= DISEASE PROCESS

= DIAGNOSTIC TESTS ; LABORATORY MODS

= SIGNS AND SYMPTOMS

= MEDICAL MANAGEMENT
LIVER THYROID
= NURSING RESPONSIBILITIES GLAND

TOTAL BILIRUBIN
Hepatic Coma (<1mg/dL),
(Hepatic Encephalopathy) Albumin Coagulation
TRIGLYCERIDES, 3.5-5 g/dL Problem
TOTAL
Bile CHOLESTEROL,
LDL, HDL
AST AMMONIA Calcium Risk for Bleeding
ALT Normal range Ascites = fluid 8.5-10.2mg/dL -Bleeding precaution
Bilirubin in peritoneal cavity Hypocalcemia -Electric razor
10-40 units (5-50mmol/L) Phosphorus
2.5-4.5 mg/dL -Soft bristled toothbrush
-Low Protein diet -pressure to site after
-Lactulose Jaundice Pruritus Venipuncture
-Neomycin -yellowish skin & sclerae -Albumin -Monitor -Avoid injury
Pruritus Neurotoxic to CNS -Chvostek's -Calcium
-dark colored urine, clay -Diuretics abdominal girth
-Brain energy failure Sign Gluconate
colored stool. -Restrict Na -Daily weights
-Altered neurotransmission -keep nails -Trousseau Oral or IV
-Cerebral Edema trimmed - Peritoneal
Sign -Calcium
-Avoid strong -soft linens Dialysis
-seizures supplements
soaps -moderate -Confusion
-Alleviate dry, -Altered LOC -Safety precaution temperature
itching skin -Raise side rails -antihistamines
-Frequent -stay with patient - dietary intake of Calcium
position -Disorientation to -Maintain Safety
changes time,place,person -Always introduce -Seizure precaution
-Baking soda self -administer calcium
Or alpha Keri -Asterixis (flapping -put clock or gluconate with orange juice
baths tremor of hand when calendar at bedside to maximize absorption
arm extended & hand
held upward
(dorsiflexed)

Severe Stress

-T3
-T4
-BMR (basal -Hypersecretion of
metabolic rate) thyroid hormone -Antithyroid drugs(SSKI methymazole,
-High titer -Accelerated physical Propylthiouracil
anti-thyroid and mental functions -Irradiation
antibodies -Surgery
-Calcium

-Hyperactivity
Activity intolerance ; Fatigue -Sensitivity to heat
-Limit activities to quiet ones ex. Reading -Rest and sleep deprivation Post-thyroidectomy care
-Provide frequent rest periods -Increased perception of stimuli -low or semi-fowler's
-Avoid Stimulants ex. Coffee, tea -Weight loss -Prevent flexion or hyperextension of neck
-Restrict visitors and control choice of roommate -Potential for respiratory difficulty -Tracheostomy and suction supplies at bedside
-Diarrhea -WATCH FOR COMPLICATION LIKE
-Tachycardia THYROIDTOXICOSIS:
-Exophthalmus -T, BP, PR,
Altered body temperature ; Hyperthermia
-Frequent mood swings - Abdominal pain,diarrhea,confusion
-Keep room cool
-Nervous, jittery
-Advice light, cool clothing
-Fine, soft hair

Social Interaction impaired

-Accept behavior
-Use calm unhurried manner when taking care for client
-Interpret behavior to family

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