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Understanding Medical Surgical Nursing Ch 32

Terms

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copy deck
striae
light silver-colored or thin red lines on the abdomen
caput medusae
bluish-purple swollen vein pattern extending out from the navel
spider angiomas
thin reddish-purple vein lines close to the skin surface
jaundice
AKA icterus

yellowing of the skin and sclera of eye
retrograde cholangiopancreatography (ERCP)
allows visualization of liver, gallbladder, & pancreas

endoscope is passed through esophagus to duodenum & then dye injected to outline pancreatic & bile ducts
Which of the following is a function of the liver?
a. Synthesis of plasma proteins
b. Elimination of carbohydrates
c. Concentration of bile
d. Secretion of cholecystokinin
a. Synthesis of plasma proteins
Which food is most likely to stimulate the release of bile?
a. Green beans
b. French fries
c. Coffee
d. Poached egg
b. French fries
The enzymes of the pancreas are involved in the digestion of which foods?
a. Starch and fat
b. Starch, fat, and protein
c. Fat and protein
d. Starch and protein
b. Starch, fat, and protein
Which of the following complications should the nurse monitor for after a liver biopsy?
a. Nausea
b. Muscle twitching
c. Bleeding
d. Hypoventilation
c. Bleeding
Which of the following nursing measures is most important after an upper or lower GI series?
a. Offer a laxative as ordered
b. Place pressure on the puncture site
c. Check for return of the gag reflex
d. Keep the patient in the semi-F
a. Offer a laxative as ordered
Mr. Sikmiller returned an hour ago from an EGD and is asking for a glass of water. Which of the following responses is best?
a. "I'm sorry, but you will need to wait 4 hours before drinking anything."
b. "I can't give you any wat
d. "Let me check your gag reflex first to make sure it is safe to drink water."
The liver fills the 1_____ and center of the upper abdominal cavity just below the 2_____. The two main lobes of the liver are called the 3_____ and 4_____ lobes.
1 right
2 diaphragm
3 right
4 left
There are three digestive functions of the liver.

TRUE or FALSE
FALSE

The only digestive function of the liver is the production of bile by the hepatocytes (liver cells).
p 535
Bile is mostly 1_____ and has an excretory function in that it carries 2_____ and excess 3_____ to the intestines for elimination in 4_____--.
1 water
2 bilirubin
3 cholesterol
4 feces
How does the liver regulate blood glucose levels?
Liver stores excess glucose as glycogen -> blood glucose level becomes low -> liver changes glycogen back to glucose
Of the 1_____ amino acids needed for the production of human 2_____, the liver is able to synthesize 12, called the 3_____ amino acids, by the process of transamination. The other 4_____ amino acids, which the liver cannot synthesize, are called the 5___
1 twenty
2 proteins
3 nonessential
4 eight
5 essential
The functions of the liver include:

(eight possible)
1 carbohydrate metabolism
2 amino acid metabolism
3 lipid metabolism
4 synthesis of plasma proteins
5 phagocytosis by Kupffer cells
6 formation of bilirubin
7 storage
8 detoxification
Kupffer cells
fixed macrophages of liver

phagocytize pathogens circulating in liver
The fixed macrophages of the liver phagocytize old WBCs & form bilirubin from the heme portion of their hemoglobin.

TRUE or FALSE
FALSE

The fixed macrophages of the liver phagocytize old RED BLOOD CELLS & form bilirubin from the heme portion of their hemoglobin.
p 537
The liver stores the minerals iron and 1_____; the fat-soluble vitamins A, 2_____, E, and 3_____; and the water-soluble vitamin 4_____.
1 copper
2 D
3 K
4 B12
The gallbladder is a 1_____ sac about 3 to 4 inches long located on the undersurface of the left lobe of the 2_____. Bile in the 3_____ 3_____ from the liver flows through the cystic duct into the gallbladder, which stores bile until it is needed in the
1 muscular
2 liver
3 hepatic duct
4 small intestine
The pancreatic enzyme amylase digests starch to _____.
maltose
Lipase (pancreatic enzyme) converts _____ _____ to fatty acids and glycerol.
emulsified fats
_____ digests polypeptides to shorter chains of amino acids.
Tripsin
Alanine aminotransferase (ALT)

normal range: 5-35 IU/dL

------------------------------

An increase indicates . . .
36 IU/dL or higher

possible chronic liver failure or hepatitis
Aspartate aminotransferase (AST)

normal range: 8-20 units/L

------------------------------

an increase indicates . . .
21 units/L or higher

possible chronic liver failure, viral hepatitis, or acute pancreatitis
Lactic dehydrogenase (LDH)

normal range: 110-250 IU/L

------------------------------

An increase indicates . . .
251 IU/L or higher

liver disease possible
In preparation for an oral cholecystogram (gallbladder series), the pt is asked to eat a 1_____ 1_____ diet for 2 days before the test, then a 2_____ 2_____ diet the day 3_____ the examination.
1 high fat
2 low fat
3 before
How long should a pt remain on bedrest following a percutaneous liver biopsy?
a. 2 days
b. 36 hours
c. 24 hours
d. 12 hours
c. 24 hours

p 542

Deck Info

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