Cirrhosis

Vocab/Basics

100

Chronic liver disease characterized by fibrotic changes and scar tissue that causes a loss of functioning cells

1. What is cirrhosis

200

This is the most common cause of cirrhosis

1. What is alcohol use

300

What are the functions of the liver?

1. Glucose metabolism, ammonia conversion, protein metabolism, fat metabolism, vitamin and iron storage, bile formation, bilirubin excretion, and drug metabolism

400

An albumin rich fluid accumulation in the peritoneal cavity

1. What is ascites

500

CNS dysfunction frequently associated w/ elevated ammonia levels that produces changes in mental status, altered LOC, and coma

1. What is hepatic encephalopathy

LFT's

100

These lab values are based on the release of enzymes from damaged liver cells

1. What is AST/ALT 

200

These studies measure the livers ability to conjugate and excrete bilirubin and an elevation could be noted in jaundice

1. Serum, total, and urine bilirubin. Also urine/fecal urobilinogen

300

This is the primary protein monitored for nutritional and liver function that is often low in chronic liver disease/cirrhosis

1. What is albumin

400

This amount of liver parenchyma may be damaged before LFT’s are abnormal

1. What is 70%

500

What happens to serum ammonia levels in liver failure?

1. What is elevation

Connections

100

What are common nursing findings for cirrhosis

1. Jaundice, nausea, poor appetite, pallor, sarcopenia, edema, itching, ecchymosis, palmar erythema, altered cognition, tremor, weakness, slurred speech, RUQ tenderness

200

These are common complications with the treatment and management of cirrhosis

1. What is fluid and electrolyte balance

300

How does cirrhosis cause pruritus 

What is the accumulation of bile salts

400

This condition is almost always caused by portal hypertension and is a high risk for complications and death in the cirrhotic patient

1. What is esophageal varices

500

How does cirrhosis cause ascites?

1. What is via portal hypertension and failure of the liver to metabolize aldosterone which increases sodium and water retention in conjunction with decreased albumin synthesis which allows fluid to escape into the peritoneal space

Treatment

100

This nutritional treatment can be successful in treating ascites when Pt is properly educated

1. What is sodium restriction

200

List two medications used in the treatment ascites

1. What are spironolactone (potassium sparing) and furosemide

300

This medication is used to treat hepatic encephalopathy but can come with side effects including hypokalemia and dehydration

1. What is lactulose

400

This procedure can be done at the bedside by the provider to remove fluid from the peritoneal cavity

1. What is paracentesis

500

Why is BP control so important in cirrhosis patients?

1. To reduce the possibility of variceal bleeding and it’s associated mortality