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In which abdominopelvic quadrant is teh pancreas located?
which vein brings blood full of nutrients from the digestive tract to the liver, before it enters the systemic circulation
hepatic portal vein
which organ can regenerate itself?
which organ secretes the enzyme trypsin?
this organ does not secrete digestive enzymes
which organ secretes bile acids
what hormones secreted by the pancreas are involved in blood glucose regulation
which endocrine gastroinstestinal regulatory peptide stimulates gallbladder contractiona and pancreatic secretions in response to peptides, amino acids, and fatty acids in the duodenum and jejunum
which endocrine gastrointestinal regulatory regulatory peptide stimulates biliary and pancreatic bicarbonate secretions in response to acid in the duodenum
what are liver cells called?
what autosomal recessive congenital metabolic disorder is characterized by progressive decline of lung and pancreas function due to abnormal exocrine body secretions plugging up passage ways
what is hepatomegaly
what is hepatitis?
acute/chronic inflammation of liver due to injury
what is liver steatosis?
excessive fat accumulation causing deteroration "fatty liver"
what is cirrhosis?
irreversible destruction of the liver
what is bilirubin?
pigment formed during breakdown of hemoglobin and is excreted in the bile
what is jaundice?
yellowing of the skin due to elevated bilirubin levels in blood and tissues
what is encephalopathy?
altering of the brain structure and deteroration of mental function
what is wernicke's encephalopathy?
inflammation of the brain with hemmorage because of the result of thiamin deficiancy
what is cholelithiasis?
presennce of cholesterol stones in the gallbladder or bile duct
what is a gallstone?
lithiasis in the gallbladder or bile duct
what is cholestasis?
flow bile stop.fail-> becomes concentrated -> stone development
what is cholecystitis?
inflammation of the gallbladder
what is a cholecystectomy?
removal of the gallbladder
what is hemochromatosis?
inheritated disorder that causes absorbtion of excessive amount of iron in tissues and organs
what is pancreatitis
inflammation of the pancreas
what is a pancreatectomy?
removal of part or all of the pancreas
what may trigger the formation of gallstones?
- -bile is supersaturated
- -no fat in diet
what factors and disease conditions are associated with an increase risk of the formation of cholelithiasis (stones in the gallbladder)
- -over age 40
- -over weight
- -rapid weight loss
- -increased # of pregnancies
what factors are commonly involved in the pathogenesis of hepatitis?
- -viral infection
- -lack of blood flow
- -toxic agents
what is the most frequent cause of chronic liver disease?
what are the clinical manifests of hepatitis?
- nutrient def
what are the complications of hepatitis?
- severe hypoglycemia
- liver failure
what are the clincal mainfests of cirrohosis?
- wt. loss
purpose of nutrition care in liver disease?
- maintain nutritional status
- prevent condition from getting worse
why are clients with liver disease at risk of protein-energy malnutrion
- don't digest/absorb
best method to determine the energy needs of clients with liver disease?
- indirect calrimetry
- carbon dioxide/oxygen exchange
what biochemical data may help identify the presence of liver disease?
AST and ALT levels
what biochemical measures are useful when assessing nutritional status of clients with liver disease
- low hemoglobin
- low hematacrit
- low mean corpuscular volume
how is the liver examined for proper diagnosis when liver disease is suspected from sign,symptoms,tests
- abdominal ultrasound
- liver scanning
- liver biopsy
what is the main dietary recommendation post cholescystectomy?
fat restriction (25-50g)
how is alcoholic liver disease managed?
- multi team
- promotion of alcohol avoidance
- adequete nutrients
what diet is recommended for liver disorders such as hepatitis, cirrosis, biliary disease?
- high calorie
- high protein
which clients with liver disease are suseptable to fat maldigestion? require fat restricted diet?
when are fluid and sodium restrictions necessary in clients with liver disease??
which vitamins and minerals may need to be supplemented in clients with liver disease due to status and def. ?
- vit. D
- vit. B6
- vit. C
treatment used for hepatic encephalopathy. Acts as a laxative
signs and symptoms of acute pancreatitis?
