NUR 210 CCTC HEPATOBILIARY || Solved Correctly.
What does the liver metabolize? correct answers Glucose and protein
What manufactures and secretes bile? correct answers the liver
What sources perfuse the liver? correct answers 80% of the blood supply comes from the portal
vein which drains the GI tract and is rich in nutrients but lacks O2 and 20% of the blood enters
from the hepatic artery and is rich in O2
Main function of Kupffer cells: correct answers to engulf particulate matter (ex. bacteria) that
enters the liver through the portal vein
Functions of the liver- Glucose Metabolism: correct answers After a meal, glucose is taken up
from the portal venous blood by the liver and converted into glycogen, which is stored in the
hepatocytes. Subsequently, the glycogen is converted back to glucose (glycogenolysis) and
released as needed into the bloodstream to maintain normal levels of blood glucose. However,
this process provides a limited amount of glucose. Additional glucose can be synthesized by the
liver through a process called gluconeogenesis. For this process, the liver uses amino acids from
protein breakdown or lactate produced by exercising muscles. This process occurs in response to
hypoglycemia
Functions of the liver- Ammonia Conversion: correct answers The use of amino acids from
protein for gluconeogenesis results in the formation of ammonia as a by-product. The liver
converts this metabolically generated ammonia into urea. Ammonia produced by bacteria in the
intestines is also removed from portal blood for urea synthesis. In this way, the liver converts
ammonia, a potential toxin, into urea, a compound that is excreted in the urine
Functions of the liver- protein metabolism: correct answers It synthesizes almost all of the
plasma proteins (except gamma-globulin), including albumin, alpha-globulins and beta-
globulins, blood clotting factors, specific transport proteins, and most of the plasma lipoproteins.
Amino acids are used by the liver for protein synthesis
,What is required by the liver for synthesis of prothrombin and Factors VII, IX and X? correct
answers Vitamin K
Functions of the liver- Fat metabolism: correct answers Fatty acids can be broken down for the
production of energy and ketone bodies. Ketone bodies are small compounds that can enter the
bloodstream and provide a source of energy for muscles and other tissues. Breakdown of fatty
acids into ketone bodies occurs primarily when the availability of glucose for metabolism is
limited, as in starvation or in uncontrolled diabetes.
Functions of the liver- vitamin and iron storage: correct answers Vitamins A, B, and D and
several of the B-complex vitamins are stored in large amounts in the liver. Certain substances,
such as iron and copper, are also stored in the liver.
Functions of the liver- Bile formation: correct answers Bile is continuously formed by the
hepatocytes and collected in the canaliculi and bile ducts
Functions of the liver- bilirubin excretion: correct answers Hepatocytes remove bilirubin from
the blood and chemically modify it through conjugation to glucuronic acid, which makes the
bilirubin more soluble in aqueous solutions. The conjugated bilirubin is secreted by the
hepatocytes into the adjacent bile canaliculi and is eventually carried in the bile into the
duodenum. In the small intestine, bilirubin is converted into urobilinogen, which is partially
excreted in the feces and partially absorbed through the intestinal mucosa into the portal blood.
