NUR 301 Final Exam with Correct Answers
portal hypertension
obstruction of flow through the liver
high pressure-->collateral circulation-->shunts to IVC
portal hypertension complications
varices
encephalopathy
ascites
congestive splenomegaly
portosystemic shunts
esophageal varices
dilated veins
increased pressure thins vessel wall
irritated by gastric acid ethyl alcohol
rupture=massive bleed
rectal hemorrhoids
varices treatment
beta blockers
compression devices
liver transplant
encephalopathy
,brain dysfunction from excess ammonia/toxins due to decreased liver function
subtle changes in personality memory
confusion
flapping tremors
coma
encephalopathy treatment
reduce ammonia levels
diet low in protein
medications
ascites
fluid accumulates in peritoneal space
(also seen in CHF, CA, and malnutrition)
(portal HTN) decreased blood volume -->increase ADH and aldosterone--> increased hydrostatic
pressure
decreased albumin-->decreased oncotic pressure
=fluid build up, fluid leakage out of vessels
ascites symptoms
weight gain
abdominal distention 10-20L
anasarca
congestive splenomegaly
,enlarged spleen due to liver damage/cirrhosis
sequestration → anemia, thrombocytopenia, leukopenia
liver failure causes
disorders of synthesis and storage functions
disorders of metabolic and excretory functions
disorders of synthesis and storage functions with liver failure
glucose-->hypoglycemic events
proteins-->hypoalbuniemia, decreased coag factors (edema/ascites and bleeding)
lipoprotein cholesterol-->decreased cholesterol
bil salts-->impaired fat absorption
(vit deficient, fatty stools)
disorders of metabolic and excretory functions with liver failure
amino acids-->impaired conversion of ammonia to urea
(encephalopathy)
steroid hormones--> increased aldosterone, increased androgens/estrogens
(edema/ascites, gynecomastia/testicular atrophy, menstrual irregularities)
drugs--> interactions and toxicities
bilirubin-->hyperbilirubinemia
(jaundice)
signs and symptoms of liver failure
, jaundice
spider neci
muscle wastin
fibrotic liver changes
ascites
hemorrhoids
edema
hepatic encephalopathy
facial telangiestasia
fetor hepaticus
esophageal varicies
gynecomastia
splenomegaly
periumbilical caput medusae
palmar erythema
testicular atrophy
purpura
labs to look for in liver failure
liver enzymes= alanine aminotransferase + aspartate aminotransferase
prothrombin/INR (synthesis of coag factors)
albumin
serum bilirubin
alkaline phosphate (to detect disorders obstructing the bile duct)
portal hypertension
obstruction of flow through the liver
high pressure-->collateral circulation-->shunts to IVC
portal hypertension complications
varices
encephalopathy
ascites
congestive splenomegaly
portosystemic shunts
esophageal varices
dilated veins
increased pressure thins vessel wall
irritated by gastric acid ethyl alcohol
rupture=massive bleed
rectal hemorrhoids
varices treatment
beta blockers
compression devices
liver transplant
encephalopathy
,brain dysfunction from excess ammonia/toxins due to decreased liver function
subtle changes in personality memory
confusion
flapping tremors
coma
encephalopathy treatment
reduce ammonia levels
diet low in protein
medications
ascites
fluid accumulates in peritoneal space
(also seen in CHF, CA, and malnutrition)
(portal HTN) decreased blood volume -->increase ADH and aldosterone--> increased hydrostatic
pressure
decreased albumin-->decreased oncotic pressure
=fluid build up, fluid leakage out of vessels
ascites symptoms
weight gain
abdominal distention 10-20L
anasarca
congestive splenomegaly
,enlarged spleen due to liver damage/cirrhosis
sequestration → anemia, thrombocytopenia, leukopenia
liver failure causes
disorders of synthesis and storage functions
disorders of metabolic and excretory functions
disorders of synthesis and storage functions with liver failure
glucose-->hypoglycemic events
proteins-->hypoalbuniemia, decreased coag factors (edema/ascites and bleeding)
lipoprotein cholesterol-->decreased cholesterol
bil salts-->impaired fat absorption
(vit deficient, fatty stools)
disorders of metabolic and excretory functions with liver failure
amino acids-->impaired conversion of ammonia to urea
(encephalopathy)
steroid hormones--> increased aldosterone, increased androgens/estrogens
(edema/ascites, gynecomastia/testicular atrophy, menstrual irregularities)
drugs--> interactions and toxicities
bilirubin-->hyperbilirubinemia
(jaundice)
signs and symptoms of liver failure
, jaundice
spider neci
muscle wastin
fibrotic liver changes
ascites
hemorrhoids
edema
hepatic encephalopathy
facial telangiestasia
fetor hepaticus
esophageal varicies
gynecomastia
splenomegaly
periumbilical caput medusae
palmar erythema
testicular atrophy
purpura
labs to look for in liver failure
liver enzymes= alanine aminotransferase + aspartate aminotransferase
prothrombin/INR (synthesis of coag factors)
albumin
serum bilirubin
alkaline phosphate (to detect disorders obstructing the bile duct)
