Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam2 NRS 202 > Hepatic Disorders > Flashcards

Hepatic Disorders Flashcards

1
Q

Functions of the liver

A

glucose metabolism
ammonia conversion
protein metabolism
fat metabolism
vitamin and iron storage
bile formation
bilirubin excretion
drug metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The majority of the blood supply to the liver, which is poor in nutrients, comes from the portal vein. T or F

A

False - majority of supply that is rich in nutrients from the GI tract comes from the portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What LFTs are associated with liver disorders and are known to increase with hepatitis, cirrhosis, and liver cancer?

A

serum aminotransferases, ALT, AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What LFT is associated with cholestasis and alcoholic liver disease?

A

GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the nurse assess in the patient with liver dysfunction?

A

H&P - exposure to toxins, travel, alcohol and drug use; skin - yellow and dry, LOC, palpation - liver inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What manifestations are seen with liver dysfunction?

A

Jaundice
Poral hypertension
Ascites, varices
Hepatic encephalopathy or coma
Nutritional deficiencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Yellow - ish coloring of sclera or skin caused by increased serum bilirubin

A

jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Jaundice occurs when bilirubin exceeds

A

> 2 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types of jaundice

A

hemolytic, hepatocellular, obstructive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs and symptoms of jaundice

A

**dark orange-brown urine
**clay colored stools
anorexia/N/V
weight loss
fatigue, weakness, malaise
headache, chills, fever, infection
dyspepsia
pruritus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complication occurring from obstructed blood flow through the liver resulting in increased pressure through the portal venous system

A

portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Portal hypertension can result in?

A

Ascites
Esophageal tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What protein draws fluid in resulting in ascites?

A

albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

s/ of ascites include

A

pain
infection
SOB
pressure on vital organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can be performed as a comfort measure for ascites?

A

regular paracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does the nurse assess ascites?

A

Record abdominal girth
Daily weight
Assess for fluid in cavity by percussion
Monitor for F&E imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is ascites managed?

A

Low sodium diet
Diuretics - spirolactone
Bed rest
Paracentesis- VS, fevers, redness@ site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What emergent condition is caused by the accumulation of ammonia and other toxins in the blood?

A

Hepatic Encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What two major alterations affect the development of hepatic encephalopathy?

A

Hepatic insufficiency
Portosystemic shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The inability of the liver to detoxify toxic by-products of metabolism

A

hepatic insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Disorder where collateral vessels develop in the liver allowing toxic portal blood to enter systemic circulation

A

portosystemic shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the earliest signs of hepatic encephalopathy?

A

severe mental changes like hallucinations and motor distrubances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does the nurse assess the patient for hepatic encephalopathy?

A

EEG - brain damage
Changes in LOC - hallucinations
Seizure precautions
Monitor F&E, ammonia levels**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most important thing to monitor in hepatic encephalopathy?

A

ammonia levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is hepatic encephalopathy managed?

A

Stop offending cause - drinking, drugs
Lactulose to reduce serum ammonia
IV glucose to minimize protein catabolism
Protein restricted diet - hard to metabolize in liver failure
Reduce ammonia by gastric suction, abx, enemas
Discontinue sedatives, analgesics, and tranquilizer - nothing metabolized by liver
Monitor/treat complications - fever, change in VS, SOB, GI beed, change in BP, I&O

26
Q

The first bleeding episode of an esophageal varices has what percentage of mortality?

A

10-30% depending on severity

27
Q

Manifestations of esophageal varices

A

hematemesis, melena, general deterioration, shock

28
Q

How often should patients with esophageal varices and cirrhosis undergo endoscopy?

A

Every 2-3 years

29
Q

How are esophageal varices managed?

