Term
| An albumin-rich accumulation in the peritoneal cavity |
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Definition
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Term
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Definition
- a chronic liver disease characterized by fibrotic changes, the formation of dense connective tissue within the liver and loss of functional cells
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Term
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Definition
- sweet, fecal odor of the breathe from intestinal origin; prevealent in extensive chronic liver disease
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Term
| Sudden, severe onset of acute liver failure that occurs within 8 weeks after the first symptoms of jaundice. |
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Definition
- fulminant hepatic failure
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Term
| Endoscopic variceal ligation |
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Definition
- procedure that uses a modified endoscope loaded with an elastic rubber band passed through an overtube directly onto the varix to band the area and stop the bleeding
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Term
| Elevated pressure in the portal circulation resulting from obstruction of venous flow into the liver. |
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Definition
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Term
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Definition
- CNS dysfunction frequently associated with elevated ammonia levels that produce changes in mental status and altered level of consciousness
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Term
| Grafting of a donor liver in the normal anatomic location with removal of the diseased native liver. |
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Definition
- orthotopic liver transplantation
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Term
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Definition
- transplantation of organs from one species to another
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Term
| Injection of substances into or around esophagogastric varices to cause constriction, thickening and hardening to stop bleedingI |
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Definition
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Term
| What is the largest gland in the body and what does it involve? |
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Definition
- the liver - aids in glucose regulation and metabolism
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Term
| What are the two categories of liver abscesses? |
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Definition
- pyogenic - less commonly seen, but most common in developed country when seen
- amebic - occur mostly in developing contries of the tropics and subtropic because of poor sanitation
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Term
| Pathophysiology of Liver Abscesses |
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Definition
- when an infection develops along the biliary tract to the liver, leukocytes will migrate to the infected area and cause and abscess (cavity full of liquified liver cells and bacteria, dead leukocytes)
- can be single or multiple
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Term
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Definition
- when the bilirubin concentration in the blood is abnormally elevated, the body tissues become a tinged yellow or greenish-yellow
- clinically evident at 2/5 mg/dL bilirubin
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Term
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Definition
- result of increased destruction of red blood cells
- plasma is rapidly flooded with bilirubin and the liver cannot excrete it quickly enough
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Term
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Definition
- inability of damaged liver cells to clear abnormal amounts of bilirubin from the blood
- can be caused by hepatits, or other liver viruses, or alcohol
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Term
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Definition
- results from obstruction or occlusion of the bile duct from gallstones, inflammation, tumors or pressure
- clay colored stools, orange, fomay urine, itchy skin
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Term
| Hereditary Hyperbilirubinemia |
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Definition
- increased serum bilirubin levels resulting from any inherited disorders and can produce jaundice
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Term
| Examples of hereditary hyperbilirubinemia |
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Definition
- Gilbert Syndrome - causes increased levels of bilirubin and causes jaundice
- Dubin-Johnson syndrome - chronic idiopathic jaundice
- Rotor's Syndrome - chronic hyperbilirubinemia without pigmentation of the liver
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Term
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Definition
- palpation performed to identify a mass or enlarged organ within an ascitic abdomen
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Term
| Pharmacologic Therapy of Ascites |
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Definition
- diuretics agents and sodium restriction is successful in 90% of cases
- Spiranolactone (Aldactone; aldosterone blocking agent) is usually the first line treatment with ascities from cirrhosis
- Furosemide can be added; watch for hyponatremia
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Term
| TIPS Procedure (Transjugular Intrahepatic Portosystemic Shunt) |
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Definition
- a cannula is threaded into the portal vein transjugularly
