Varice Vibes
This medication is used as preventative therapy for varices that are already present; reduces portal pressure & prevents variceal bleeding!
Propanolol!
Functional loss of bowel movement causing a type of paralysis of the intestines is called _______
Paralytic Illeus
The main and most easily distinguished problem with hepatic encephalopathy is that it can cause what type of complications in the patient?
Neurological problems! (sleep, mood, altered LOC, speech problems!)
What type of diet would a patient be on if they are experiencing ascites?
Low sodium diet/ fluid restriction!
Elevated levels of this enzyme are indicative of liver damage/disease.
AST!
This procedure is used to visually examine the esophagus for early detection of varices.
Endoscopy
A bowel obstruction would have what kind of bowel sounds when ausculatating?
Absent/Hypoactive
Hepatic encephalopathy is caused by the excessive accumulation of ________ in the body
Ammonia
Surgical treatment for ascites, involves removing fluid from abdominal cavity.
Paracentesis.
What labs would be low in a patient with active esophageal varices?
PT, INR, Hct, Hgb, spO2 (bleeding!!!)
Cirrhosis
Why should you not give opioids to a patient with an obstruction?
Opioids can cause constipation/slow GI motility.
What is "Fetor Hepaticus?"
(AKA Breath of the dead)
Musty garlic and rotten egg smell on patient’s breath that results from the liver not being able to filter compounds.
Would a patient with ascites be edematous or non-edematous? Hypervolemic or Hypovolemic??
They would be edematous and hypovolemic!
This substance accumulates in the blood, and is a yellow-orange pigment produced when red blood cells are broken down, causing jaundice if not processed by the liver.
Billirubin
What type of foods should you avoid if you have active esophageal varices?
Dry/hard food!
What type of line(s) do you give TPN through?
PICC or Central Line
Define "Asterixis"
Flapping tremors of the hand; a neurological sign most often associated with hepatic encephalopathy.
What laxative is given to patient's with cirrhosis/chronic liver disorder to help them excrete ammonia?
Lactulose
What is this???
Patient receiving TPN;
- elevation of the serum triglyceride level
- increased temp/ fever
-decrease in coagulation (PT)
Fat Overload Syndrome
What medications do you use in emergency situations of acute bleeding of the esophageal varices?
Vasopressin/ Octreotide Acetate
***Its an unlabeled use for Octreotide Acetate, this is actually growth hormone/antidiarrheal
What are some medications that you can give to help promote GI motility?
Metoclopramide (Reglan), and Alvimopam (Entereg)
Name pre-existing conditions that a patient absolutely NOT have, to be elligible for a liver transplant?
Severe cardiac instability/ advanced cardiac disease
Severe respiratory disease
Metastatic Tumors
Medically non-compliant
OTHER THAN ALCOHOL, name another cause for Cirrhosis.
Viral hepatitis/other drugs and toxins/autoimmune disorders/Nonalcoholic Fatty Liver Disease
What labs would be elevated in a case of an acute graft rejection? (NAME 3!)
Bilirubin ALT, AST, Alk Phos, PT/INR