NUR 243 exam
NUR 243 Exam 2 Questions and
Answers 2025
Nursing Care of Patient With Hepatic Dysfunction -
Hepatic Cells - Phagocytes
Kuppfer Cells - Macrophages line sinusoids
RBC broken down by Kupffer cells (RES)
Bloody Supply of Liver - Portal vein and hepatic artery
70% venous
30% arterial (oxygenated;output)
Helps fight infection
Decreased blood volume with R sided heart failure
Increased blood volume with hemorrhage
Liver Function - Bile formation and excretion
Metabolizes carbs, proteins, and fats
Blood reserve and filtration
Store vitamins and minerals
Coagulation (Vitamin K)
Drug metabolism/detoxification
Folic acid and thiamine if history of alcoholism or liver damage
NUR 243 exam
, NUR 243 exam
S&S of Liver Dysfunction - Jaundice
Ascites (build up of fluid in third space; veins across belly is called caput medusa)
Dark colored urine (build up of bilirubin)
Indigestion, anorexia
Malaise
Fatty food tolerance
Bilirubin > 2.5mg/dl
Alk phos elevated
Nursing Interventions - Interventions for pruritus (build up of bile salts)
Antihistamines
Bile acid binders
Cholestyramine (Questran)
Avoid soap
Cream moisturizers
Avoid hot showers/baths
Symptoms r/t Metabolism - Muscle wasting
Alteration in glucose
Iron deficiency anemia, fatigue
Ascites/peripheral edema
Changes in hormone levels
Sleepiness, encephalopathy, coma
Bleeding tendencies
Anorexia, N/V
NUR 243 exam
, NUR 243 exam
Intrinsic and Extrinsic Pathways - PTT: measures intrinsic pathways
PT/INR: measures extrinsic pathway
S&S d/t Clotting Factors - Petechiae
Ecchymosis
Bleeding = hemorrhage
DIC
Metabolism Detoxification - Metabolism of fat soluble drugs
Affects drug 1st pass
Steroids/hormones inactivates and excretes
May have to change dose, smaller or not extended release, etc.
With age, spread out dosages, start low and go slow
Liver Function Tests - ALT < 35 units/mL
AST < 35 units/mL
ALP < 90 units/L
GGT 10-48 IU/L
Bilirubin 0.1 - 1.2 mg/dl
Serum ammonia 15 - 45 mcg/dl
(increase in this causes confusion)
Total protein 3.5 5 g/dl
Serum albumin 3.5 - 5 g/dl
PT 10 - 13 sec or 1.5 - 2x
INR normal (0.8 - 1.1) if on meds therapeutic (2-3)
PTT 25 - 35 sec up to 2.5x
NUR 243 exam
NUR 243 Exam 2 Questions and
Answers 2025
Nursing Care of Patient With Hepatic Dysfunction -
Hepatic Cells - Phagocytes
Kuppfer Cells - Macrophages line sinusoids
RBC broken down by Kupffer cells (RES)
Bloody Supply of Liver - Portal vein and hepatic artery
70% venous
30% arterial (oxygenated;output)
Helps fight infection
Decreased blood volume with R sided heart failure
Increased blood volume with hemorrhage
Liver Function - Bile formation and excretion
Metabolizes carbs, proteins, and fats
Blood reserve and filtration
Store vitamins and minerals
Coagulation (Vitamin K)
Drug metabolism/detoxification
Folic acid and thiamine if history of alcoholism or liver damage
NUR 243 exam
, NUR 243 exam
S&S of Liver Dysfunction - Jaundice
Ascites (build up of fluid in third space; veins across belly is called caput medusa)
Dark colored urine (build up of bilirubin)
Indigestion, anorexia
Malaise
Fatty food tolerance
Bilirubin > 2.5mg/dl
Alk phos elevated
Nursing Interventions - Interventions for pruritus (build up of bile salts)
Antihistamines
Bile acid binders
Cholestyramine (Questran)
Avoid soap
Cream moisturizers
Avoid hot showers/baths
Symptoms r/t Metabolism - Muscle wasting
Alteration in glucose
Iron deficiency anemia, fatigue
Ascites/peripheral edema
Changes in hormone levels
Sleepiness, encephalopathy, coma
Bleeding tendencies
Anorexia, N/V
NUR 243 exam
, NUR 243 exam
Intrinsic and Extrinsic Pathways - PTT: measures intrinsic pathways
PT/INR: measures extrinsic pathway
S&S d/t Clotting Factors - Petechiae
Ecchymosis
Bleeding = hemorrhage
DIC
Metabolism Detoxification - Metabolism of fat soluble drugs
Affects drug 1st pass
Steroids/hormones inactivates and excretes
May have to change dose, smaller or not extended release, etc.
With age, spread out dosages, start low and go slow
Liver Function Tests - ALT < 35 units/mL
AST < 35 units/mL
ALP < 90 units/L
GGT 10-48 IU/L
Bilirubin 0.1 - 1.2 mg/dl
Serum ammonia 15 - 45 mcg/dl
(increase in this causes confusion)
Total protein 3.5 5 g/dl
Serum albumin 3.5 - 5 g/dl
PT 10 - 13 sec or 1.5 - 2x
INR normal (0.8 - 1.1) if on meds therapeutic (2-3)
PTT 25 - 35 sec up to 2.5x
NUR 243 exam