- a stent is placed to serve as a shunt between portal circulation and the hepatic vein
- second line therapy for ascites D/T cost and high risk of ecephalopathy
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Term
| Pathophysiology of Esophageal varices |
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Definition
- starts with portal hypertension caused by resistance of portal flow
- presure becomes 12 mmHg or greater between portal vein and inferior vena cava
- abnormal varicoid vessels form in locations of esophagus, peritoneum
- can rupture, cause hemorrhage
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Term
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Definition
- most common type; 60% of all cirrhoses
- usually present with more than a decade of heavy drinking
- causes inflammation of liver cells, leads to fatty deposits amd hepatomegaly
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Term
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Definition
- 10-30% of cirrhoses
- caused by viral hepatitus or hepatoxins
- scar tissue will destroy liver loves and the liver englarges and then shrinks over time
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Term
| Most common hepatoxin and where is it found? |
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Definition
- carbon tetreachloride found in cleaning solutions and fire extinguishers
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Term
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Definition
- rarer than alcohol and post necrotic; 5-10% of all cirrhoses
- caused by chronic biliary obstruction or stasis of bile
- causes biliary inflammation and hepatic fibrosis
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Term
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Definition
- liver becomes engorged with venous blood, enlarges and becomes edematous and black
- venous congestion can cause anoxia and lead to cell necrosis
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Term
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Definition
- involuntary flapping of the hands that occurs with hepatic encephalopathy
- patient will hold out arm and hold hand up; few seconds later, the hand flops down and then returns up
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Term
| Inability to reproduce a simple image/figure in two or three dimensions is called _____? |
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Definition
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Term
| What liver complication can occur r/t liver failure? What can help? |
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Definition
- hepatic encephalopathy - can cause dull mental functioning and mental status from build up of ammonia
- Lactulose helps to decrease ammonia levels; clients should have 2-3 stools a day for desired effect
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Term
| What is normal serum bilirubin total levels? |
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Definition
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Term
| How do you prepare a client undergoing a paracentesis? |
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Definition
- sit the client upright at the edge of the bed, or fowler's position
- monitor ammonia, electrolytes, VS, mental status, bleeding and encephalopathy
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Term
| How does albumin help in a paracentesis procedure? |
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Definition
- prevents massive shifts of fluid into extracellular space
- decreases arterial blood volume that can lead to sodium retention
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Term
| Medications fo Bleeding Esophageal Varices |
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Definition
- Vitamin K - helps the blood clot
- Somastatin - decreased bleeding; preferred treatment
- Propanoolol/Nadolol - decrease portal pressure
- Ocetreotide - decreases splenic blood flow and increase clotting
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Term
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Definition
- impaired thinking and concentration
- fatigued, drowsy
- slurred or slow speech
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Term
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Definition
- Confusion, disoriented
- asterixis sign ("hand flap") can be noted at this stage
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Term
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Definition
- Drowsy, but arousable
- more severe asterixis
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Term
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Definition
- Responds to painful stimuli only, or is unresponsive
- seizures begin to occur; 85% mortality rate
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Term
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Definition
- caused by RNA virus of enterovirus family, also called "infectious hepatitis"
- found in stool, hand and mouth contact, contaminated food/water
- vaccine is available, good handwashing helps prevent spread
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Term
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Definition
- mild flu-like symptoms, low grade fever
- jaundice and dark urine
- enlarged liver or spleen
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Term
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Definition
- spread by contact with blood such as transfusions, breaks in the skin; can be spread through sexual contact, saliva, mother to baby
- major cause of cirrhosis and liver cancer; can be chronic
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Term
| How long can hepatitis B remain infectious? |
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Definition
- hepatitis B can remain infection on surface (countertops, sinks, etc) for seven days
- must be disinfected with bleach!