Functions of the liver- Drug metabolism: correct answers Biotransforms drugs and other
chemicals into harmless substances that are altered so they can be excreted by the body
Plays a major role in the metabolism of fat-soluble drugs
Detoxifies harmful substances (alcohol)
Glycogenesis- correct answers formation of glycogen from glucose (sugar)
Glycogenolysis- correct answers the breakdown of glycogen especially to glucose
,Gluconeogenesis- correct answers the formation of glucose by the liver from substances (such as
fats and proteins) other than carbohydrates
How many essential amino acids does the human body require to live? How many total amino
acids are there? correct answers 9 amino acids to live
20 total amino acids
When gluconeogenesis takes place what is the byproduct of the process? correct answers
Ammonia
What happens to the byproduct of gluconeogenesis? correct answers We can't live with it so the
body gets rid of it. The liver converts it to urea and it is eliminated through the kidneys
What is needed for the absorption of the fat soluble vitamins A, D, E, & K? correct answers
Adequate levels of bile
What hormones does the liver inactivate? correct answers Estrogen
Testosterone derivatives
Progesterone
Aldosterone
Cortisol
Why would a individual with liver failure develop jaundice? correct answers He would not be
able to remove bilirubin from the blood and convert it into bile
What is the most common change in the liver in an older adult? correct answers a decrease in
size and weight, accompanied by a decrease in total hepatic blood flow
Age-Related Changes of the Hepatobiliary System: correct answers •Atypical clinical
presentation of biliary disease
, •Decreases in the following: •Clearance of hepatitis B surface antigen•Drug metabolism and
clearance capabilities•Intestinal and portal vein blood flow•Gallbladder contraction after a
meal•Rate of replacement and or repair of liver cells after injury•Size and weight of the liver,
particularly in women
•Increased prevalence of gallstones due to the increase in cholesterol secretion in bile
•More rapid progression of hepatitis C infection and lower response rate to therapy
•More severe complications of biliary tract disease
Nursing Health History of the Liver: correct answers Focuses on previous exposure of the patient
to hepatotoxic substances or infections agents, occupational hx, recreational hx, travel hx,
alcohol hx, drug use, medication hx, lifestyle behaviors, medical hx, all medical conditions
Physical Assessment of the liver: correct answers assess for physical signs that may occur with
liver dysfunction. assess skin mucosa and sclerae. assess for muscle atrophy, edema, and skin
exoriation secondary to scratching. assess skin for petechia, spider angiomas, and palmar
erythema. Male patient assessed for unilateral or bilateral gynecomastia and testicular atrophy
due to hormonal changes. Assess cognitive status (recall, memory, and abstract thinking) and
neurologic status. Assess for general tremor, asterixis, weakness, and slurred speech. Assess for
abdominal fluid. Palpate abdomen to asses liver size and detect tenderness over the liver
How much bile does the liver secrete per day? correct answers 700-1200 mL
Capacity of the gallbladder: correct answers 30-50 mL of bile
Functions of the gallbladder: correct answers storage depot for bile.
Between meals, when the sphincter of Oddi is closed, bile produced by the hepatocytes enters the
gallbladder. During storage, a large portion of the water in bile is absorbed through the walls of
What does the liver metabolize? correct answers Glucose and protein
What manufactures and secretes bile? correct answers the liver
What sources perfuse the liver? correct answers 80% of the blood supply comes from the portal
vein which drains the GI tract and is rich in nutrients but lacks O2 and 20% of the blood enters
from the hepatic artery and is rich in O2
Main function of Kupffer cells: correct answers to engulf particulate matter (ex. bacteria) that
enters the liver through the portal vein
Functions of the liver- Glucose Metabolism: correct answers After a meal, glucose is taken up
from the portal venous blood by the liver and converted into glycogen, which is stored in the
hepatocytes. Subsequently, the glycogen is converted back to glucose (glycogenolysis) and
released as needed into the bloodstream to maintain normal levels of blood glucose. However,
this process provides a limited amount of glucose. Additional glucose can be synthesized by the
liver through a process called gluconeogenesis. For this process, the liver uses amino acids from
protein breakdown or lactate produced by exercising muscles. This process occurs in response to
hypoglycemia
Functions of the liver- Ammonia Conversion: correct answers The use of amino acids from
protein for gluconeogenesis results in the formation of ammonia as a by-product. The liver
converts this metabolically generated ammonia into urea. Ammonia produced by bacteria in the
intestines is also removed from portal blood for urea synthesis. In this way, the liver converts
ammonia, a potential toxin, into urea, a compound that is excreted in the urine
Functions of the liver- protein metabolism: correct answers It synthesizes almost all of the
plasma proteins (except gamma-globulin), including albumin, alpha-globulins and beta-
globulins, blood clotting factors, specific transport proteins, and most of the plasma lipoproteins.
Amino acids are used by the liver for protein synthesis
,What is required by the liver for synthesis of prothrombin and Factors VII, IX and X? correct
answers Vitamin K
Functions of the liver- Fat metabolism: correct answers Fatty acids can be broken down for the
production of energy and ketone bodies. Ketone bodies are small compounds that can enter the
bloodstream and provide a source of energy for muscles and other tissues. Breakdown of fatty
acids into ketone bodies occurs primarily when the availability of glucose for metabolism is
limited, as in starvation or in uncontrolled diabetes.
