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Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Ed., Hinkle & Cheever
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49 - Assessment and Management of Patients With Hepatic Disorders

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Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Ed., Hinkle & Cheever | Registered Nurse (RN) School Study Aid

49 - Assessment and Management of Patients With Hepatic Disorders
15 Picmonics to Learn | 24 mins
Albumin Lab Value
3.5 - 5.5 g/dL
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49 secs
Bilirubin Lab Value
0.2-1.2 mg/dL
Increased Bilirubin Causes Jaundice
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54 secs
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 8-20 U/L
ALT: 8-20 U/L
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1 min
Total Protein Lab Values
6.4 - 8.3 g/dL
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1 min
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
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2 mins
Cirrhosis Interventions
Interventions
Maintain Nutrition
Paracentesis
Esophageal and Gastric Varices
Drug Therapy
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hepatic Encephalopathy
Lactulose
Antibiotics
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2 mins
Complications of Cirrhosis
Portal Hypertension
Ascites
Esophageal Varices
Coagulation Defects
Portal-Systemic Encephalopathy
Hepatorenal Syndrome
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1 min
Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Users
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
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2 mins
Mannitol (Osmitrol)
Mechanism
Osmotic Diuresis
Indications
Reducing Intracranial Pressure
Reducing Intraocular Pressure
Renal Failure Prophylaxis
Side Effects
Edema
Fluid and Electrolyte Imbalance
Considerations
Avoid Use in Cardiac Patients
IV Administration
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2 mins
Vitamin B1 (Thiamine)
Mechanism
Carbohydrate Metabolism
Indications
Dietary Deficiency
Beriberi
Wernicke-Korsakoff
Considerations
Alcoholics Highest Risk
Give Before Glucose
Give IM or IV
Enriched Whole Grains
Pork
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2 mins
Vitamin C (Ascorbic Acid)
Mechanism
Antioxidant
Collagen Formation
Steroid Synthesis
Indications
Dietary Deficiency
Scurvy
Side Effects
GI Distress
Considerations
Citrus Fruits
May Improve Healing
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2 mins
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
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2 mins

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