NURS 4390 Lecture Notes - Lecture 15: Hepatic Encephalopathy, Varices, Portal Vein
3 May 2020
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Put band around where varices are and keep it from bleeding. Put a shunt between hepatic and portal vein so blood can bypass the liver. Reduces pressure and give circulation back to the heart. Ammonia levels going to rise because it is in the liver and is excreted: procedure done in late liver disease. Gi bleeding breakdown of blood, ammonia levels increase: protein broken down and ends up being ammonia in the end. Metabolic alkalosis: ammonia crosses bbb easier. Uremia/renal failure: nitrogen build up in the blood. Goal: decrease ammonia production and increase elimination: diet. Vitamin replacement (b, a, d, k: liver no longer making and storing vitamins. Protein (vegetable vs animal) intake individualized, complex carbohydrate: many patients with liver disease are malnourished. Probiotics: builds up good bacteria in the gut. Monitor stools/emesis for gi bleeding: often have varices. Trade name = flagel, kills bad bacteria so there is less bacteria to break down nitrogen into ammonia: rifaximin.
