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Liver Disease Question

Posted

Hello everyone!

I am making notes on the liver content right now on hepatitis and I wrote out the simplified version of hepatitis and now I am looking at the signs and symptoms and I feel like I get a general drift of some of them but am confused as to what the pathophys behind it is.

So for acute hepatitis the S/S are

diarrhea, fatigue, loss of appetite, mild fever, muscle or joint aches, nausea (manifestations of the right upper quadrant pain), slight abdominal pain (enlargement of the liver or fluid retention?), vomiting (vagus nerve stimulation?), weight loss (low protein production - albumin?).

Those mentioned above can help to reverse the effects of hepatitis but if not treated it will lead to these S/S

circulation problems (only toxic/drug induced hepatitis)

dark urine (from excess bilirubin being produced and also because it is the water soluble conjugated bilirubin that is being excreted to the urine?)

dizziness (only toxic/drug induced hepatitis)

enlarged spleen (only alcoholic hepatitis)

headache (only toxic/drug induced hepatitis)

hives (?)

itchy skin (manifested from the jaundice produce bile salts that come in contact with the blood with will cause the itching)

light coloured feces (contain little stercobilin therefore the pale stools - abolis?)

yellow skin, white eyes, tongue (liver parenchymal cell damage?)

I just want everyone to take a look at this and see if I am on the right track and that any of this makes sense!

Thank you all!

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 14 years experience.

You're on the right track, although I think you are spending too much time memorizing the signs and symptoms.

NCLEX will not ask you about signs and symptoms. NCLEX-style questions are not at the memorization level; therefore, rote memory is useless when studying for it.

A typical NCLEX question will be something along the lines of: "Patient A, a 48-year-old male, has gained 15 pounds in one week. He has no significant health history with the exception of a blood transfusion in 1984 secondary to trauma that arose during a motor vehicle accident. Which tests do you anticipate the physcian will order?"

A. thyroid stimulating hormone

B. comprehensive metabolic panel

C. b-type natrieuretic peptide

D. antibody test for HCV

ANSWER: D

Rationale: Ascites, the abnormal accumulation of excessive fluid in the peritoneal cavity, arises frequently as a part of the decompensation of previously asymptomatic chronic liver disease secondary to chronic hepatitis. Blood banks did not routinely screen donated blood products for the presence of hepatitis C virus until 1992. Therefore, the patient may have been exposed during the blood transfusion in the middle 1980s.

Wow! Thank you so much that question was really good. I think I put this post under the wrong section, but I have short answer quiz for my pathophysiology class and the structure of the quiz would be something like a scenario where it would have the signs and symptoms present when they arrive at the ER (so my previous quiz was on diabetes and a pt came in with signs of dehydration, nausea, RR 32, hypoglycemia, BP 90/60, HR 130) and then the questions had a t-chart with HR, BP, polyuria, polydipsia and the pathophysiological state of each one. Then there were questions on ABGs, and medications (insulin, OAHD). We also had only 20 minutes to complete the quiz, which for this quiz was crazy amount of stuff to answer.

Any suggestions on how I can connect the S/S in a pathophysiological way?

Thanks!