Endocrine Disorders Related to Liver Dysfunction

Overview

• Focus on endocrine disorders linked to liver dysfunction
• Key disorders discussed: hepatitis, cirrhosis, fatty liver

Objectives

• Identify metabolic functions and alterations in hepatic disorders
• Explain liver function tests and clinical manifestations
• Relate conditions like jaundice, portal hypertension, and hepatic encephalopathy to liver alterations
• Describe medical, surgical, and nursing management of esophageal varices
• Use nursing process for cirrhosis patient care

Liver Anatomy and Functions

• Largest gland; located in right upper quadrant
• Functions:
  • Glucose and protein metabolism
  • Bile production for fat digestion
  • Bloodstream cleansing
  • Ammonia conversion to urea
  • Drug metabolism

Hepatitis

• Inflammation or infection of the liver
• Causes: viral (A, B, C), drugs (e.g., acetaminophen), toxins, alcohol
• Symptoms: flu-like with or without jaundice

Fatty Liver Disease

• Alcoholic: Caused by excess alcohol, leads to cirrhosis
• Non-Alcoholic (NAFLD/NASH): Linked with obesity, high fructose intake

Cirrhosis

• Chronic disease with fibrous tissue replacing liver tissue
• Impairs liver functions

Clinical Manifestations of Liver Dysfunction

• Jaundice: Yellowing of skin and eyes
• Portal Hypertension: Impaired blood flow causing fluid backup
• Ascites: Fluid in peritoneal cavity; dehydration in bloodstream
• Esophageal Varices: Enlarged veins in esophagus, risk of bleeding
• Hepatic Encephalopathy: Ammonia buildup causing confusion, lethargy

Assessment and Priorities

• Mental status and neuro function
• Skin assessment for jaundice, excoriation
• GI and abdominal assessment for liver size and tenderness

Medical Management

• Labs: Serum tests like ALT, AST, albumin, bilirubin, etc.
• Biopsy: Tissue samples for diagnosing conditions like cancer
• Treatments:
  • Esophageal Varices: Octreotide, vasopressins, beta blockers
  • Ascites: Nutritional therapy, albumin, diuretics
  • Encephalopathy: Lactulose to manage ammonia levels

Nursing Management

• Daily weights and intake/output monitoring
• Monitor labs, respiratory status, and abdominal girth
• Safety precautions to prevent falls and manage bleeding risks

Complications and Teaching

• Bleeding Varices: Emergency treatments needed
• Confusion from Ammonia Buildup: Reorientation, lactulose administration
• Patient Teaching:
  • Monitor weight and report significant changes
  • Medications and dietary changes
  • Alcohol avoidance
  • Fall prevention and cognitive monitoring

Holistic and Psychosocial Considerations

• Dietary changes might need gradual implementation
• Emotional support for lifestyle changes
• Monitor mental status with help from family

This summary provides a comprehensive overview of liver-related endocrine disorders, focusing on understanding the function and management of liver diseases like hepatitis, fatty liver, and cirrhosis. For further clarification or additional resources, students are encouraged to revisit the presentation material or seek guidance from the instructor.