Alcoholic Liver Cirrhosis – Kaitlyn Hitch, Megan Scherber, Alex Gelinas, Annie Alward

  Who? (Who gets it?)(population) : alcoholics, women are at greater risk What? (What is it?)(Pathophysiology) : It is the replacement of liver tissue with scar tissue around the portal areas When? (frequency, when, related to?)(presentations, SS): between the ages of 40-60, insidious onset and protractive course occurring over 30 years, presents with abdominal pain … Continue reading “Alcoholic Liver Cirrhosis – Kaitlyn Hitch, Megan Scherber, Alex Gelinas, Annie Alward”

 

Who? (Who gets it?)(population) : alcoholics, women are at greater risk

What? (What is it?)(Pathophysiology) : It is the replacement of liver tissue with scar tissue around the portal areas

When? (frequency, when, related to?)(presentations, SS): between the ages of 40-60, insidious onset and protractive course occurring over 30 years, presents with abdominal pain due to the recent rapid enlargement of the liver, the liver will then decrease in size because of the scar tissue, portal obstructions and ascites are late manifestions, indigestion, jaundice, peripheral edema due to overproduction of aldosterone, mental deterioration, vitamin deficiency and anemia, bacterial peritonitis and risk of infection, GI varices

Where? (systems affected) (organs involved): organs affected are the skin, spleen, GI tract, and liver

Why? (why does this occur) (risk factors): alcohol abuse because it causes necrosis of the liver cells

Medication of Choice: Gentamicin

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why … Continue reading “Medication of Choice: Gentamicin”

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Introduction

My Favorite Lab Value: Sodium (135-145)
My Least Favorite Lab Value: Creatine (0.6-1.2)

img_7143My Favorite Lab Value: Sodium (135-145)

My Least Favorite Lab Value: Creatine (0.6-1.2)

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