Hepatic Dysfunction Overview

These flashcards cover the key concepts related to hepatic dysfunction, including liver functions, complications, diagnostic tests, and specific liver diseases.

What are the primary functions of the liver?

The liver's primary functions include glucose metabolism, ammonia conversion, protein metabolism, fat metabolism, vitamin and iron storage, bile formation, bilirubin excretion, and drug metabolism.

What happens to the liver's functions during liver failure?

In liver failure, the liver loses its ability to perform crucial functions, leading to complications for the patient.

What are common causes of liver disorders?

Liver disorders can result from viruses, obesity, insulin resistance, exposure to toxins like alcohol, or tumors.

What process occurs when glucose is needed in the bloodstream?

Glycogenolysis occurs, releasing glucose into the bloodstream to maintain normal levels of blood glucose.

What is gluconeogenesis?

Gluconeogenesis is the synthesis of glucose from non-carbohydrate sources, such as amino acids.

How does the liver convert ammonia into urea?

The liver converts ammonia, a toxic by-product of protein metabolism, into urea, which is excreted in urine.

What role does the liver play in drug metabolism?

The liver metabolizes many medications, leading to their inactivation or potential activation.

What is the first-pass effect?

The first-pass effect is the decreased bioavailability of an oral medication that is extensively metabolized by the liver before reaching systemic circulation.

What are some signs and symptoms of liver disease?

Signs and symptoms include jaundice, weakness, fatigue, pruritus, abdominal pain, and changes in mental status.

What diagnostic tests can be used to assess liver function?

Liver function tests include serum aminotransferases (ALT, AST, GGT), bilirubin levels, and possibly liver biopsy or imaging studies.

What is ascites?

Ascites is the accumulation of fluid in the peritoneal cavity, often resulting from portal hypertension due to liver dysfunction.

What are Esophageal varices?

Esophageal varices are dilated veins in the esophagus resulting from increased pressure in the portal venous system, and they can be a source of significant bleeding.

What complications can result from liver disease?

Complications include portal hypertension, ascites, varices, hepatic encephalopathy, and increased bleeding due to coagulopathy.

What is hepatic encephalopathy?

Hepatic encephalopathy is a neuropsychiatric manifestation of liver failure characterized by altered mental state and cognitive function, often due to elevated ammonia levels.

How is hepatitis A primarily transmitted?

Hepatitis A is primarily transmitted through the fecal-oral route, often by ingestion of contaminated water or food.

What are the routes of transmission for Hepatitis B?

Hepatitis B is transmitted through blood, saliva, semen, and vaginal secretions.

What is the significance of a MELD score in liver transplantation?

The MELD score stratifies the level of illness in patients awaiting liver transplant and indicates short-term mortality risk.

What is the role of immunosuppressants in liver transplantation?

Immunosuppressants are used to prevent the immune system from rejecting the transplanted liver.

What are the metabolic functions of the liver?

The liver performs various metabolic functions including carbohydrate metabolism, protein synthesis, fat metabolism, detoxification of harmful substances, and production of biochemicals necessary for digestion.

What alterations occur with hepatic disorders?

Alterations can include impaired drug metabolism, changes in blood coagulation factors, alterations in glucose metabolism, and disturbances in lipid and protein synthesis.

What are liver function tests?

Liver function tests are blood tests that measure the levels of enzymes, proteins, and substances produced by the liver, helping assess liver health and function.

What are the clinical manifestations of liver dysfunction?

Clinical manifestations can include jaundice, fatigue, weakness, loss of appetite, nausea, swelling in the abdomen, and confusion.

How does jaundice relate to liver dysfunction?

Jaundice is caused by the accumulation of bilirubin in the blood due to impaired liver function, leading to yellowing of the skin and eyes.

What is portal hypertension?

Portal hypertension is increased blood pressure in the portal venous system, often due to liver cirrhosis, leading to complications like esophageal varices.

What are esophageal varices?

Esophageal varices are enlarged veins in the esophagus that develop due to increased pressure from portal hypertension, posing a risk of rupture and bleeding.

What is hepatic encephalopathy?

Hepatic encephalopathy is a decline in brain function as a result of severe liver disease, leading to confusion, altered level of consciousness, and coma.

What nursing management exists for patients with esophageal varices?

Nursing management includes monitoring for bleeding, administering medications like beta-blockers to decrease portal pressure, and preparing for procedures like band ligation.

