Altered Hepatobiliary Function

Introduction

  • Topic of discussion: Altered Hepatobiliary Function (NR 325 - Adult Health II)

Objectives

  • Understand the following key areas related to hepatobiliary function:

    • Pathophysiology of nutrition, elimination, and the hepatobiliary system.

    • Compensatory mechanisms related to nutrition and elimination.

    • Client assessment for hepatobiliary system alterations.

    • Nursing diagnoses for clients with hepatobiliary issues.

    • Development and implementation of care plans for these clients.

    • Health promotion and preventive strategies for at-risk clients.

    • Evaluation of care plans based on nursing assessments.

Pathophysiology Review

  • Focus on the liver, pancreas, and gallbladder:

    • Important organs in the hepatobiliary system.

Hepatitis Overview

  • Types of Viral Hepatitis:

    • Hepatitis A (HAV):

      • Transmission: Fecal/Oral

      • Vaccine: Yes

      • Cure: Recovery results in lifelong immunity.

      • Incubation: Few weeks.

    • Hepatitis B (HBV):

      • Transmission: Blood to blood & sexual contact

      • Vaccine: Yes

      • Cure: No

      • Incubation: 1 to 4 months.

    • Hepatitis C (HCV):

      • Transmission: Blood to blood

      • Vaccine: No

      • Cure: Treatment available for most cases. (-90% clear infections)

      • Incubation: 2 weeks to 6 months.

  • Symptoms of Hepatitis A, B, C:

    • Loss of Appetite

    • Nausea/Vomiting

    • Fever

    • Joint Pain

    • Dark urine/Clay-colored stool

    • Jaundice

    • Right upper quadrant pain

Post-Exposure Prophylaxis (PEP)

  • Understand which types of hepatitis have PEP available and when it should be administered.

Hepatitis Management

  • Manifestations:

    • Clinical symptoms, lab findings, and potential complications.

  • Plan of Care for Hepatitis:

    • Differentiate approaches for Acute vs. Chronic Hepatitis.

    • Importance of patient education on health management.

Cirrhosis Overview

  • Comparison of Normal Liver vs. Liver with Cirrhosis

Cirrhosis Manifestations

  • Clinical signs and symptoms of cirrhosis.

Cirrhosis Plan of Care

  • Key considerations:

    • Management of ascites.

    • Addressing portal hypertension and varices.

    • Prevention and management of hepatic encephalopathy.

    • Nutritional assessment and management.

Nursing Management for Cirrhosis

  • Emphasis on health promotion, acute care, evaluation of treatment, and patient education.

Acute Pancreatitis Overview

  • Recognize the importance of bile ducts and pancreatic enzymes in digestion.

Acute Pancreatitis Manifestations

  • Signs and symptoms associated with acute pancreatitis.

Acute Pancreatitis Plan of Care

  • Focus areas:

    • Reduction of pancreatic secretions.

    • Pain relief.

    • Removal of precipitating causes.

    • Prevention and treatment of shock and infection.

    • General nursing care strategies.

Chronic Pancreatitis Overview

  • Management focus for chronic pancreatitis:

    • Pain management.

    • Diet and nutrition adjustments.

    • Management of diabetes.

    • Potential surgical interventions.

Cholecystitis Overview

  • Pathophysiology related to gallstones leading to inflammation of the gallbladder.

Cholecystitis Manifestations and Diagnosis

  • Symptoms to identify in clients suspected of cholecystitis.

Cholecystitis Plan of Care

  • Address the care needs in acute and post-operative settings.