liver dysfunction 2

Question 1

hepatitis

Answer 1

• inflammation of liver d/t virus
• A, B, C, D, E, G
• may also be caused by etoh, drugs, chemicals, and autoimmune liver dz

Question 2

preicteric/prodomal phase of hepatitis

Answer 2

• lasts from 1-21 days

- maximal infectivity for HAV

Question 3

icteric phase of hepatitis

Answer 3

• lasts 1-4 months
• jaundice, pruritus, dark urine
• gray, white, light yellow stool

Question 4

posticteric/convalescent phase

Answer 4

• lasts 2-4 months

- begins when jaundice disappears

Question 5

s/s of hepatitis

Answer 5

• anorexia, n/v, wt loss
• decrease sense of smell
• RUQ abd discomfort
• malaise, arthralgias
• skin rash, urticaria, pruritus, jaundice
• low grade fever
• hepatomegaly, splenomegaly
• dark urine, light stools

Question 6

abnormal labs in hepatitis

Answer 6

• AST/ALT
• GTT
• Alk phos
• bilirubin
• aPTT

Question 7

chronic hepatitis

Answer 7

• labs still show antigen for 6+ months
• liver biopsy may be required to assess inflammation and degree of fibrosis
• risk of developing hepatic carcinoma and cirrhosis

Question 8

s/s of chronic hepatitis

Answer 8

• easy fatigability
• malaise
• hepatomegaly
• splenomegaly subsides

Question 9

collaborative care for hepatitis

Answer 9

• no specific tx
• ensure rest and assist the liver in regenerating
• rest reduces the metabolic demands on the liver and promotes cell regeneration

Question 10

nutritional tx for hepatitis

Answer 10

• no special diet needed
• enough calories to prevent wt loss
• vitamin B and K
• small frequent meals: increase carbs and protein, decrease fats
• adequate fluids

Question 11

alcohol w/d syndrome

Answer 11

• s/s begins within 6/12 hours

- usually relieved by consuming alcohol

Question 12

classic hangover

Answer 12

early and mild alcohol w/d

Question 13

assessment of alcohol w/d

Answer 13

• type of alcohol
• duration
• time of last ingestion
• reason for stopping
• previous w/d s/s
• meds
• medical problems

Question 14

stage 1 of w/d

Answer 14

• mild anxiety and alcohol craving

- 6-12 hours

Question 15

stage 2 of w/d

Answer 15

• 24-36 hours

- excessive adrenergic effects

Question 16

stage 3 of w/d

Answer 16

• 12-48 hours
• tonic clonic sz
• not everyone goes to stage III

Question 17

stage 4 of w/d

Answer 17

• 48-72

- delirium tremors

Question 18

tx of w/d

Answer 18

• bzd (ativan)
• CV agents: propanolol, clonidine
• thiamine, vit b-12, mvi, folic acid
• ethanol 10% 50-75mL/hr
• mg sulfate 2g/L
• propfol