Chapter 43

Question 1

The largest gland of the body is what?

Answer 1

Liver

Question 2

What is considered a chemical factory that manufactures, stores, alters, and excretes a large number of substances involved in metabolism?

Answer 2

Liver

Question 3

What does the liver receive?

Answer 3

Nutrient rich blood from the GI tract and then stores it

Question 4

The liver is essentially important in what?

Answer 4

Important in the regulation of glucose and protein metabolism

Question 5

The bile produced by the liver is stored where?

Answer 5

Gallbladder

Question 6

Where is the liver located?

Answer 6

Behind ribs in the URQ

Question 7

What is the major importance of liver function?

Answer 7

Circulation of blood into and out of the liver

Question 8

What vitamins are stores in large amounts in the liver?

Answer 8

A,B, and D

Question 9

Chronic liver disorder characterized by fibrotic change
Loss of functional liver tissue

Answer 9

Cirrhosis

Question 10

What is a major symptom of liver disease/ hepatic dysfunction

Answer 10

Jaundice

Question 11

Involuntary flapping movements of the hands

Answer 11

Asterixis

Question 12

The patient may observe for signs of associated liver dysfunction when they see what?

Answer 12

Obesity
High alcohol intake

Question 13

A liver with cirrhosis might feel?

Answer 13

Small and hard

Question 14

A liver with acute hepatitis may feel?

Answer 14

Soft

Question 15

Enlargement of the liver is what type of finding?

Answer 15

Abnormal

Question 16

Removal of small amount of liver tissue usually through needle aspiration

Answer 16

Liver biopsy

Question 17

Familial disorder characterized an increased level of unconjugated bilirubin that causes jaundice

Answer 17

Gilbert syndrome

Question 18

What is a chronic idiopathic jaundice, with pigment in the liver?

Answer 18

Rubin-Johnson syndrome

Question 19

Increased pressure throughout the portal venous system that results in obstruction of blood flow into and through the damaged liver

Answer 19

Portal hypertension

Question 20

What med is the first line therapy in patients with ascites from cirrhosis

Answer 20

Spironolactone

Question 21

Removal of fluid from the peritoneal cavity

Answer 21

Paracentesis

Question 22

A method of treating ascites in which a cannula is threaded into the portal vein by the trans jugular route

Answer 22

Trans jugular intrahepatic portosystemic shunt (TIPS)

Question 23

What is life-threatening and can result in hemorrhagic shock that produces decreased cerebral, hepatic, and renal perfusion?

Answer 23

Bleeding esophageal varices 

Question 24

Which medication should not be used with coronary artery disease, because it may precipitate in MI 

Answer 24

Vasopressin

Question 25

What medications decreases portal pressure and prevents a first bleeding episode in patients with varices

Answer 25

Beta blockers (-olol)

Question 26

What is a therapy that is used to temporarily control hemorrhage and to stabilize a patient with massive bleeding?

Answer 26

Balloon Tamponade 

Question 27

A patient under treatment of a balloon tamponade should what? 

Answer 27

Be observed in the ICU for serious complication such as aspiration, esophageal ulcer formation, and perforation

Question 28

When would you see asterixis, which is involuntary flapping of the hands

Answer 28

Stage II encephalopathy

Question 29

What is a sweet slightly fecal odor to the breath? May be described as freshly mowed grass, acetone, or old wine

Answer 29

Fector hepaticus

Question 30

With hepatic dysfunction many patients develop what? that is caused by hypoalbuminemia do to decrease hepatic production of albumin

Answer 30

edema

Question 31

Patients with liver dysfunction resulting from biliary obstructions commonly develop what? due to retention of bile salts

Answer 31

Pruritis

Question 32

What is the most common cause of acute liver failure?

Answer 32

Drug induced liver disease

Question 33

What meds may be indicated to decrease ascites? 

Answer 33

Potassium sparing diruretic agents (Spironolactone or triamterene

Question 34

What may help minimize bleeding gums?

Answer 34

Soft bristled toothbrush

Question 35

Primary liver tumors are usually associated with what?

Answer 35

Liver disease hepatitis B+C  cirrhosis

Question 36

What are early manifestations of malignancy of the liver?

Answer 36

Dull ache in the RUQ or back Weight loss Anorexia Anemia 

Question 37

What is the most common surgical procedure for getting rid of a liver tumor?

Answer 37

Lobectomy 

Question 38

What is the leading cause of death after liver transplantation

Answer 38

Infection

Question 39

Vitamin deficiency leading to beriberi

Answer 39

Thiamine deficiency

Question 40

Vitamin deficiency resulting in scurvy

Answer 40

Vitamin C

Question 41

Vitamin deficiency resulting in macrolytic anemia

Answer 41

Folic acid

Question 42

Nurses will expect to see asterixis with what?

Answer 42

Hepatic encephalopathy

Question 43

Hepatitis A is transmitted how?

Answer 43

Fecal-oral route

Question 44

Hepatitis B is transmitted how?

Answer 44

Through blood, saliva, semen

Question 45

With the a balloon tamponade from a hemorrhage what is your main goal?

Answer 45

Maintaining the airway

Question 46

Hepatitis A symptoms include?

Answer 46

Anorexia Nausea/vomiting

Question 47

What procedure would you use to diagnose cirrhosis?

Answer 47

Liver biopsy

Question 48

What medication helps with elevated ammonia due to cirrhosis

Answer 48

Lactulose

Question 49

What medication is administered with acute liver failure?

Answer 49

N-Acetylcysteine

Question 50

What color stool will a patient have who is diagnosed with cirrhosis

Answer 50

Clay colored or whitish

Question 51

Where can you palpate the liver?

Answer 51

RUQ

Question 52

Diuretic that spares potassium and prevents hypokalemia

Answer 52

Spironolactone

Question 53

What increases the risk for liver cancer?

Answer 53

Hepatitis C

Question 54

Symptoms of hypovolemia include?

Answer 54

Cool clammy skin Tachycardia Hypotension Decreased urine output

Question 55

Type of jaundice An adult experiencing transfusion reaction

Answer 55

Hemolytic

Question 56

When is the 2nd and 3rd hepatitis B vaccine given after the 1st

Answer 56

2nd in 1 month 3rd in 6 months

Question 57

What color stool indicated obstructive jaundice?

Answer 57

Clay colored stool