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NUR 213 ( LATEST 2024 / 2025 ) EXAM 6 | GUARANTEED A+ ACTUAL QUESTIONS AND ANSWERS
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NUR 213 ( LATEST 2024 / 2025 ) EXAM 6 | GUARANTEED A+ ACTUAL QUESTIONS AND ANSWERS
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NUR 213 Exam 61. Metabolism
Answer
Bio chemical reaction necessary to produce energy, repair cells and maintain life
2. Liver function
Answer
Metabolism of proteins, carbs, fats
Stores minerals and fat-soluble vitamins Stores glycogen
Metabolism of medication (narcotics/sedatives/Tylenol) Metabolism of steroids
Produces albumin and clotting factors - albumin affects oncontic pressure
Detoxifies drugs and alcohol
3. What is a toxic by product of protein metabolism , converted to urea in the liver for
elimination by the kidneys.
Answer
Ammonia
4. what does bile do?
Answer
Bile- produced in the liver, stored in the gallbladder, absorbs fat, eliminates bilirubin from the
body
5. Fat soluble vitamins
Answer
ADEK iron and copper
Vit K is necessary for clotting
6. What side is your liver on?
Answer
Right side
7. Liver blood supply
Answer
Sees 75% of venous blood from stomach, intestines, spleen, to the liver
Liver detoxify blood
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,8. Impaired liver function
Answer
Low albumin = edema in peripheral tissue and as cities Impaired clotting factors = risk for
bleeding
Impaired glucose metabolism = alterations in blood glucose levels
Impaired bile production= decreased absorption of lipids and fats-soluble vitamins Decreased
vit k= increased bleeding
Impaired metabolism or steroid hormones= feminization in men and change in menses in
women
9. Cirrhosis
Answer
Caused by necrotic injury or chronic reaction to inflammation over a prolonged period of time.
Develops over years and is irreversible
Normal tissue is replaced with non-functioning fibrotic tissue
Developers slowly, progressive, irreversible, liver no longer able to regenerate itself Fibrous
tissue disrupts bile and blood flow through liver
Liver enlarges and becomes hard then shrinks as function is lost
10. Cirrhosis types
Answer
Alcoholic- chronic ETOH use
Hepatitis, medication, or toxins. (Tylenol OD can cause acute cirrhosis) Chorionic biliary
obstruction
11. Cirrhosis risk factors
Answer
Alcohol use Fatty liver
Hepatitis
Hepatotoxic medications Severe right sided heart failure
12. Early Signs and symptoms of cirrhosis
Answer
Early-vague
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,Dull, achy, pain RUQ Loss of appetite Indigestion
N/V Constipation/diarrhea
Jaundice (more advanced) Fatigue
Weight loss
13. Progressive signs and symptoms of cirrhosis
Answer
Later signs-loss of cell func- tion
Pruitis
Altered mental status Personality change Esophageal varicose Splenomegaly Profound
weakness Bleeding
Ascites
Palmar erythema (red palms)
Spider angiomas (spider veins on upper extremities due to increased estrogen) Peripheral edema
Asterixis (hand flapping) Gynecomastia
Anemia Thrombocytopenia
14. Hepatic encephalopathy
Answer
Results from cerebral edem and Neurotoxin accu- mulation in the blood (ammonia)
-confusion
-Asterixix is the early sign
*monitor mental status*
Risk factors of people who have cirrhosis to get encephalopathy
Answer
(think of blood like a protein)
GI bleed
Blood transfusion Hypoxia
High protein diet
15. Early signs of hepatic encephalopathy
Answer
Agitation Restlessness
Impaired judgment Slurred speach
16. Progression of hepatic encephalopathy
Answer
Confusion Disorientation
Incoherence
SUBSCRIBE
, *the more sleep they get the worse it is*
17. What is the leading cause of death in encephalopathy?
Answer
Increased cerebral edema and cerebral hypoxia
18. What is the treatment for hepatic encephalopathy?
Answer
Lactulose - binds to the ammonia and helps the patient poop it out
-monitor for signs and symptoms of dehydration
Antibiotic is given (neomycin) to kill the the bacteria in the gut that produces ammonia
19. What is portal hypertension
Answer
Impaired circulation through the liver Increases hydrostatic pressure (increases pressure in the
portal vein)
-Shunts it into the lower pressure veins in the esophagus, stomach and rectum
Ascites, peripheral edema- primary cause portal hypertension, plus decreased albumin (
decreased colloidal osmotic pressure) and increased aldosterone(RAAS activation)- Na and
water retention
Splenomegaly(due to backflow of blood to the spleen)
-Anemia-decrease RBC/WBC/PLT
*PTs are at a huge risk for bleeding*
Hepatorenal syndrome (kidney failure secondary to cirrhosis) Spontaneous bacterial peritonitis
20. Esophageal varices
Answer
Engorged veins that are super fragile
*Medical Emergency if they start to bleed* Vessels are hypertensive
Blood in vomit/stool
No NG tubes Prevent bleeding
TEACH PATIENTS
-no heavy lifting/straining
-no bending at waist
-use stool softener
-stop drinking
-chew food completely
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