt may report: HA, chills, & fever if cause is infectious)
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| Depending on the cause & extent of liver cell damage, hepatocellular jaundice may be? | Completely reversible
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| The skin and mucose & sclera are inspected for? | Jaundice
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| The extremities are assessed for? (3) | muscle atrophy, edema, skin excoration secondary to scratching.
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| Increase serum bilirubin levels resulting from any several intented disorders (increase unconjuguated bili) | Hereditary Hyperbilirubinemia
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| What is a familial disorder assoc. w/ jaundice? | Gillberts syndrome (also Dubin-johnson's syndrom & rotor's)
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| What is caused from extraheptaic obstruction. may be caused by occlusion of the bile duct from a gallstone, inflammation, tumor, or pressure from an enlarged organ. | obstructive jaundice
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| Making bile cannot flow normally into intestine & becomes backed up into the livr . How does this cause jaundice? | it is then reabsorbed into blood and carried throughout the body, staining the skin, mucous membranes, and sclerae
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