Understanding Medical Surgical Nursing Ch 32
Terms
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copy deck
- striae
- light silver-colored or thin red lines on the abdomen
- caput medusae
- bluish-purple swollen vein pattern extending out from the navel
- spider angiomas
- thin reddish-purple vein lines close to the skin surface
- jaundice
-
AKA icterus
yellowing of the skin and sclera of eye - retrograde cholangiopancreatography (ERCP)
-
allows visualization of liver, gallbladder, & pancreas
endoscope is passed through esophagus to duodenum & then dye injected to outline pancreatic & bile ducts -
Which of the following is a function of the liver?
a. Synthesis of plasma proteins
b. Elimination of carbohydrates
c. Concentration of bile
d. Secretion of cholecystokinin - a. Synthesis of plasma proteins
-
Which food is most likely to stimulate the release of bile?
a. Green beans
b. French fries
c. Coffee
d. Poached egg - b. French fries
-
The enzymes of the pancreas are involved in the digestion of which foods?
a. Starch and fat
b. Starch, fat, and protein
c. Fat and protein
d. Starch and protein - b. Starch, fat, and protein
-
Which of the following complications should the nurse monitor for after a liver biopsy?
a. Nausea
b. Muscle twitching
c. Bleeding
d. Hypoventilation - c. Bleeding
-
Which of the following nursing measures is most important after an upper or lower GI series?
a. Offer a laxative as ordered
b. Place pressure on the puncture site
c. Check for return of the gag reflex
d. Keep the patient in the semi-F - a. Offer a laxative as ordered
-
Mr. Sikmiller returned an hour ago from an EGD and is asking for a glass of water. Which of the following responses is best?
a. "I'm sorry, but you will need to wait 4 hours before drinking anything."
b. "I can't give you any wat - d. "Let me check your gag reflex first to make sure it is safe to drink water."
- The liver fills the 1_____ and center of the upper abdominal cavity just below the 2_____. The two main lobes of the liver are called the 3_____ and 4_____ lobes.
-
1 right
2 diaphragm
3 right
4 left -
There are three digestive functions of the liver.
TRUE or FALSE -
FALSE
The only digestive function of the liver is the production of bile by the hepatocytes (liver cells).
p 535 - Bile is mostly 1_____ and has an excretory function in that it carries 2_____ and excess 3_____ to the intestines for elimination in 4_____--.
-
1 water
2 bilirubin
3 cholesterol
4 feces - How does the liver regulate blood glucose levels?
- Liver stores excess glucose as glycogen -> blood glucose level becomes low -> liver changes glycogen back to glucose
- Of the 1_____ amino acids needed for the production of human 2_____, the liver is able to synthesize 12, called the 3_____ amino acids, by the process of transamination. The other 4_____ amino acids, which the liver cannot synthesize, are called the 5___
-
1 twenty
2 proteins
3 nonessential
4 eight
5 essential -
The functions of the liver include:
(eight possible) -
1 carbohydrate metabolism
2 amino acid metabolism
3 lipid metabolism
4 synthesis of plasma proteins
5 phagocytosis by Kupffer cells
6 formation of bilirubin
7 storage
8 detoxification - Kupffer cells
-
fixed macrophages of liver
phagocytize pathogens circulating in liver -
The fixed macrophages of the liver phagocytize old WBCs & form bilirubin from the heme portion of their hemoglobin.
TRUE or FALSE -
FALSE
The fixed macrophages of the liver phagocytize old RED BLOOD CELLS & form bilirubin from the heme portion of their hemoglobin.
p 537 - The liver stores the minerals iron and 1_____; the fat-soluble vitamins A, 2_____, E, and 3_____; and the water-soluble vitamin 4_____.
-
1 copper
2 D
3 K
4 B12 - The gallbladder is a 1_____ sac about 3 to 4 inches long located on the undersurface of the left lobe of the 2_____. Bile in the 3_____ 3_____ from the liver flows through the cystic duct into the gallbladder, which stores bile until it is needed in the
-
1 muscular
2 liver
3 hepatic duct
4 small intestine - The pancreatic enzyme amylase digests starch to _____.
- maltose
- Lipase (pancreatic enzyme) converts _____ _____ to fatty acids and glycerol.
- emulsified fats
- _____ digests polypeptides to shorter chains of amino acids.
- Tripsin
-
Alanine aminotransferase (ALT)
normal range: 5-35 IU/dL
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An increase indicates . . . -
36 IU/dL or higher
possible chronic liver failure or hepatitis -
Aspartate aminotransferase (AST)
normal range: 8-20 units/L
------------------------------
an increase indicates . . . -
21 units/L or higher
possible chronic liver failure, viral hepatitis, or acute pancreatitis -
Lactic dehydrogenase (LDH)
normal range: 110-250 IU/L
------------------------------
An increase indicates . . . -
251 IU/L or higher
liver disease possible - In preparation for an oral cholecystogram (gallbladder series), the pt is asked to eat a 1_____ 1_____ diet for 2 days before the test, then a 2_____ 2_____ diet the day 3_____ the examination.
-
1 high fat
2 low fat
3 before -
How long should a pt remain on bedrest following a percutaneous liver biopsy?
a. 2 days
b. 36 hours
c. 24 hours
d. 12 hours -
c. 24 hours
p 542