Medical Surgical Nursing

 Manifestations of sensitivity to a medication may occur on the first day of its

use or not until several months later, depending on the medication.

 Usually the onset is abrupt, with chills, fever, rash, pruritus, arthralgia,

anorexia, and nausea. Later, there may be jaundice and dark urine & enlarged

and tender liver. When the offending medication is withdrawn, symptoms may

gradually subside.

FULMINANT HEPATIC FAILURE

 Is the clinical syndrome of sudden and severely impaired liver function in a

previously healthy person. According to the original and generally accepted

definition, fulminant hepatic failure develops within 8 weeks of the first

symptoms of jaundice.

 Three categories are frequently cited: hyperacute, acute, and subacute liver

failure.

FULMINANT HEPATIC FAILURE

 Is the clinical syndrome of sudden and severely impaired liver function in a

previously healthy person.

 In hyperacute liver failure, the duration of jaundice before the onset of

encephalopathy is 0 to 7 days; in acute liver failure, it is 8 to 28 days; and in

subacute liver failure, it is 28 to 72 days.

 The prognosis for fulminant hepatic failure is much worse than for chronic liver

failure. However, in fulminant failure, the hepatic lesion is potentially

reversible, with survival rates of approximately 50% to 85% (depending on

etiology). Those who do not survive die of massive hepatocellular injury and

necrosis

FULMINANT HEPATIC FAILURE

 Fulminant hepatic failure is often accompanied by coagulation defects, renal

failure and electrolyte disturbances, infection, hypoglycemia, encephalopathy,

and cerebral edema.

 Viral hepatitis is a common cause of fulminant hepatic failure; other causes:

toxic medications (eg, acetaminophen) and chemicals (eg, carbon tetrachloride),

metabolic disturbances (eg, Wilson's disease, a hereditary syndrome with

deposition of copper in the liver), and structural changes (eg, Budd-Chiari

syndrome, an obstruction to outflow in major hepatic veins .)