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NUR 213 – Liver: Questions With Solutions (Rated A+)
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NUR 213 – Liver: Questions With Solutions (Rated A+)
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NUR 213 – Liver: Questions With Solutions (Rated A+)What is Cirrhosis? Right Ans - -Chronic, progressive disease of the liver
characterized by diffuse degeneration and destruction of hepatocytes
-Destruction --> Scarring or nodules --> Block bile ducts & blood flow --> Liver
dysfunction
Causes for Cirrhosis Right Ans - •Alcoholic Liver Disease - direct toxic affect
•Hepatitis
•Drugs/Toxins
•Biliary disease - stones or strictures which cause chronic inflammation
•Metabolic/genetic causes - cystic fibrosis (interferes with how the liver
processes and stores enzymes)
•CHF - R-sided - backs up into liver
Complications of Cirrhosis Right Ans - •Portal Hypertension
-Persistent increase in pressure in the portal vein
-Caused by obstruction of blood flow or increased resistance
-Causes splenomegaly
Causes veins in the esophagus, the intestine, abdomen and rectum to become
enlarged/dilated and inflamed - Can lead to ascites, esophageal varices, and
hemorrhoids
•Ascites
-Accumulation of free fluid w/in peritoneal cavity - leads out of veins and into
peritoneal cavity (Ascites --> respiratory depression and distress due to fluid
build up)
-Caused from increased pressure from portal HTN causing fluid to leak into
peritoneal cavity
•Bleeding Esophageal Varices
-Fragile, thin-walled esophageal veins become distended and irritated and
rupture
-Caused by increased pressure from portal HTN
-Life threatening emergency! - hemopsis, vomiting blood, melina - no straining
during BM
, •Coagulation Defects
-Decrease in the production of bile --> prevents absorption of fat-soluble
vitamins (Vit K)
-Without Vitamin K, clotting factors are not produced
-So what is the patient at risk for??? BLEEDING
-What labs should the RN monitor? PT/INR, PTT
-Thrombocytopenia is also a risk because of platelet destruction because of
splenic disfunction
•Jaundice - skin, eyes, muscous membranes, palms of hands, soles of feet, nails
-Liver is unable to metabolize bile therefore excess bilirubin is circulating
-The hepatic bile ducts are edematous and scarred which interferes with
normal bile and bilirubin excretion
•Hepatorenal syndrome
-Progressive renal failure associated with hepatic failure
-Sudden decrease in UOP, Elevated BUN and Creatinine, Decreased urine
sodium excretion
•Portal-Systemic Encephalopathy/Hepatic Encephalopathy
-Seen in end-stage hepatic failure and cirrhosis
-Altered LOC and neurological symptoms, impaired thinking, and
neuromuscular disturbances
- Elevated ammonia l
Clinical Manifestations of Cirrhosis - Comprehensive list Right Ans - Neuro:
- asterixis
- paresthesias of feet
- peripheral nerve degeneration
- portal-systemic encephalopathy
- reversal of sleep-wake pattern
- sensory disturbances
GI:
- abd pain
- anorexia
- ascites
- clay-colored stools
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