Liver Flashcards
(27 cards)
Functions of Liver
- Removal of toxins
- Bile secretion
- Regulates blood clotting
- Storage
- Clearance of bilirubin
- Plasma protein production
- Carbohydrate metabolism
Symptoms of liver disease
- abdominal pain
- fatigue
- Jaundice
- Vomiting
- Dark Urine
- Pruritus
- Bruising
- Change to behaviour
Effects of liver disease
- Portal hypertension
- Coagulopathy
- Pruritis
- Ascites
- Malnutrition
Portal hypertension in liver disease
- High blood pressure in the portal circulation.
- Commonly caused by a blockage in the
portal vein or from scarring in the liver. - Symptoms include: an enlarged spleen,
abdominal swelling, signs of bleeding and
varices.
(avoid aspirin and ibuprofen in those with portal hypertension)
coalgulopathy in liver disease
Reduced production of clotting factors and proteins – resulting in increased risk of bleeding.
- Vitamin K supplements
- Blood products given to cover invasive
procedures - Monitor for signs of bleeding/ bruising
- Minimise invasive procedures for children
with a raised INR level
Pruritis in liver disease
(severe itching)
- Caused by poor bile flow which leads to
high levels of bile acids in the blood
stream - Treatment includes administration of
various medication:
Ursodeoxycholic Acid, Rifampicin,
Cholestryamine
Ascites in liver disease
- Ascites is a fluid collection in abdomen
- Caused by low albumin levels and increased
pressure in the blood vessels - Symptoms include: protruding abdomen, shiny and tight skin over the abdomen, prominent veins on the abdomen, quick weight gain, breathing difficulties
Malnutrition in liver disease
- Liver plays a fundamental role in
maintaining good nutrition. - Regular nutritional assessments are
undertaken by dietician team - Specialist milk formulas (high MCT’s which
are easily absorbed by the liver) - High calorie diets for some children
- Enteral feeding
Airway
- Haematemesis –
risk of bleeding in
airway
(Sengstaken tube)
Breathing
- ↑ Respiratory rate and ↑ work of breathing – ascites
- Oxygen saturations and oxygen requirement
Circulation
- ↑ Heart rate and ↓ blood pressure - signs of bleeding or dehydration
- Prolonged capillary refill & skin colour
DISABILITY
- Encephalopathy
- Changes in behaviour
- Blood glucose
- Neuroprotection measures
Exposure
- Losses from drains/ wounds
- Bleeding from any site - ↑INR
- Rashes – sepsis (at risk post transplant)
- Signs of oedema
BILIARY ATRESIA
- Biliary atresia is a congenital condition
affecting the bile ducts in the liver – the
bile ducts may be blocked or missing. - This untreated would lead to complete
blockage of the bile ducts and scarring. - Most common symptoms: jaundice, pale
stools and dark urine. - Initial treatment: Kasai procedure
NURSING MANAGEMENT OF Biliary atresia
Preparation for family
Bowel preparation
Management of fluid and blood sugars
Adequate pain relief
Urinary catheter
Nil by mouth for 48-72 hours (after birth)
+/- Abdominal drain
Long term care for Biliary atresia
Specialist formula milk
Vitamin supplements
Medications to help
with bile flow
Regular check ups
If Kasai is unsuccessful – liver transplant
Autoimmune Liver disease
Autoimmune liver disease are a group
of conditions where the immune
system attacks the liver.
- Causes are often unknown but can
be due to a problem with the
individual’s immune system, their
genes or environmental factors.
Autoimmune Hepatitis:
Inflammation of the liver
Autoimmune Sclerosing Cholangitis:
Inflammation of the liver and bile ducts
Symptoms of Autoimmune liver disease
- Abdominal pain
- Weight loss
- Itching
- Nausea
Diagnosis of Autoimmune liver disease
- Blood tests
- Liver biopsy
- Ultrasound Scan
Treatment of autoimmune liver disease
- Prednisolone(high dose initially)
- Azathioprine
- Ursodeoxycholic Acid for autoimmune sclerotising cholangitis
Monitoring autoimmune liver disease
- Short term response to steroids
- Monitoring for several years to check if
treatment can stop - Monitoring for signs of progression of liver
disease
Wilson’s disease
Wilsons disease is a rare inherited condition, where the body does not break down
copper adequately.
Symptoms of Wilson’s disease
- Fatigue
- Loss of appetite
- Abdominal pain
- Vomiting
- Weight loss
- Nose bleeds
- Anaemia
- Jaundice
- Change in behaviour
Investigations for wilson’s disease
- Blood tests
- 24-hour urine collection
- Liver biopsy
- Eye examination
