Function Review
This organ produces bile, metabolizes nutrients, detoxifies medications and toxins, and synthesizes many proteins involved in coagulation.
What is the liver?
This chronic liver condition involves progressive fibrosis and disruption of normal hepatic structure and can eventually cause portal hypertension and liver failure.
What is cirrhosis?
Portal hypertension causes collateral veins in the esophagus to enlarge, creating this potentially life-threatening complication.
What are esophageal varices?
This neurotoxin normally travels to the liver and is converted to urea but can accumulate in the systemic circulation when severe liver dysfunction or portosystemic shunting occurs.
What is ammonia?
This type of viral hepatitis is primarily transmitted by the fecal-oral route and can be prevented through vaccination and careful hand hygiene.
What is hepatitis A (HAV)?
This organ does not produce bile but stores and concentrates it before releasing it into the small intestine.
What is the gallbladder?
Double Jeopary Freebie +400 points
Yay!
This potassium-sparing aldosterone antagonist is commonly used to help manage ascites in patients with cirrhosis.
What is spironolactone (Aldactone)?
The nurse asks a patient with cirrhosis to extend the arms and hands. Rapid involuntary flexion and extension or “flapping” of the hands is documented using this term.
What is asterixis?
A patient's hepatitis B serology demonstrates the presence of this antibody, indicating immunity from previous HBV infection or vaccination.
What is anti-HBs?
A patient has significant impairment of this portion of pancreatic function and therefore has difficulty digesting carbohydrates, proteins, and fats.
What is exocrine pancreatic function?
A patient with cirrhosis develops increasing abdominal distention, bilateral lower-extremity edema, and a 2-kg weight gain. Identify the complication most consistent with these findings.
What is ascites/fluid retention?
A patient with esophageal varices receives propranolol. Identify the major therapeutic purpose of this medication.
What is reducing portal pressure and decreasing the risk of variceal bleeding?
A patient receiving lactulose for hepatic encephalopathy begins having regular bowel movements and demonstrates improving orientation. Explain why this indicates the treatment is effective.
What is lactulose trapping ammonia in the intestine and promoting its elimination through stool?
A patient's anti-HCV screening test is positive. The nurse anticipates this additional test to determine whether the patient has active viral replication.
What is HCV RNA testing?
A patient develops obstruction of the common bile duct. The nurse expects these two characteristic changes in urine and stool color.
What are dark urine and clay-colored stools? Ch 48 Liver Gallbladder Pancreas
During assessment of a patient with cirrhosis, the nurse observes jaundice, spider angiomas, palmar erythema, increasing abdominal girth, and black tarry stools. Identify the finding requiring the most immediate follow-up.
What is black tarry stool (melena)?
A patient with cirrhosis suddenly vomits a large amount of bright-red blood. BP is 82/48 mmHg, HR 132/min, and SpO₂ 89%. Identify the nurse's immediate priority.
What is protecting the airway?
A previously alert patient with cirrhosis suddenly develops confusion and asterixis after experiencing an episode of hematemesis. Identify the event that likely precipitated the encephalopathy and explain why.
What is GI bleeding? Because blood in the GI tract increases the nitrogen/protein load, bacteria break it down and subsequently produce large amounts of ammonia.
A patient with chronic hepatitis C asks about the goal of direct-acting antiviral therapy.
What is eradication of HCV and prevention of HCV-related complications? more than 95% of patients completing DAA treatment achieve cure.
A patient with advanced liver dysfunction has an albumin level of 2.1 g/dL and increasing ascites. Identify the physiologic change related to the low albumin that contributes to fluid moving into the peritoneal cavity.
What is decreased plasma oncotic pressure?
The nurse has four patients with cirrhosis: one has generalized pruritus, one has ankle edema, one has increasing abdominal girth, and one has become newly confused and difficult to arouse. Identify the patient the nurse should assess first.
Who is the patient with new confusion and decreased level of consciousness?
A patient with an acute variceal hemorrhage is receiving IV octreotide while being prepared for endoscopic band ligation. Explain the purpose of both treatments.
What is octreotide decreases splanchnic blood flow and portal pressure, while band ligation mechanically controls the varices to stop/prevent bleeding? Ch 48 Liver Gallbladder Pancreas
A patient receiving lactulose has four watery stools in 6 hours, BP 92/56 mmHg, potassium 2.9 mEq/L, increasing lethargy, and worsening asterixis. Identify the priority problem contributing to the worsening encephalopathy.
What is dehydration and hypokalemia from excessive diarrhea?
When blood potassium drops, potassium moves out of cells. To balance electrical charges, hydrogen ions move into the cells, creating a state of low acid (metabolic alkalosis) in the body fluids.Increased Ammonia Production: Low potassium and alkalosis signal the kidneys to ramp up production of ammonia
A liver-transplant recipient receiving immunosuppressive therapy develops fever, increasing abdominal pain, and a sudden decline in overall condition. Identify the two major post-transplant complications the nurse should be concerned about.
What are infection and transplant rejection/graft dysfunction?