- LUQ abdominal pain
- increased amylase
- increased lipase
- increased AST
- increased blood glucose
most severe complication of acute pancreatitis
- rapid intense inflammation
- sudden onset
- death of cells in pancreas
- necrotizing pancreatitis
MNT for clients with chronic pancreatitis
- avoid alcohol
- maintain body wt.
- increase calorie
- increase protein
- 40-60% carb
MNT for clients with acute pancreatitis?
- intravenous fluids and electrolytes
- enternal nutrition
recurrent insults followed by repair of the liver tissue can cause fiberosis and scarring known as ______, irreversible damage... usually occurs with long term liver dysfunction
what is the effect of long-term alcohol abuse on the liver
- stores fat -> fatty liver
how hepatic steatosis becomes cirrohosis
- fat builds on liver
- cells become large
- continue behaviors with healing
hepatitis a,b,c,d,e differences
- hep a - inflammation by virus - transmission = food/water
- hep b- '' '' - '' = blood, semen
- hep c- '' '' - '' = blood products
- hep d- '' '' - '' = serum hepatitis
- hep e- '' '' - '' = water
what is biliary cirrhosis?
irreversible destruction, damage in bile duct and liver
how advanced liver disease alters metabolism of carbohydrates?
blood glucose becomes low
how advanced liver disease alters metabolism of lipids?
- fat buildup
- no lipoproteins
- vitamin def. = ADEK
how advanced liver disease alters metabolism of proteins?
- nitrogen buildup of ammonia
how is hepatic encephalopathy treated?
- lower protein intake
what are clinical manifests of severe alcoholism
- fat in liver
- cant make lipoprotein
- alcohol toxic to tissue
- impair folate, thiamin, vit. C
diet therapy for management of cystic fibrosis?
- enteric coating supplement
- high nutrient diet
_______ is synthesized by the liver and is the main blood protein, used as a marker of liver function
albumin half life?
complications associated with alcoholic cirrhosis?
- impaired glucose tolerance
dietary recommendations for clients with mild chronic cholecystitis with symptomatic gallstones
- low fat diet
- small frequent meals
- avoid food intolerances (gas forming)
functions of the liver for carbohydrate?
- galactose and fructose from digestion are converted to glucose
- store glucose as glycogen
- synthesis fat from carbohydrate
- produce new glucose from precursers
- maintain blood glucose
- gluconeogensis when fasting
functions of liver for protein?
- convert amino acids to substrates
- detoxify ammonia by converting it to urea for kidney to excrete
- synthsis of vital body proteins ex. albumin
functions of liver for fat?
- fatty acids from diet and adipose tissue are converted in liver
- ketone bodies produced
- synthesizes triglycerides and phospholipids, cholesterol, bile acids and lipoproteins
- bile is needed to emulsify fat for digestion
function of liver for vitamins?
- storage, activation and transportation of vitamins and minerals
- stores all fat soluble vitamins
- OH added to vit. D in process of activation of vit. D
alcoholism causes what deficiencies?
- vit. c
- vit. d
- vit. k
- vit. a
function of pulmonary system
- gas exchange
- acid base balance of body
___________ and _______________ are interdependent
- nutritional status
- pulmonary function
malnutrition on pulmonary status effects what nutrients?
- vit. c
- vit. a
- vit B6
- decreased surfactant
symptoms of pulmonary disease?
- full really fast
- wt. loss
- shortness of breath while eating
what is COPD?
presence of chronic bronchitis or emphysema leading to airway obstruction
primary cause of COPD?
what is emphysema?
abnormal permanent enlargement of alveoli accompied by destruction of walls
what is bronchitis?
inflammation of bronchial mucus membrane
treatment of COPD?
- lifestyle changes
- good nutrition
pathophysiology of fatty liver to alcoholism?
- lack of NAD
- fatty acids cant be transported out of liver
- no lipoproteins
- extra ATP built up as fat
hgb and hct are depressed and MCV is elevated why?
- cant make protein
- folate def.
- megaloblastic cells
what is hyperbilirubinemia?
high bilirubin levels
what is ascites?
excess fluid buildup in tissues
what is hypocalcemia?
low blood calcium