AMMONIA LEVELS IF ELEVATED IN LIVER FAILURE ,CIRRHOSIS,HEPATIC ENCEPHALOPATHY
10-80 UG/DL
INDIRECT BILLIRUBIN
0.2-0.8 MG/DL
DIRECT BILLIRUBIN
0.03 MG/DL
TOTAL BILIRUBIN
0.2-1.2 MG/DL
ALP
40-120
LIVER ENZYMES ALT
15-40 UL
WHAT TEST FOCUS ON LIVER
BILLARY TEST
LIVER ENZYMES AST
10-40 UL
PHOSPHOROUS
2.5-4.5
CL-
98-106
MG2+
1.5-2.5
CA2+
8.2-10.2
ELECTROLYTES K+
3.5-5.O
ELECTROLYTES NA +
135-145
Prothrombin time (pt)
10-13 seconds elevated on billiary obstruction, cirrhosis AND VITAMIN K DEFICIENCY AND FOR THOS ON WARAFIN 9 ANTICOAG THERAPY
platelets testing for bruising
150,000 -400,000
hematocrit bleeding in body
female
37-47 percent
Hematocrit any bleeding body for men
42-52 percent
Hemoglobin female
12-16
Hemoglobin Male
42-52 percent
rbc female
4.2 to 5.4
rbc male
4,7-6.1
wbc
5,00-10,000
when fatty meals get released to duodenum when bad can develope jaundice
which you end up being in pain from greasy pizza
when a resident has a decreased appetite and everything is rule out
think of depression
synthesis of plasma proteins
The liver synthesizes albumin,clotting factors, and globulin.Albumin is the most abundant plasma protein; it maintains osmotic balance.
when you have to much diarhea what happens to body
dehydration and electrolytes and potassium levels get low
nsaids , aleeve and asprin does what
Gives uclers
black stool
upper gi bleed or different medication can make it greenish black
peptobismol does what
turns stool black
bright red bleeding in bm
lower gi bleed or hemroids
opiod and iron does what
constipate
diverticulosis
as you age most of the time in large colon develope little pockets
the liver stores what
adek and fat soluble
phagpcytosis by kuffer cells
fixed macropages of the liver phagocytize worned formed elements and pathogens
ERCP (endoscopic retrograde cholangiopancreatography)
Endoscope through stomach if their are stones it will crush them !
colonoscopy
scope light, Gi doctor will go through the rectum Must be bowel prep Miralax and gatorade
no blue,red or purple dies,invasive procedure must have consent iron and coagulants physician may stop you must have a driver and you are put to sleep clear liquid diet
must monitor rectal bleeding and you want patient to pass gas
why they do Edg
to check for cancer,ulcers, gerd
globulin functions
include becoming part of lipoproteins,acting as carriers and acting as antibodies
edg
massive procedure upper scope/fast, need conscious consent anything invasive you need consent must have a driver 12 to 24 hours no food or drink
what happens when ast is in the liver, pancreas what disease could happen
acute hapatitis especially viral hepatocellular disease, shock, and acute pancreatitis.
moderately in billary tract obstruction,cirrhosis,chronic hepatitis, and liver tumors
aspartate aminotransferase -AST
enzyme found in large amounts in the liver and myocardial tissue, and smaller amounts in the pancreas muscles, kidneys, red blood cells, and brain it is release into bloodstream with tissue damage levels reflect with degree of damage
blood in stool
may indicate hemorrhoids, signs of cancer, or inflamatory diseases suchas ulcerative colitis
nausea,vomiting,bloating, excess gas
can be associated with gi disorders
fatty stools
pancreatic disease
clay colored stool
liver or gallbladder disease
clotting factors
produced by the live include prothrombin and fibrinogen which circulate the blood untill need for coagulation.
