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NURA 308 EXAM 2 QUESTIONS AND ANSWERS
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NURA 308 EXAM 2 QUESTIONS ANDANSWERS
fluid accumulation in the peritoneal cavity
ascites
chronic liver disease is characterized by fibrotic changes & formation of
dense connective tissue within the liver leading to the loss of functioning
cells
cirrhosis
what area of the abdomen is the liver located?
RUQ (right upper quadrant)
what organ plays a major role in glucose metabolism?
liver
pigment derived from the breakdown of haemoglobin cells (RBCs)
bilirubin
should there be changes in liver function do to aging?
no liver function should not change with age
as patients age should you expect changes in the way the liver
metabolizes medication?
yes metabolism may decrease and medications should be closely
monitored & dosages reduced if necessary
what information regarding liver function should you collect regarding
health history?
- check liver function
-exposure to toxic substances or infectious agents
- travel, recreation, occupational acivity (injectable drugs, alcohol use,
etc.)
-lifestyle risk factors (sexual practices, foreign travel, drug use)
What are physical signs of liver diease?
pallor, jaundice, edema, ascites, extremely itchy skin, petechiae or easy
bruising
how do you palpate the liver?
palpate under right costal margins, have patient inhale then exhale
slowly
,jaundice that results from increased destruction of RBCs causing plasma
to get rapidly flooded with bilirubin preventing the liver from excreting
bilirubin fast enough
hemolytic jaundice
is liver function impaired with hepatic jaundice?
no
type of jaundice that is caused by the inability of damaged liver cells to
clear normal amounts of bilirubin from the blood
hepatocellular jaundice
cirrhosis, hepatitis, alcohol, etc can lead to hepatocellular destruction
causing what form of jaundice?
hepatocellular jaundice
type of jaundice where bile cannot flow normally into the intestine &
becomes backed up into the liver & then reabsorbed into the blood &
carried throughout the body
obstructive jaundice
what are some causes of obstructive jaundice?
occlusion of bile duct from gallstones, inflammation, tumor, or pressure
from enlarged organs
what color is stool when bilirubin is lacking in the intestines?
light or clay-colored
what are medications are give for ascites?
spironolactone
furosemide
diuretics
which aldosterone blocking medication is potassium sparing?
spironolactone
what are the clinical manifestations of ascites?
Abdominal distention, increased abdominal girth, and weight gain
type of hepatitis caused by fecal-oral route via ingestion of food or liquid
containing the virus
hepatits A
where does hepatitis A most commonly occur?
in overcrowded countries or areas with poor sanitation
type of hepatitis that is transmitted through blood, saliva, semen, &
vaginal secretions
hepatitis B
, type of hepatitis transmitted by blood, sexual contact, sharing used
needles, unintentional needlesticks, etc
hepatitis C
what are risk factors for hepatitis B?
exposure to blood, IV drug use, multiple sex partners, born to mother
with hepatitis, tattooing
What is postnecrotic cirrhosis?
Broad bands of scar tissue from previous acute hepatitis
life threatening complication of liver disease that occurs with profound
liver failure that causes abnormal psychological affects
hepatic encephalopathy
What causes hepatic encephalopathy?
The buildup of ammonia in the body
What are clinical manifestations of hepatic encephalopathy?
mental status changes, motor disturbances, confusion, asterixis, coma,
seizures, constructional apraxia, difficult to awaken/disoriented
involuntary hand flapping
asterixis
why should you check handwriting daily of someone with liver disease?
if they are suffering from progressive hepatic encephalopathy their
handwriting will begin to deteriorate
what drug is used to treat blood ammonia levels?
lactulose
why should you monitor a patient on lactulose closely?
watery diarrhea can indicate OD
Nursing interventions for hepatic encephalopathy
-monitor I & O/ body weight daily
-neurological status assessed frequently
-mental status and daily handwriting checks
-serum ammonia levels
-vital signs every 4 hours
where is bile stored?
gallbladder
what hormone regulates bile release?
CCK (cholecystokinin)
How does bile aid in digestion?
It breaks down fats to smaller particles in chemical digestion to prepare
for absorption.
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