hepatic > intro + LF + meds + F&E

which organ is the most forgiving in the body

liver

what does the liver store

glycogen

the liver helps produce what

erythropoeitin

what are the top three things the liver produces

clotthing factors, bile, albumin

what two clotting factors does the liver make

fibrinogen and prothrombin

what are 6 things the liver filters out or “detoxes” from the body

ammonia, alcohol, drugs, toxins, hormones, bilirubin

what three things does the liver store

glycogen, vitamins, and minerals

what is the #1 hepatoxic drug

tylenol

what does the portal vein do

brings blood from digestive organs to the liver

what 2 things does the liver metabolize

nutrients and meds

define liver failure

inability for liver to functional normally

liver failure starts out as

inflammation

chronic inflammation results in what

fibrosis > cirrhosis

if someone has liver failure would their medications need to be increased or decreased dosage wise

decreased

as long as the damage isn’t extremely severe the liver can do what

regenerate

what is the #1 medication responsible for liver failure

tylenol

what is the generic name for tylenol

acetaminophen

what is the antidote to acetaminophen/tylenol

acetylcysteine

besides acetylcysteine what generalized antidote can be used for too much acetaminophen/tylenol

activated charcoal

name the term: rapid loss of liver function in a person without pre-existing severe liver disease

acute liver failure

acute liver failure is ______ months

<6 months

what viruses are common causes of acute liver failure

Hep A, B, C

what is commonly used to help give patients activated charcoal

NGT

what two drugs (especially paired with alcohol) can cause acute liver failure

acetaminophen and TB meds

what genetic disease can cause acute liver failure

Wilson’s disease

what is a telltale sign of Wilson’s disease

copper ring around iris

name the term: genetic disorder where the body can't properly get rid of copper

Wilson’s disease

what does Wilson’s disease target

brain and liver

ingestion of what poisonous substance can cause acute liver failure

mushrooms

• fatigue

• jaundice

• change in mentation

• hematologic disorders

• encephalopathy

these are all S/S of what

liver failure

jaundice sometimes presents with what

pruritus

what causes pruritus with jaundice

excess bilirubin

what two things are important to teach the patient who is experiencing pruritus secondary to jaundice and acute renal failure

slap don’t scratch, trim nails

a change in mentation in renal failure is caused by what

buildup of ammonia

permanent scarring of the liver is

cirrhosis

with acute liver failure what two signs can be masked if the patient is drunk/an alcoholic

change in mentation, hematologic disorders

• cerebral edema

• hypoglycemia

• renal failure

• sepsis

• metabolic acidosis

• MODS

these are all complications of

liver failure

once the patient is stable and admitted to the hospital, what is one of the nurse’s top priorities to monitor for a patient in liver failure

fluid and electrolytes

besides fluid and electrolytes what other things should the nurse monitor for once the liver failure patient is stable

monitor for GI bleed and infection

what should the nurse recommend to patients to eat before a night out on the town

mexican/greasy food

what GI disease is seen sometimes in alcoholics and why

peptic ulcer disease, alcohol damages stomach lining

• any chronic liver disease

• chronic alcoholism

• chronic viral hepatitis

• nonalcoholic fatty liver disease which can lead to nonalcoholic steatohepatitis

• cardiac cirrhosis

• biliary cirrhosis

these are all possible contributing factors of what

cirrhosis

pain in _____ is a S/S of cirrhosis/liver issues

RUQ

chronic liver failure is when it lasts ____

>6 months

when taking a history for someone with liver failure it is important to see if they have a history of what two things

chronic hepatotoxic drug use, chronic Hep C

does liver failure mean that someone is an alcoholic

no

name the term: hands will briefly drop/flap downward and then return upward

asterixis

for early/compensated cirrhosis the patient may report fatigue, weakness, _________, __________, __________, and sometimes no S/S at all

loss of apetite, mild nausea, unintentional weight loss

with advanced/decompensated cirrhosis the patient may report/present with jaundice, _________, ______________, _________/_______, _________ and ____________

asterixis, hepatic encephalopathy, hormonal/vascular changes, low albumin and portal HTN

name the term: scar tissue building up in the liver because of repeated or ongoing injury

fibrosis

where is the easiest place to assess jaundice

sclera

should lasix be given fast or slow

slow

name the term: buildup of fluid in the belly due to cirrhosis blocking normal blood flow

ascites

when a liver failure patient presents with ascites what kind of diet will they be put on

low sodium

with liver failure, production of what goes down and filtration is harder causing what to increase

albumin; bilirubin

what two medications are given for ascites

albumin, diuretics

when giving diuretics for ascites what lab should the nurse make sure to monitor

potassium

what is the normal potassium range

3.5-5

what procedure can be done to help alleviate ascites

paracentesis

with paracentesis it is important to monitor for what two things

electrolyte imbalances and hypovolemia

a paracentesis will pull off __________ amounts of fluid

massive

what should the patient do right before a paracentesis

void

what should urine output average to per hour

~30mL

what two VS should the nurse get frequently after a paracentesis

BP and HR

besides fluid and electrolytes, BP, HR, and output what should the nurse check often after a patient undergoes a paracentesis

bleeding at puncture site

if the bladder is knicked during the paracentesis what might the patient report/be noticeable in the GU system

hematuria

after a liver biopsy the patient should lay in what side and why

right > put pressure on puncture site