A

Treat for shock - admin O2
IV fluids, blood and blood products, volume expanders to pull fluid where it needs to go
Vasopressin
Nitroglycerin
Propranolol to decrease portal pressure
Balloon tamponade
Maintain safe environment, prevent injury, bleeding and infection
Administer prescribed treatments
Monitor for complications
Encourage deep breathing and position changes

30
Q

A systemic viral infection that causes necrosis and inflammation of liver cells

A

viral hepatitis

31
Q

A disorder that is toxic to the liver and is drug induced

A

nonviral hepatitis

32
Q

What types of hepatitis are transmitted via fecal-oral route?

A

A and E

33
Q

What types of hepatitis are blood borne pathogens?

A

B and C

34
Q

What type hepatitis only affects those who already have hep B?

A

Hep D

35
Q

Hepatitis A is transient lasting 4-8 weeks. T or F

A

True

36
Q

S/s of Hepatitis A

A

flu-like symptoms
low grade fever
jaundice w dark urine
indigestion
epigastric distress
enlarged liver and spleen

37
Q

How is hep A managed?

A

Good hygiene - hand washing, safe water, proper sewage disposal
Vaccinate
Immunoglobulin for contacts to provide passive immunity
Bed rest
Nutritional support - anorexia

38
Q

How is hep B transmitted?

A

blood, saliva, semen, vaginal secretions, STD, mother to baby during birth

39
Q

Hep B has a long incubation period of 1-6 months. T or F

A

True

40
Q

S/s of hep B

A

insidious and variable
anorexia
dyspepsia
abdominal pain
generalized aches
malaise
weakness
fatigue
**jaundice may or may not be present

41
Q

How is hep B managed?

A

Meds - interferon, antivirals: entecavir and tenofovir
Bed rest
Nutritional support - anorexia
Vaccine

42
Q

How is hep C transmitted?

A

Blood and sexual contact, needles

43
Q

What is the most common blood borne infection?

A

hep C

44
Q

Hep C is curable. T or F

A

False

45
Q

How is hep C managed?

A

Antiviral medications
Avoid alcohol
Avoid meds that effect liver
Prevention is key
Safe needle use

46
Q

How is hep D transmitted?

A

Blood and sexual contact, needles, hemodialysis, transfusions

47
Q

What is the only drug available to treat hep D?

A

interferon alfa

48
Q

How is hep E transmitted?

A

fecal - oral route; contaminated water

49
Q

How is hep D managed?

A

good hygiene, handwashing

50
Q

Types of hepatic cirrhosis

A

Alcoholic
Postnecrotic
Biliary

51
Q

Type of cirrhosis involving scar tissue that surrounds the portal areas of the liver

A

alcoholic cirrhosis

52
Q

Type of cirrhosis that involves bands of scar tissue

A

postnecrotic cirrhosis

53
Q

Type of cirrhosis that involves scarring around the bile ducts of the liver

A

biliary

54
Q

Manifestations of cirrhosis

A

liver enlargement
portal obstruction
ascites
infection and peritonitis
varices
GI varices
edema
vitamin deficiency
anemia
mental deterioration

55
Q

How is cirrhosis managed?

A

Promote rest
Improve nutritional status - restrict protein, supplement vitamins
Provide skin care
Reduce risk for injury - risk for bleeding

56
Q

Potential complications of cirrhosis

A

Bleeding and hemorrhage
Hepatic encephalopathy
Fluid volume excess

57
Q

Primary liver tumors are associated with what?

A

Hep B and C
Hepatocellular carcinoma

58
Q

Manifestations of liver cancer

A

dull persistent RUQ pain
weight loss
anemia
anorexia
weakness
jaundice
ascites
obstructed portal veins

59
Q

How is liver cancer managed?

A

Radiation therapy
Chemotherapy
Percutaneous biliary drainage
Surgery - lobectomy, cyrosurgery, transplant

60
Q

Preoperative nursing care for liver transplant

A

support
educatoin
encouragement

61
Q

Postoperative nursing care for liver transplant

A

monitor for infection, vascular complications, respiratory and liver dysfunction
Caregiver stress

Exam2 NRS 202 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions