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NURS 1345 > Liver > Flashcards

Liver Flashcards

1
Q

Widespread fibrotic (scarred) bands of connective tissue

Tissue becomes nodular

Nodules block blood flow and lymph

Liver shrinks and hardens

A

Cirrhosis

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2
Q

Laennec’s cirrhosis is caused by

A

Alcoholism

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3
Q

______ a rare autoimmune disease that slowly destroys the liver’s bile ducts. This causes bile and other toxins to build up in the liver, a condition known as cholestasis.

The inflammation and scarring of the bile ducts can lead to cirrhosis

A

Biliary (cirrhosis)

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4
Q

Ascites is…

A

Fluid in the peritoneal space

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5
Q

Portal hypertension
Ascites
Esophageal varices
Biliary obstruction
Hepatic Encephalopathy

Are all complications of…

A

Cirrhosis

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6
Q

Biliary obstruction =

Lower

Bile, Vit. K, Clotting Factors

Which has an increased risk for…

A

Bleeding

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7
Q

Pruritus….

A

Itching

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8
Q

Hep B, C, D

NAFLD (Obesity)

Alcohol use

Contribute to

A

Cirrhosis

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9
Q

Why is employment history important to a health history

A

Exposure to toxins

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10
Q

Esophageal varices usually develop when blood flow to the liver is blocked. They often occur in people with advanced liver disease.

Usually there are no symptoms

Symptoms include vomiting blood, tar-like or bloody stools, and, in severe cases, shock.

Treatments include
This medicine ____

Medical procedures to stop bleeding, and, in rare cases, liver transplant

A

Beta blockers

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11
Q

Lactate dehydrogenase (LDH) is …

A

an enzyme that helps the body convert glucose (sugar) from food into usable energy for cells

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12
Q

Cirrhosis has this effect on

AST, ALT, LDH
Alkaline phosphate
GGT
Serum bilirubin
Ammonia

A

Increase

Norms

AST 10 - 36
ALT 4 - 36 alanine transaminase
LDH 140 - 280
ALP 44 - 146

Serum Bilirubin <1mg/dl

Ammonia < 30

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13
Q

Cirrhosis has this affect on

Albumin
Platelets
Hgb
Hct
RBC

A

Lower

Norms

Albumin 3.5 - 5.3
Platelets 150,000 and 450,000 microliter of blood

Hgb 12 - 17
Hct 36 - 50

RBC: 4 - 6 million

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14
Q

US transient elastography (TE) is….

A

Ultrasound elastography or FibroScan, is a non-invasive method that uses ultrasound to measure liver stiffness

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15
Q

EGD & ERCP may be used to test for cirrhosis

T or F

A

T

EGD esophagastroduodeno

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses an endoscope and X-rays to examine and treat problems with the bile and pancreatic ducts

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16
Q

Why pruritis from cirrhosis

A

Increased serum bilirubin & jaundice

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17
Q

Why acute confusion from cirrhosis

A

Increased ammonia level

Alcohol withdrawal

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18
Q

How can a hemorrhage occur from cirrhosis

A

HTN in portal hypertension

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19
Q

Fluid Overload occurs from cirrhosis how

A

Lack of albumin

20
Q

Paracentesis is….

A

A procedure for ascites, during which a needle is inserted into the peritoneal cavity to obtain ascitic fluid

21
Q

A patient undergoing a paracentesis (drainage of fluid from the peritoneal cavity using a needle) must ______ prior to the procedure.

Measure the patient’s abdominal girth and vital signs before and after the procedure, and assess for signs of ____

A

Empty bladder

hypovolemia

22
Q

Cirrhosis hemorrhage intervention

Decrease HR & Hepatic Pressure by giving

A

Beta blockers

Propranolol

23
Q

Transfusion management for hemorrhage

What do the following mean

PRBC, FFPs, albumin, platelets

A

Packed Red Blood Cells

Fresh Frozen Plasma

Albumin keeps fluid inside veins

24
Q

Transfusion management

What kind of study is

PT, PTT, INR, platelets

A

Coagulation

25
Q

Sengstaken-Blakemore tube is used for…

How does it work

A

Treatment of Esophageal Varices

Tube is inserted down throat

Pumped up to 20 - 40 mm Hg to put pressure on the fundal vein

26
Q

Preventing or managing confusion in cirrhosis

(2)

A

Lactulose (titrate 2 - 3 soft stools daily)

Non- absorbable antibiotics
Neomycin Sulfate
Rifaximin

27
Q

2 meds given to help with alcohol withdrawal

A

Benzodiazepine

Thiamine

28
Q

Asterixis …

To assess for…

A

Neurological condition that causes people to lose motor control in their fingers and wrists

Patient makes Stop with hands like directing traffic

Closes eyes

Observe for 30 seconds

29
Q

Fetor hepaticus…

Seen in this disease…

A

also known as breath of the dead

breath, in urine, or in sweat of people with severe liver diseaseIt’s a late sign of liver failure

Clinical feature of hepatic encephalopathy

30
Q

Alcohol Withdrawal Symptoms

A

Withdrawal is Oppsite of its effects

Alcohol is a downer so Withdrawal is UPPER

Whole body: restlessness, shakiness, sweating, or loss of appetite

Gastrointestinal: nausea or vomiting

Behavioral: agitation or irritability

Mood: anxiety or nervousness

Also common: fast heart rate, tremor, disorientation, headache, insomnia, or seizures

31
Q

Asterixis
Fetor hepaticus
Alcohol Withdrawal Symptoms

Assess this body system

A

LOC

32
Q

Corticosteroids creams & SSRI (Sertraline) can be used to manage this symptom of Cirrhosis

A

Pruritus

33
Q

Avoid which medication with cirrhosis

A

Acetaminophen (Tylenol)

Not an NSAID

34
Q

Viral Hep A can be caught from

A

Shell fish

Feces to mouth- food contamination

35
Q

Viral hep B & C are caught how?

A

Sex
Needles
Blood Transfusion prior 92
Birth

36
Q

How are Hep D & E caught

A

D: defective RNA virus needs helper function of HBV

E: Waterborn epidemic in some countries

37
Q

Which hep have cirrhosis & liver cancer risks

A

B & C

38
Q

Most common blood born infection in US

No vaccine

A

HCV

39
Q

Which hep has vaccines

A

A & B

40
Q

Icterus …

A

also known as jaundice, is a condition that causes the skin, mucous membranes, and whites of the eyes to turn yellow.

It’s caused by too much bilirubin, a yellow chemical in hemoglobin that carries oxygen in red blood cells

41
Q

Arthralgia is

A

Joint pain, or soreness where two or more bones meet at a joint.

It can be a symptom of injury, infection, illness, or an allergic reaction to medication

42
Q

Laboratory assessment

Hepatitis

Liver enzymes

ALT, AST, Bilirubin

A

Increase

43
Q

Hepatitis

Staging/ grading of liver damage/ cancer

Which procedure…

A

Liver biopsy

44
Q

Nutrition in Hepatitis

A

High carbs and calories

Mod protein & fat

Small frequent meals

Vitamins

45
Q

Normal albumin range

A

3.5 - 5.3

Same as K

46
Q

Platelets: normal range

A

150,000 and 450,000 microliter of blood

NURS 1345 (12 decks)

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