The Fulminant Patient Flashcards
(12 cards)
Whate are the causes of Fulminant Hepatic Failure?
- viral: hepatitis A-E, CMV, EBV
- drugs and toxins
- ischaemia- shock, hepatic vascular occlusion
- fatty liver
What is Fulminant Hepaitc Failure?
clinical syndrome developing as a result of massive necrosis of any ofter sudden and severe impairment of hepatic function.
under the circumstances that there is no evidence or history of pre-existing liver disease and encephalopathy (condition causing brain dysfunction) will appear within 8 weeks of the onset of illness
What are the symptoms of Fulminant Hepatic Failure?
Often vague and vary between presentations
include:
- fatigue
- anorexia
- nausea
- abdominal pain
- might be slightly jaundiced
How is Fulminate Hepatic Failure diagnosed?
- establishing PMHx is vital in confirming diagnosis
- ensure there is no chronic disease
- toxic causes need to be established as this is treated differently- send for a toxicology test to see if drug levels are high
- viral and microbiology test- to rule out any other issues
How does fulminant heaptic failure present in the respiratroy system?
- hyperventilation
- aspirations as not protecting airway
- can lead to acute-respiratroy distress syndrome (ARDS)
- bleeding may lead to acute lung injury
How does fulminant heaptic failure present in the cardiovascular system?
- hypotension, vasodialated, and increased cardiac output
- bleeding- from line sites, gums, gastric losses, blood in urine
- clotting factors will be off- shown in coagulopathy in haemotology review
- metabolic and lactic acidosis (build up of acid in the body)
How does fulminant heaptic failure present in the renal system?
- acute kindey injury is common (pre-renal, acute tubular necrosis, hepato-renal syndrome)
- if liver treated quickly enough then AKI is reversed
- oliguria- passing very little urine
- evevated urea and electrolytes
How does fulminant heaptic failure present neurologically?
- cerebral oedema, swelling of the brain, happens quickly
- encephalopathy (condition causing brain dysfunction) due to swelling of the brain
How does fulminant heaptic failure affect nutrition?
- hypoglycaemia
- electrolyte imbalances-
- nausea, vomiting, and abdominal pain
- may have NG tube in place to establish what’s in gastric content
- GI bleeding- may have faecal bleeding
How does fulminant heaptic failure affect the skin?
- bleeding or oozing from the lines
- jaundice
- bruising
- hepatic foetor- odd smell coming from skin, classic in unwell liver patients
How is the airway affected in fulminant pateints?
- may be patent or obstructed due to loss of consciousness
- insertion of an oropharyngeal or nasopharyngeal airway
- must be careful when insertion nasopharangeal airway as tissues are friable and suceptible to damage and bleeding
How is breathing affected in fulminant pateints?
- will become intubated- once intubated remains on HFNO to prevent further deteroiation
- rate and depth altered to avoid underlying metabolic acidosis
- repsonse to oxygen therapy
