NSG 233 Med Surg 3 exam 3
1. Pathophysiology of he- Liver cells become destroyed and replaced with fibrotic tissue (cirrho-
patic disfunction sis)
Blood can no longer flow easily through the liver back to the right side
of the heart
2. What are some causes of Infectious agents (i.e. hepatitis virus)
hepatic dysfunction
Anorexia (inadequate organ perfusion)
Metabolic disorders (i.e. acidosis)
Toxins (i.e. ETOH)
Medications (i.e. acetaminophen)
Malnutrition (often ETOH induced)
Cirrhosis
3. What is cirrhosis? And Cause damage to liver cells ¡inability to clear bilirubin ¡yellowing of skin
what can cause ? and dark urine
Increase intrahepatic vascular resistance
Elevate portal pressure
Leads to portal hypertension
, NSG 233 Med Surg 3 exam 3
4. How many stages has Assess mental (neurological)status change & motor disturbances
hepatic encephalopathy
and what the nurse There are 5 stages
should assess
5. What are the symptoms Stage 1
for each stage Normal LOC with period of lethargy
Impaired writing
Stage 2
Increased drowsiness
Confusion
Agitation
Asterixis
Fedora hepaticus
Constructional Apraxia
Stage 3
Stoporous
Confusion
Incoherent speech
Asterexis
, NSG 233 Med Surg 3 exam 3
Increased DTR
Rigid extremities
Stage4
Comatose
No response to painful stimuli; flaccid
6. What is asterixis? In what flapping tremor of the hands
stage do you see it ?
Stage 2
7. What is fetor hepaticus? which occurs when the liver is unable to properly filter toxins from
What is it indicative of? the blood, causing them to be released through breath due to their
And what stage do you sulfurous compounds
see it ?
Fetor Hepaticus:
This term refers to the distinct bad breath associated with liver disease,
often described as a musty or garlic-like odor.
Stage 2
, NSG 233 Med Surg 3 exam 3
8. What is constructional a neurological disorder that makes it difficult or impossible to build,
apraxia ? And what stage assemble, or draw objects, even if the person understands the task
do you see it ? and has the physical ability
Stage 2
9. medications for en- Lactulose
cephalopathy. Removes ammonia via stool: 2-3 soft solos per day desirable
Antibiotics
Reduce ammonia - forming bacteria in colon
Metronidazole
Rifaximin
Neomycin
10. Hepatic encephalopathy Monitor
management neuro status
1. Pathophysiology of he- Liver cells become destroyed and replaced with fibrotic tissue (cirrho-
patic disfunction sis)
Blood can no longer flow easily through the liver back to the right side
of the heart
2. What are some causes of Infectious agents (i.e. hepatitis virus)
hepatic dysfunction
Anorexia (inadequate organ perfusion)
Metabolic disorders (i.e. acidosis)
Toxins (i.e. ETOH)
Medications (i.e. acetaminophen)
Malnutrition (often ETOH induced)
Cirrhosis
3. What is cirrhosis? And Cause damage to liver cells ¡inability to clear bilirubin ¡yellowing of skin
what can cause ? and dark urine
Increase intrahepatic vascular resistance
Elevate portal pressure
Leads to portal hypertension
, NSG 233 Med Surg 3 exam 3
4. How many stages has Assess mental (neurological)status change & motor disturbances
hepatic encephalopathy
and what the nurse There are 5 stages
should assess
5. What are the symptoms Stage 1
for each stage Normal LOC with period of lethargy
Impaired writing
Stage 2
Increased drowsiness
Confusion
Agitation
Asterixis
Fedora hepaticus
Constructional Apraxia
Stage 3
Stoporous
Confusion
Incoherent speech
Asterexis
, NSG 233 Med Surg 3 exam 3
Increased DTR
Rigid extremities
Stage4
Comatose
No response to painful stimuli; flaccid
6. What is asterixis? In what flapping tremor of the hands
stage do you see it ?
Stage 2
7. What is fetor hepaticus? which occurs when the liver is unable to properly filter toxins from
What is it indicative of? the blood, causing them to be released through breath due to their
And what stage do you sulfurous compounds
see it ?
Fetor Hepaticus:
This term refers to the distinct bad breath associated with liver disease,
often described as a musty or garlic-like odor.
Stage 2
, NSG 233 Med Surg 3 exam 3
8. What is constructional a neurological disorder that makes it difficult or impossible to build,
apraxia ? And what stage assemble, or draw objects, even if the person understands the task
do you see it ? and has the physical ability
Stage 2
9. medications for en- Lactulose
cephalopathy. Removes ammonia via stool: 2-3 soft solos per day desirable
Antibiotics
Reduce ammonia - forming bacteria in colon
Metronidazole
Rifaximin
Neomycin
10. Hepatic encephalopathy Monitor
management neuro status
