N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide

©2017 Achieve Test Prep Page 97 of 140 • Alkaline phosphate (ALP) can be elevated (evaluates liver or bone dysfunction) • Gamma glutamyl transferase (GGT) is acutely elevated with alcohol consumption and hepatotoxic drugs • Transaminases: ALT and AST elevated to a varying degrees • Bilirubin, both direct and indirect levels, may be elevated secondary to liver cell injury • Prothrombin time (PT) is prolonged if liver is injured to the point that it can no longer produce proteins necessary for blood coagulation Interventions: controlling spread of infection; report to local public health department for Hepatitis A and B; for Hepatitis A, patient requires a private bathroom and proper bagging, cleansing, and disposal of contaminated items; provide antiemetic medications as ordered and encourage a high CHO diet, low in fat, with the abstinence from alcohol; if liver function is compromised, protein and salt should be restricted; IV fluids as ordered; encourage bedrest initially and very gradual increase in activity as tolerated; monitor for signs of dehydration and monitor electrolyte status; inform patient they may never donate blood; observe for blood in stool, urine, multiple ecchymosis, petechiae, or oozing blood from gums or minor cuts, which may indicate a complication Medications: symptom relief; Hepatitis B vaccination is a series of three intramuscular injections to adults, children, and infants with the second and third injections given at 1 and 6 months after initial injection; efficacy of vaccination is 95%; for Hepatitis C, combination therapy is used for 12- 18 weeks or as long as 48 weeks with interferon alfa-2b and ribavirintherapy; antihistamines can be given for pruritus Inherited diseases that lead to Hepatitis are alpha-1 antitrypsin deficiency, hemochromatosis, Wilson's disease, galactosemia, and glycogen storage diseases. These interfere with the way the liver produces, processes, and stores enzymes, proteins, metals, and other substances the body needs to function properly. Liver biopsy: • Patient is NPO after midnight prior to biopsy; have compatible donor blood available • Correct position for liver biopsy is recumbent with right upper abdomen exposed; insert biopsy needle between the 6th and 7th ribs; immediately before needle insertion, have the patient inhale and exhale deeply and then hold breath at end of expiration until needle is inserted. • After biopsy assist patient to right-side-lying position with a pillow placed under the right costal margin. • Observe for signs and symptoms of shock and pneumothorax. • Position client on the right lateral side for 2 hours for hemostasis. Antibodies to specific virus Diagnostics: •