NS210 Liver Study Guide

  1. Name 8 functions of the liver?
    Glucose metabolism, ammonia conversion, protein metabolism, fat metabolism, vitamin and iron storage, bile formation, bilirubin excretion, and drug metabolism.
  2. What are the functions of bile?
    Excrete bilirubin; also serves as an aid to digestion through the emulsification of fats by bile salts.
  3. To find out if a patient may be at risk for liver disease what kind of information would the nurse be interested in?
    The patient’s occupational, recreational, and travel history; the patient’s history of alcohol and drug use; patient’s history of past and current prescription medications, OTC medications, herbal remedies, and dietary supplements; lifestyle behaviors (eg. sexual practices); the amount and type of alcohol consumption; past medical history and family medical history pertaining to genetic liver diseases; and symptoms that may suggest liver disease.
  4. What symptoms could suggest that a person has a liver disease?
    Jaundice, malaise, weakness, fatigue, pruritus, abdominal pain, fever, anorexia, weight gain, edema, increasing abdominal girth, hematemesis (vomiting of blood, could look like coffee grounds), melena (black, tarry stools), hematochezia (passage of fresh blood per anus, usually in or with stools.), easy bruising, changes in mental acuity, personality changes, sleep disturbances, decreased libido in men and secondary amenorrhea in women.
  5. What are the major complications after a liver biopsy?
    Bleeding and bile peritonitis (leakage of bile from the common bile duct or gallbladder may occur as a result of trauma, including perforation during percutaneous needle biopsy of the liver, and (rarely) erosion from biliary calculi. A chemical peritonitis results and may be fatal unless surgical repair is accomplished).
  6. What are the preprocedure nursing interventions for a patient who is about to have a percutaneous liver biopsy done?
    Make sure that coagulation tests are available and that compatible donor blood is available. Check for signed consent. Record patient’s vital signs. Explain the procedure.
  7. What are the nursing interventions during the liver biopsy procedure?
    Offer support. Expose the right side of the patient’s upper abdomen. Instruct patient to inhale and exhale deeply several times, finally to exhale, and to hold breath at the end of expiration. After the physician aspirates and withdrawal the needle instruct the patient to resume breathing.
  8. What are the postprocedure nursing interventions for a patient after a liver biopsy?
    Immediately after the biopsy have the patient turn on to the right side; place a pillow under the costal margin, and caution the patient to remain in this position, recumbent and immobile for several hours. Instruct the patient to avoid coughing or straining. Measure and record vital signs. If patient his discharged after the procedure, instruct the patient to avoid heavy lifting and strenuous activity.
  9. What are the two major consequences of portal hypertension?
    Ascites and varices
  10. What is the dietary modification for ascites?
    Reduce sodium, should be on a 2g sodium diet. Use salt substitutes such as lemon juice, oregano, and thyme.
  11. What is paracentesis?
    Paracentesis is the removal of fluid (ascites) from the peritoneal cavity through a puncture or a small surgical incision through the abdominal wall under sterile conditions.
  12. What are the nursing responsibilities before, during, and after a paracentesis?
    Pre-procedure: have patient void; place patient in upright position on edge of bed with feet supported on stool or place in chair, use fowlers position if pt. is confined to bed. Procedure: help pt. maintain position and monitor vitals. Post-procedure: return pt. to bed; measure, describe, and record fluid collected, continue to monitor vitals, assess puncture site for bleeding and leakage.
Card Set
NS210 Liver Study Guide
NS210 Liver Study Guide