Functions of the liver- vitamin and iron storage: correct answers Vitamins A, B, and D and
several of the B-complex vitamins are stored in large amounts in the liver. Certain substances,
such as iron and copper, are also stored in the liver.
Functions of the liver- Bile formation: correct answers Bile is continuously formed by the
hepatocytes and collected in the canaliculi and bile ducts
Functions of the liver- bilirubin excretion: correct answers Hepatocytes remove bilirubin from
the blood and chemically modify it through conjugation to glucuronic acid, which makes the
bilirubin more soluble in aqueous solutions. The conjugated bilirubin is secreted by the
hepatocytes into the adjacent bile canaliculi and is eventually carried in the bile into the
duodenum. In the small intestine, bilirubin is converted into urobilinogen, which is partially
excreted in the feces and partially absorbed through the intestinal mucosa into the portal blood.
Functions of the liver- Drug metabolism: correct answers Biotransforms drugs and other
chemicals into harmless substances that are altered so they can be excreted by the body
Plays a major role in the metabolism of fat-soluble drugs
Detoxifies harmful substances (alcohol)
Glycogenesis- correct answers formation of glycogen from glucose (sugar)
Glycogenolysis- correct answers the breakdown of glycogen especially to glucose
,Gluconeogenesis- correct answers the formation of glucose by the liver from substances (such as
fats and proteins) other than carbohydrates
How many essential amino acids does the human body require to live? How many total amino
acids are there? correct answers 9 amino acids to live
20 total amino acids
When gluconeogenesis takes place what is the byproduct of the process? correct answers
Ammonia
What happens to the byproduct of gluconeogenesis? correct answers We can't live with it so the
body gets rid of it. The liver converts it to urea and it is eliminated through the kidneys
What is needed for the absorption of the fat soluble vitamins A, D, E, & K? correct answers
Adequate levels of bile
What hormones does the liver inactivate? correct answers Estrogen
Testosterone derivatives
Progesterone
Aldosterone
Cortisol
Why would a individual with liver failure develop jaundice? correct answers He would not be
able to remove bilirubin from the blood and convert it into bile
What is the most common change in the liver in an older adult? correct answers a decrease in
size and weight, accompanied by a decrease in total hepatic blood flow
Age-Related Changes of the Hepatobiliary System: correct answers •Atypical clinical
presentation of biliary disease
, •Decreases in the following: •Clearance of hepatitis B surface antigen•Drug metabolism and
clearance capabilities•Intestinal and portal vein blood flow•Gallbladder contraction after a
meal•Rate of replacement and or repair of liver cells after injury•Size and weight of the liver,
particularly in women
•Increased prevalence of gallstones due to the increase in cholesterol secretion in bile
•More rapid progression of hepatitis C infection and lower response rate to therapy
•More severe complications of biliary tract disease
Nursing Health History of the Liver: correct answers Focuses on previous exposure of the patient
to hepatotoxic substances or infections agents, occupational hx, recreational hx, travel hx,
alcohol hx, drug use, medication hx, lifestyle behaviors, medical hx, all medical conditions
Physical Assessment of the liver: correct answers assess for physical signs that may occur with
liver dysfunction. assess skin mucosa and sclerae. assess for muscle atrophy, edema, and skin
exoriation secondary to scratching. assess skin for petechia, spider angiomas, and palmar
erythema. Male patient assessed for unilateral or bilateral gynecomastia and testicular atrophy
due to hormonal changes. Assess cognitive status (recall, memory, and abstract thinking) and
neurologic status. Assess for general tremor, asterixis, weakness, and slurred speech. Assess for
abdominal fluid. Palpate abdomen to asses liver size and detect tenderness over the liver
How much bile does the liver secrete per day? correct answers 700-1200 mL
Capacity of the gallbladder: correct answers 30-50 mL of bile
Functions of the gallbladder: correct answers storage depot for bile.
Between meals, when the sphincter of Oddi is closed, bile produced by the hepatocytes enters the
gallbladder. During storage, a large portion of the water in bile is absorbed through the walls of
