LIVER
Terms
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- Cardiac Cirrhosis
- most commonly caused by severe long term right sided CHF. Decreased O2 by the liver cells and cellular death charaterized by this disease
- nepmycin adn lactulose
- teh 2 dugs that can be administered to reduce bacterail breakdown of protein in teh bowel.
- Health care workers
- hep B prophylaxis is recommended for what group of people
- Hep E
- refers to an epidemiec form of hep that is smilar in characteristis to hep A. transmitted vial fecal oral route and does not progress to a chronic phase. common in develponing conuntries.
- bile salts
- these emulsify fat adn foster their absorption. they are resabsorbed in the terminal portion of teh ilem and are transported back to teh liver where they are used again
- Melena
- Shiny black floul smelling stool and results from degradation of blood by stommach acids or intestinal bacteria
- Acetaldehyde
- is a toxic metabolite of alcholol ingestion, caused liver damage and death
- perioneovenous shunting
- is a surgical procedure used to releive acities that is resistant to other therapies.
- 9 weeks with hep A and 16 weeks in B
- recovery for hep A is usually in _____ weeks. recovery for hep B is usually in _____ weeks
- Billiary cirrhosis
- decrease in bile flow which commonly caused by loong term obstruction of bile ducts
- hep A
- most commmon type of viral hepatitis. the virsu infects teh liver and is eliminated by the fecces. this virus is promarily sperad through oral ingestion of food water and shellfish that have been infected by fecal contaminates. is self limiting.
- A and B
- hepitis ___ and ____ have available prophylaxis
- hetatochezia
- bright red or maroon blood can all be passed from the rectum.
- stage 4
- in this stage in portal systemic encephalopathy include profound coma, unresponsive to pain, adn GI alterations
- cirrhosis
- is charachteized by inflammation and liver cell necrosis that may be focal or diffuse.
- Kupffer cells
- remove bacteria and other foreign material from teh blood. Extremely phagocytic and thus normally prevent all bacter from reaching the systemic circulation
- 20-40
- protein in portal systemic encephalopathy is limited to ______
- greater than 10
- Normal venous pressure is 2-6. formantion of varicies require that this pressure increased to __________
- at least 12
- Portal venous pressure needs to be at least _____ for the varicies to bleed
- Hematemesis
- bloody vomitis that is either bright red or coffe gound.
- gastric lavage
- in the treatment of variceal Bleeding this may be used to clear the stomach adn to document the amount of blood loss
- viral Hepatitis
- most common cause of hepatocellylar jaundice
- LOC and UOP
- what two areas should be monitored for people who have chronic hypertension when assessing for shock?
- hep C
- transmitted through blood or body fluids and from mother to child during child birth. highest in drug usessers. leading indicator for liver transplants
- vasopressin
- this drug is commonly given by IV adn lowers portal vein pressure. should be continued for at least 24 hours after bleeding is controlled. wean slowly.
- Hep D
- always seen with presence of Hepp B.
- 3
- Jaundice is generally preset in pts with a serum bilirubin level greater than _____
- Hep B
- persons considered infectious as long as antigens or the virus are found in teh blood stream. spread promiarily by blood. blood products, and blood bodily fluids or secretions such as semen. can spread percutaneously, thoguth mucus memebranes, through contact with infectedfulids or child birth. can result inteh developemnt of a carrier state, chronic hepititis or liver cancer.
- Kupffer Cells
- damage to these cells will cause risk for sever infection
- esophageal rupture
- is characterized by the onset of abrupt pain. if htis occurs the 3 lumen are sut adn the entire tube is removed. endotrachea intubation is recommended to protect the airway
- esophageal ballon
- which balloon is deflated first? if not the entire tube will be displaced upward and will occlude the airway.
- Fatty Liver
- is an accumulation of excessivev fats in teh liver. alcohol abuse, obesity, diabetes, hepatic resection, starvation and TPN are common causes. damage is caused by the fat deposits may result in liver dysfunction, failure and death.
- TIPS
- is a nonsurgical treatment for recurrent variceal bleeding aftter sclerotherapy. placement of teh shunt is perfomred by the use of fluroscopy. a stainless steel shunt is placed to decrease portal pressure therefor decreasing the acute hemorrhage.
- thought processes
- with liver failure, loss of amonia conversion to urea in the liver is responsible for what?
- Hemolytic jaundice
- results in form increased RBC destruction such as blood incompatibilities adn sicle cell disease
- Postnecrotic cirrhosis
- can be a result of exposure to hepatotoxins, chemical or infection or it can be a metabolic disorder
- 20-45
- is the normal inflation pressure of the balloon for balloon tamponade.
- obstructive jaundice
- is usually caused by gallbladder disease such as gall stones
- Portal systemic encephalopathy
- functional derenagement of the CNS that causes altered level of Consciousness and cerebral manifestations ranging from confusion to coma
- asterixis
- a flapping tremor of the hand, and is an early sign of encephalopathy that can be assessed by the nurse
- liver transplants
- this treatment for liver failure is conteraindicated in HIV infections, malignancy, and significant heart, lung or kidney dysfunction
- encephalopathy
- with surgical interventions to decrease protal hypertension. the procedure is associated with a higher risk of _______
- stage 2
- in this stage in portal systemic encephalopathy includes drosiness, loss of sphincter contrla and asterixis
- glycogensis
- when the concentration of glucose is increased to greater than normal levels it is stroed as glycogen this is reffered to as?
- stage 1
- in this stage in portal systemic encephalopathy includes tremors, slurred speech, impaired decision making
- gluconeogensis
- if blood glucose levels decrese to less than normal and glycogen stores are depleted, the liver can make gllucose form proteins and fats is called _________
- glycolysis
- when blood glucose levels decrease, glycogen stored in the liver is split to for glucose. this process is called ______
- Stage 3
- in this stage in portal systemic encephalopathy include dramatic confusion and sommolance
- soatostatis or ocreotide
- commonly ordered to slow ar stop the bleeding.
- 1000 ML
- a systolic blood pressure of less than 100, a postural decrease in BP of greater than 10 or a heart rate of greater than 120 reflects a blood loss of at least ______
- Oxazepam, siazepam, and lorazepam
- are used judiciously becouse these drugs are less dependent on liver function of excretion
- sclerotherapy
- an agent is injected into the varix and the surrounding tissue. several applications are needed several days apart
- Jaundive
- Excess bilirubin accumulation in teh blood results in what?
- fhepatorenal syndrome
- associated with end stage cirrhosis adn acites, decreased albumin level or portal hypertension. decreased UOP and increased serum creatine level usually occur acutely.