– Cardiac output (receives entire volume of cardiac output.)
What is the functional cell of the liver?
--last two create the blood filtration system
funcitons of liver?
Hepatic A & P review for liver function
Folks with hepatic encephalopathy will not respond to narcan.
Urea cannot be broken down--> ^ in ammonia levels-->v loc. Use laculose instead to absorb ammonia.
How does liver change with age?
Decreased liver weight and size
Decreased ability to detoxify drugs
Increased risk of toxic levels in elderly
Tylenol: very toxic to liver. Max dose =4000mg/day.
What are some liver fxn tests?
• Bilirubin (conjugated and unconjugated: makes stuff yellow (urine, skin, poo, bruises). RBCs get broken down and recycled. Hemogobin is recycled, unconjugated Bilirub (not water soluable) is a byproduct which will bind to albumin. Anything watersoluable can be broken down by bacteria. High levels of unconjugated will result in jaundice. Bilirubin is a problem because it will hemolocize healthy RBCs (rabdoanemia)-->poor filtration in kidneys-->renal damage.
• Liver Biopsy: bleeding is a problem. Positioning can help. Look it up in book.
• MRI: if fluid pouching.
What are some etiologies of jaundice?
What are some nursing interventions for jaundice?
– Determine cause
– Pruritis early sign
– Check sclerae, skin
Impaired skin integrity
– Control itching (benadryl, but only low doses if liver failure)
Body image disturbance
– Reassure temporary
– Express feelings
• Altered health maintenance
– Resolves 4-6wks with tx
Make a chart to compare/contrast hep types.
general pathophys about hep viral types.
Similar changes for all causes of viral hepatitis
Hepatocytes affected by immune response
Specific antigen-antibody responses to different types of viral hepatitis
Liver inflammation and necrosis lead to altered function
Healing occurs in 3 to 4 months
What are the preicteric SnSs of viral hep
Lasts 1-21 days
GI symptoms: Anorexia, nausea, abd pain, vomiting, diarrhea
Other symptoms: Malaise, HA, fever, arthralgias
What are snss of icteric phase of viral hep?
Jaundice: Lasts 2-4 weeks
– Urine dark
– Light or clay colored stools
– Pruritus: caused by secreting toxins through skin.