N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide A hepatitic coma is caused by high ammonia levels. Give Cephalic or lactulose to decrease the ammonia level. This results in an increased level of ammonia in the stool and improved constipation. Portal hypertension: Blood from the intestines and spleen is carried to the liver thru the portal vein; cirrhosis slows the flow causing HTN. Portal hypertension leads to varices. The treatment is to control blood pressure (i.e. beta-blocker). The major complications are fluid, electrolyte, and acid base imbalances. Medications are aimed at decreasing the portal venous pressure without causing hypotension; diuretics and fluid restrictions are treatments of choice. Propranolol (Inderal), a beta blocker is used to decrease portal venous pressure. Ascites Ascites is an accumulation of plasma rich fluid within peritoneal cavity secondary to portal hypertension. Patient will have increased aldosterone and decreased oncotic pressure (from decreased circulating albumin levels called hypoalbuminemia). Assessment: abdominal distension; weight gain; increased abdominal girth; dilated abdominal veins (caput medusa); generalized edema; respiratory distress if accumulation of ascetic fluid is large Interventions: Paracentesis to remove fluid; diuretics; shunting devices (to treat portal hypertension); monitor fluid and electrolytes, give fluids as ordered; monitor daily weights and measure abdominal girth; restrict intake of protein and sodium; monitor for respiratory distress from upward pressure on diaphragm; monitor vital signs for hypotension and or tachycardia. Nonalcoholic steatohepatitis (NASH): In NASH, fat builds up in the liver and eventually causes scar tissue. This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and corticosteroid treatment. Blocked bile ducts: When the ducts that carry bile out of the liver are blocked, bile backs up and damages liver tissue. In babies, blocked bile ducts are most commonly caused by biliary atresia, a disease in which the bile ducts are absent or injured. In adults, the most common cause is primary biliary cirrhosis, a disease in which the ducts become inflamed, blocked, and scarred. Secondary biliary cirrhosis can happen after gallbladder surgery, if the ducts are inadvertently tied off or injured. Wilson’s Disease Wilson's disease, or hepatolenticular degeneration, is an autosomal recessive genetic disorder in which copper accumulates in the tissues. This manifests as neurological or psychiatric symptoms and liver disease. It is treated with medication that reduces copper absorption or removes the ©2017 Achieve Test Prep Page 99 of 140