NURS 2230 Lecture Notes - Lecture 1: Esophageal Varices, Hepatic Encephalopathy, Liver Function Tests
22 Sep 2016
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Monitor lab levels and liver function tests. Ast is the most specific indicator of hepatic cell destruction. Normal ammonia levels: 15 45 ug/dl; too high = risk for encephalopathy. Record abdominal girth and weight daily (ascites) Will see jaundice (yellow/green tinged body tissues) due to serum bili levels. Pts may appear mildly/severely ill, lack of appetite (weight loss), nausea, weak. Dark orange-brown urine, light clay-colored stools; dyspepsia and intolerance of fats (impaired digestion), pruritis. End stage liver disease will see less protein (chronic) because plasma protein is made in the liver. Portal hypertension: huge vein; since liver becomes large, blocks off flow/increases portal vein resistance; flow gets backed up into tributaries including spleen, which then causes splenomegaly repeat cycle. Asterixis: flapping tremor hands, side effect of hepatic encephalopathy, will see twitching and hyperreflexia; cognitive abilities deteriorate; picking at the bedclothes, hallucinations/seizures; musty breath odor.
