NSG 210 Test 3 Study Guide

Dilated engorged veins are known as varices portal

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Unformatted text preview: amaged liver cells to clear normal amounts of bilirubin from the blood.  ­Cellular damage may be caused by hepatitis, medications, chemical toxins, cirrhosis & alcohol S/S: lack of appetite, nausea, fatigue, weakness, weight loss, yellow ­tinged skin & sclera Lab Results: increased serum bilirubin concentration, urine urobilinogen level; AST & ALT may be increased too. Obstructive Jaundice: caused by occlusion of the bile duct from a gallstone, inflammatory process, tumor or pressure from an enlarged organ. Disease process: bile cannot flow normally into the intestine & becomes backed up into the liver. It is then reabsorbed into the blood & carried through entire body (staining the skin & sclera). Later, excreted into urine (where it becomes a deep orange & foamy). B/c of the decreased amt of bile in the intestines, stools become light & clay ­colored. Other s/s: pruritis, dyspepsia, intolerance to fatty foods Lab results: AST, ALT, GGT levels rise moderately; bilirubin levels are elevated Portal Hypertension Disease Process:  ­Occurs when blood flow in the portal vein becomes obstructed and pressure increasesLiver does not receive enough blood to carry out proper functioningBlood backs up into the spleen & GI tract causing splenomegalyB/c of the backflow of blood, veins in the esophagus & stomach dilate & become engorged w/ blood. Dilated & engorged veins are known as varices. Portal HTN can also lead to ascites.  ­Portal HTN is a major complication of cirrhosis (discussed later). Tx: TIPS procedure (discussed later) Ascites Disease Process:  ­Liver fails to metabolize aldosteronehyperaldosteronismdecreased blood flow to the kidneysretention of Na & H20 by the kidneyfluid shift from the vascular system into peritoneal space.  ­Large amts of albumin ­rich fluid (15L+) may accumulate in the peritoneal cavity. S/S: increased abdominal girth, rapid weight gain, SOB, distended veins around umbilicus, umbilicus...
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This document was uploaded on 03/29/2014.

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