Medical Surgical Nursing

Medical Surgical Nursing Part III Dr. Nasser Abu-El-Noor 2013 ...

Chapter 39 Management of Patients with Hepatic Disorders Learning Objectives  Identify the metabolic functions of the liver and ...

 Describe the postoperative nursing care of the patient undergoing liver transplantation Anatomic and Physiologic Overview  Th ...

 A thin layer of connective tissue surrounds each lobe, extending into the lobe itself and dividing the liver mass into small u ...

the junction where the common bile duct enters the duodenum, controls the flow of bile into the intestine. FUNCTIONS OF THE LIVE ...

 Fatty acids and their metabolic products are also used for the synthesis of cholesterol, lecithin, lipoproteins, and other com ...

 Bile salts are then reabsorbed, primarily in the distal ileum, into portal blood for return to the liver and are again excrete ...

 Increased prevalence of gallstones.  Decreased gallbladder contraction after a meal.  More severe complications of biliary t ...

Diagnostic Evaluation Liver Function Tests  More than 70% of the parenchyma of the liver may be damaged before liver function t ...

Pigment Studies Normal 1. Serum bilirubin, direct 1. 0 – 0.3 mg/dL (0–5.1 μmol/L) 2. Serum bilirubin,total 2. 0 – 0.9 mg/dL (1.7 ...

α2-Globulin β-Globulin γ-Globulin Albumin/globulin (A/G) ratio Serum Aminotransferase or Transaminase Studies AST (SGOT) ALT ...

 Liver biopsy (percutaneous or transjugular)  Ultrasonography  Computed tomography (CT scan)  To show size of abdominal orga ...

NURSING ACTIVITIES RATIONALE  Ascertain that results of coagulation tests (prothrombin time, partial thromboplastin time, and p ...

 Immediately after the biopsy, assist the patient to turn onto the right side; place a pillow under the costal margin, and caut ...

Portal hypertension, ascites, and varices, resulting from circulatory changes within the diseased liver and producing severe G ...

Hemolytic Jaundice  Results from increased destruction of the red blood cells, too much bilirubin reaches the liver, although ...

of impaired fat digestion in the absence of intestinal bile. AST, ALT, and GGT levels generally rise only moderately, but biliru ...

 With the movement of albumin from the serum to the peritoneal cavity, the osmotic pressure of the serum decreases.  This, com ...

Assessment and Diagnostic Evaluation  The presence and extent of ascites are assessed by percussion of the abdomen. When fluid ...

often the first-line therapy. When used with other diuretics, it helps prevent potassium loss.  Daily weight loss should not ex ...