Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Alcohol Use Disorder Assessment (Formerly Alcohol Abuse Assessment)
- CNS Depression
- Wernicke-Korsakoff Syndrome
- GI Distress
- Cardiomyopathy
- Pancreatitis
- Cirrhosis
- Immunosuppression
- Sexual Dysfunction
- Screening (Assessments)
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
- Changes in Mood
- Poor Hygiene
- Odd Sleep Patterns
- Frequent Injuries
- Relationship or Job Difficulty
- Poor Performance
- Anorexia OR Weight Loss
- Social Isolation
- Financial Problems
Liver Enzyme Tests: AST and ALT
- AST/ALT Ratio
- AST: 8-20 U/L
- ALT: 8-20 U/L
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
Cirrhosis Interventions
- Maintain Nutrition
- Paracentesis
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Lactulose
- Antibiotics
Loop Diuretics
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Furosemide
- Lasix
- Ototoxicity from Rapid Injection
- Gout
- Dehydration
- Hypocalcemia
- Hypokalemia
- Orthostatic Hypotension
Spironolactone (Aldactone)
- Inhibition of Aldosterone
- Potassium Retention
- Hypertension
- Edema
- Heart Failure
- Hyperkalemia
- Endocrine Effects
- Avoid Potassium Supplements
Beta Blockers
- "-olol" suffix
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Hypertension
- Heart Failure
- Angina Pectoris
- Asthma and Heart Block Patients
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
Hepatitis A (HAV) Assessment
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- 4 Weeks
- Fever
- General Malaise
- Hepatomegaly
- Self-Limiting
- Proper Hand Washing
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
Hepatitis C (HCV) Assessment
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- 7 Weeks
- Cirrhosis
- Barrier Protection
Liver Biopsy Procedure
- Diagnosis of Liver Disease
- Incisional (Open Method)
- Needle Biopsy (Closed Method)
- Coagulation Status
- Type and Crossmatch Blood
- Right-Side Lying
- Post-Biopsy Monitoring