black colored stools
bleeding
hepatobillary scan
liver and gallbladder Npo must stay still
barium enema radiographic test
Goes up the rectum to high descending colon must have laxatives the day before to be cleaned out npo after testing force fluids encouraged fluids
Radiographic tests
barium swallow
you drink barium drink must be npo after procedure as long as they are not on fluid restriction force fluid clients may have white stools after and may need to order laxatives
lipid metabolism
the liver forms lipoproteins for transport of lipids of the blood to the other tissues.Liver also synthesize cholesterol and excretes excess cholesterol into bile to be excreted
essential amino acids are acquired by
diet
Amino acid Metabolism
The liver regulates the blood levels of amino acids based on tissue needs for protein synthesis of 20 amino acids needed to produce human protein the liver is able to sythesize 12.
carbohydrate metabolism
The liver regulates the blood glucose level by storing excess glucose as glycogen and performing glycogenolysis when blood glucose level is low.
If a person has messed up teeth
be aware of aspiration
aging and gastrointestinal system
decreased hcl, decreased mucous secretions,decreased elasticity to the rectal wall, weakness of intestinal wall
ALCOHOL AND GALLBLADDER ISSUES
Are specific for Gallbladder issues
aging and gastrointestinal system
weaker gag reflex / hcl backup,tooth loss, saliva production decreased
esophagus motility is less empty slower
AMYLASE and Lipase
WHEN HIGH CAN MAYBE HAVE PANCRIATITIS
BROKEN DOWN RED BLOODCELLS
TURNS INTO BILLIRUBIN
NEPHROLYSTATIS
KIDNEYSTONES
CHOLESTIAS
GALLSTONES
WHAT VITAMINS METABOLIZE MEDICATION
ADEK
IF YOUR BILLIRUBIN IS HIGH
HIGH IS FOR JAUNDICE
THE LIVER ACTIVATES WHAT
VITAMIN D
WHERE IS BILLI RUBIN MADE
LIVER AND SPLEEN
BILE IS STORE IN THE GALLBLADER AND MADE WHERE
THE LIVER
THE REASON WHY HYDROCLORIC ACID DONT EAT AT THE STOMACH
THE MUCOUS LINES IT
WHATS THE CLOTTING MECHANISM FOR THE STOMACH
BLOODVESSELS CONSTRICT PLATELETS GATHER TO FORM A PLUG AND COAGULANTS CASCADE CREATES A STABLE FIBRIN MESH
WHAT DOES TRYPSIN DO WHEN RELEASED FROM PANCREAS
CONVERTS POLYPEPTIDES TO PEPTIDES
WHAT DOES LIPASE DO WHEN RELEASED FROM FROM PANCREAS
CONVERTS EMULSIFIED FATS TO FATTY ACIDS AND GLYCEROL
WHAT DOES AMYLASE FROM PANCREAS WHEN RELEASED FROM PANCREAS
CONVERTS STARCH TO MALTOSE
bile salts in liver
emulsify fats
where is the liver and gallbladder, what side of the body.
Located on the right side of the body.
how many click sounds for a normal bm
5 to 30
how many click sounds for a hyperactive bm
30 plus
how many clicks for a hypoactive bm sound
fewer then 5 sounds per minute
how long should you ausultate
5 mins in total
carbohydrates are mostly digested where
the stomach
what happens when pyloric sphincter contracts
the stomach churns and relaxes at intervals so small amounts of chyme can go into the duodenum
what is the lumen surrounded by
The lower esophageal sphincter which relaxes to allow food bolus to enter stomach and contracts to prevent backflow of stomach contents
what happens if to much bile comes out
You can become Jaundice
where does most digestion occur
duodenum
what does the liver produce
It produces bile to break down fats
the end products of digestions goes where
absorbed back into the blood and lymph
The pylorus sphincter
guards entry to duodenum which is part of the small intestine
hepatopancreatic ampulla vater
is the entrance of the common bile duct and the pancreatic duct
The presence of food stimulates what
The parasympathetic sympathetic response which releases gastrin by gastrin mucosa which increases gastric juice
what does the pyloric sphincter do
...