NSG 210 Test 3 Study Guide

During storage a lot of the water in bile is absorbed

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Unformatted text preview: d by cirrhosis. See above sections for details.  ­Early s/s of cirrhosis include: Fatigue Significant weight changes GI s/s abdominal pain & liver tenderness liver tends to be large & firm & has a sharp edge noticeable upon palpation  ­In late stages of cirrhosis, the following s/s include: GI bleeding Jaundice, pruritis & Icterus (sclera is yellow) Ascites, that may lead to SBP Spontaneous bruising (petechiae or ecchymosis) Liver decreases in size as scar tissue contracts the liver tissue; liver edge is nodular, if palpable Portal obstruction, leading to indigestion & altered bowel function Edema in lower/upper extremities & presacral area Mental deterioration, usually due to PSE  ­Additional s/s generally seen in cirrhotic pts include: Caput medusae (distended abdominal blood vessels visible upon inspection) Esophageal varices and/or hemorrhoids Rashes Osteoporosis Fetor hepaticus (usually b/c of PSE) Spider angiomas (small, broken blood vessels) Palmar erythema (reddened palms) Asterixis (indicative of PSE) Elevated or decreased lab values (see values in book)  ­Hepatorenal Syndrome (HRS) is caused by PSE & may be present in cirrhotic pts. It is characterized by a sudden decrease in urinary flow (<500 mL/24 hours). Elevated BUN & creatinine levels w/ abnormally decreased urine Na excretion would be present. There would also be an increase in urine osmolality. Ax/Dx: Ax includes history, physical assessment & lab findings.  ­Lab findings (see TBL 39 ­1 for more detailed info) Serum albumin level decreases Serum globulin level increases Liver enzyme tests (serum alkaline phosphatase, AST, ALT, GGT, bilirubin) levels increase Serum cholinesterase levels decrease Prothrombin time is prolonged  ­Pt’s history should include questions regarding employment, exposure to drugs/alcohol or HCV, sexual history & orientation, previous medic...
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