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Term
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Definition
- most common blood borne viral infection; usually life long
- spread by blood and bodily fluids
- avoid ETOH which encouraged the disease progression and affects the liver
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Term
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Definition
- only those with hepatitis B are at risk for hepatitis D
- transmitted through blood and sexual contact
- treated with Interferon alfa; S/S mirror that of hepatitis B but are more likely to develop liver failure, cirrhosis
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Term
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Definition
- transmitted fecal-oral route
- resembles HAV, and comes on abruptly
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Term
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Definition
- antibodies are absent and clients (50%) usually receive blood transfusions
- significance remains under study
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Term
| Prevention and Management of Hep B |
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Definition
- Hepatits B immune globulin provides passive immunity to Hep. B and is indicated for those exposed to HBV who have never had Hep. B and never received the vaccine.
- Chronic Hep. B treated with alpha-interferon 5 million Units daily or 10 million Units 3x week for 16 – 24 weeks results in remission of the disease in 1/3 of the clients.
- Antiviral agents: lamivudine (Epivir) & adefovir (Hepsera) oral agents approved in USA for chronic Hep B. Reduced progression of cirrhosis with Epivir. Loss of detectable virus, improved liver function. Can be used in those with decompensated cirrhosis who are awaiting liver transplant.
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Term
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Definition
- used for irreversible, endstage liver disease
- provides organ recipient with a healthy liver so the body can return to relatively normal functioning
- success depends on successful immunosuppression
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Term
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Definition
- Loss of >80% of hepatocyte function
- causes: acute necrosis, chronic disease, Reyes Syndrome
- presents with jaundice (bili level >2.5mg/dl)
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Term
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Definition
- benign liver tumors occur most frequently in women taking oral contraceptives
- few cancers originate from the liver, and usually come from another site
- Rx: chemo or surgery
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Term
| S/S of Cancer of the Liver |
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Definition
- usually fatal within six months
- dull continous ache in RUQ, stomach or back
- weight loss, weakness, anorexia, anemia
- jaundice can occur if bile duct is occluded
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Term
| Cancer of Liver Treatment |
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Definition
- lobectomy - remove section of the liver with the tumor
- Ablation therapy - radiofrquency is standard for liver cancer; watch for pain and bleeding postop
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Term
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Definition
- inflammation of gallbladder can be acute or chronic; causes pain, tenderness, and abdomen rigidity that can radiate to midsternum or right shoulder
- usually precipitated by gallstones and is cause of more than 90% of cases
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Term
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Definition
- formation of stones in the gallbladder from a high calorie/cholesterol diet
- most common in women, those with diabetes, pancreatitis and cystic fibrosis
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Term
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Definition
- Female, fat, fertile, flatulent, family (history), forty and up
- women taking birth control pills are twice as likely to develop illness
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Term
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Definition
- breaks up stones with ultrasound waves
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Term
| Advantages to LAP surgery vs. Open Cholecystectomy |
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Definition
- LAP avoids paralytic ileus
- less pai
- earlier discharge and recovery (regular activity usually resumed within one week)
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Term
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Definition
- can be mild to severe to rapidly fatal that does not respond to treatment
- inflammation of the pancreas
- often undetected until 80-90% of endocrine tissue is destroyed
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Term
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Definition
- only five percent survival rate at five years regardless of stage of disease
- seventy percent originate from the head of the pancreas
- fifth leading cause of cancer-related deaths, affects more men than women
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Term
| Pathophysiology of Pancreas Cancer |
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Definition
- causes are unknown, usually appears in ductal area and causes blockage causing pancreatitis
- can metastasize quicky, rapid and invasive
- many only live 3-6 months after diagnosis
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Term
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Definition
- resection of tumor at the head of the pancreas
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Term
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Definition
- produce secretion of insulin and excessive rate of glucose metabolism
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Term
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Definition
- results from overproduction of insulin by pancreatic islets
- S/S - sweating, headache, nervousness, N/V
- Rx - administer glucose
- post op - assess for hypoglycemia
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Term
| Zollinger-Ellison Syndrome |
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Definition
- hypersecretion of gastric acid that produces ulcers in the stomach, duodenum and jejunum from the pancreas
- Rx - excision of tumor responsible for syndrome or total gastrectomy when tumor removal is not possible
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