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210 Ch. 39
Liver Disorders
| Question | Answer |
|---|---|
| What is the liver fx? | regulation of glucose and protein metabolism, manufactures/secretes bile, removes waste from blood, metabolize drugs |
| The blood to liver comes from two sources | 1.80% from portal vein draining GI tract, rich in nutrients, no O2 2.Hepatic art, rich in O2 |
| What does liver do to ammonia and where does ammonia come from | Liver converts ammonia to urea to b peed out....ammonia is breakdown from proteins or GI blood |
| Most of the plasma proteins are synthesized where | liver Vit K needed by liver for synthesis of PT(prothrombin) |
| Which vit are stored in liver? | A,B,D, Bcomplex, iron, copper |
| Portal HTN can be serious and lead to what complication in the esophagus>? | esophageal varices tx: like hemorrhoids, band, balloon tamponade, ice cold lavage |
| What is accumulated to form ascites | plasma in abd cavity with extra proteins |
| what are nsg mgmt for ascites | measure girth same place, daily wts, diuretics(spirinolactone), bed rest, paracentesis(take 5-6L safe)*take VS b4,during,after for shock |
| what is nursing imperitive for pt wtih esophageal varices | Never leave pt alone! give vasopressin,somatostatin,inderal,nitrates to lower pressure |
| Hepatic encephalopathy is build up of what and how to manage? | ammonia due to liver disease....lactulose(laxative to pull out ammonia, assess for diarrhea), assess for personality changes, Babinski reflex, asterixis(hand flapping) |
| Normal bilirubin level? Jaundiced level? | 0-0.3 2.5 |
| three types of jaundice | hemolytic: RBC breakdown too fast, flood plasma with bilirubin hepatocellular, obstructive(gray stool), hereditary |
| vasopressin contricts and reduces portal pressure, what contraindications are there | CAD, because may start MI |
| Somatostatin decr bleeding from esophageal varices, but lacks what that vasopressin has | vasoconstriction |
| Propranodol/nadolol are what kind of drugs? How do they help varices? | Beta blockers prevent first bleeding, prophylaxis |
| How do nitrates help portal pressrue? | venodilation, decr CO |
| What is key nsg priority wtih abd surgery | Turn, cough, deep breath |
| Hep A? B? C? | A: virus, fecal-oral route, 2-6wk incubation, vaccine B: blood borne, 28-160d, rash, vaccine, not pass to baby, nurse at risk C: No vaccine, blood born, Nurses at risk, pass to baby |
| vasopressin contricts and reduces portal pressure, what contraindications are there | CAD, because may start MI |
| Somatostatin decr bleeding from esophageal varices, but lacks what that vasopressin has | vasoconstriction |
| Propranodol/nadolol are what kind of drugs? How do they help varices? | Beta blockers prevent first bleeding, prophylaxis |
| How do nitrates help portal pressrue? | venodilation, decr CO |
| What is key nsg priority wtih abd surgery | Turn, cough, deep breath |
| Hep A? B? C? | A: virus, fecal-oral route, 2-6wk incubation, vaccine B: blood borne, 28-160d, rash, vaccine, not pass to baby, nurse at risk C: No vaccine, blood born, Nurses at risk, pass to baby |
| Regarding liver cancer, does primary or secondary tumors happen more? | metastic liver tumors becuase of blood supply from all body parts |
| What is greatest threat to transplants? | rejection and will see fever and hypotension |
Created by:
palmerag
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