What are the types of hepatitis?

Various types include Hepatitis A (viral, often foodborne), Hepatitis B (viral, bloodborne), Hepatitis C (viral, bloodborne), and Hepatitis D (requires Hepatitis B for infection), each with different causes and management.

What are the clinical manifestations of hepatitis?

Clinical manifestations can include jaundice, fatigue, abdominal pain, loss of appetite, nausea, and dark urine.

What is cirrhosis of the liver?

Cirrhosis is severe scarring of the liver caused by long-term liver damage, leading to liver dysfunction.

What postoperative care is required for liver transplantation patients?

Postoperative care includes monitoring vital signs, liver function tests, signs of rejection, ensuring adequate fluid balance, and educating about medication adherence.

What role does the nursing process play in caring for patients with cirrhosis?

The nursing process involves assessment, diagnosis, planning, implementation, and evaluation to provide comprehensive care aligned with the patient's needs and symptoms.

What are the metabolic functions of the liver, and what alterations occur with hepatic disorders?

The liver performs numerous metabolic functions, including carbohydrate, protein, and fat metabolism, as well as detoxification and bile production. Hepatic disorders can disrupt these functions, leading to hypoglycemia or hyperglycemia, altered protein synthesis (e.g., clotting factors, albumin), impaired detoxification of drugs and toxins, and reduced bile production affecting fat digestion and absorption.

Explain liver function tests (LFTs) and the clinical manifestations of liver dysfunction in relation to pathophysiologic alterations of the liver.

Liver function tests (LFTs) such as ALT, AST, bilirubin, albumin, and prothrombin time (PT) assess liver health. Clinical manifestations of liver dysfunction include jaundice (elevated bilirubin), edema and ascites (low albumin), bleeding tendencies (impaired clotting factor synthesis), and encephalopathy (failure to detoxify ammonia).

Relate jaundice, portal hypertension, ascites, varices, nutritional deficiencies, and hepatic encephalopathy and coma to pathophysiologic alterations of the liver.

• Jaundice: Yellowing of the skin and sclera due to elevated bilirubin levels.
• Portal Hypertension: Increased pressure in the portal venous system, often leading to varices and ascites.
• Ascites: Accumulation of fluid in the peritoneal cavity due to portal hypertension and decreased albumin.
• Varices: Enlarged veins (e.g., esophageal varices) due to portal hypertension, prone to bleeding.
• Nutritional Deficiencies: Resulting from impaired nutrient metabolism and absorption.
• Hepatic Encephalopathy and Coma: Neurological dysfunction due to the liver's inability to detoxify ammonia, leading to confusion, asterixis, and coma.

Describe the medical, surgical, and nursing management of patients with esophageal varices.

Medical management includes medications to reduce portal pressure (e.g., beta-blockers), endoscopic procedures (e.g., banding, sclerotherapy) to treat varices, and blood transfusions for acute bleeding. Surgical management may involve shunt procedures (e.g., TIPS). Nursing management focuses on monitoring for bleeding, administering medications, providing emotional support, and educating patients on preventing complications.

Compare the various types of hepatitis and their causes, prevention, clinical manifestations, management, prognosis, and home health care needs.

Types of hepatitis include viral (A, B, C, D, E), alcoholic, and drug-induced. Prevention includes vaccination (A and B), safe injection practices, and avoiding excessive alcohol and drug use. Clinical manifestations vary but often include jaundice, fatigue, and abdominal pain. Management focuses on supportive care, antiviral medications (for some viral types), and avoiding further liver damage. Prognosis varies depending on the type and severity. Home health care needs include medication management, monitoring for complications, and lifestyle modifications.

Use the nursing process as a framework for care of the patient with cirrhosis of the liver.

Nursing assessment includes monitoring for signs of liver dysfunction, assessing nutritional status, and evaluating mental status. Nursing diagnoses may include impaired liver function, fluid volume excess, and risk for injury. Nursing interventions focus on managing symptoms, preventing complications, providing nutritional support, and educating patients on self-care. Evaluation involves assessing the effectiveness of interventions and adjusting the plan of care as needed.

Specify the postoperative nursing care of the patient undergoing liver transplantation.

Postoperative nursing care includes monitoring for signs of graft rejection, infection, and bleeding. Administering immunosuppressant medications, managing pain, and providing respiratory support. Educating patients on medication management, lifestyle modifications, and follow-up care.