Liver

• It lies under the diaphragm on the right side of the abdomen
• The liver is the largest glandular organ, weighing about 1500g.
• The liver is the largest gland in the human body and plays a central role as a chemical factory, responsible for manufacturing, storing, altering, and excreting numerous substances involved in metabolism.
• The location of the liver is strategically important as it receives nutrient-rich blood directly from the gastrointestinal (GI) tract.
• The blood supplied to the liver contains absorbed nutrients from the digestive system.
• The liver is essential for the regulation of glucose and protein metabolism and transforms nutrients received from the GI tract into various chemicals that are utilized elsewhere in the body to meet metabolic needs.
• The liver manufactures and secretes bile, a digestive fluid, which has a significant role in the digestion and absorption of fats in the GI tract.
• The liver functions as a detoxifying organ by removing waste products from the bloodstream and secreting them into bile for eventual elimination from the body.
• Bile produced by the liver is temporarily stored in the gallbladder and when needed for digestion, the gallbladder releases bile into the intestine.
• Bile aids in the emulsification of fats, breaking them down into smaller particles for easier digestion and absorption, a process vital for the effective utilization of nutrients from the diet.
• Dysfunction of the liver can have profound effects on various metabolic processes and can lead to health issues.
• Monitoring liver function is crucial for assessing overall health and diagnosing certain medical conditions.
• Liver function is complex and hepatic dysfunction affects all body systems.
• The nurse must understand how the liver functions and must have expert clinical assessment and management skills to care for patients undergoing diagnostic and treatment procedures.
• Laparoscopy is used to examine the liver and other pelvic structures.
• These studies may reduce the need for liver biopsy.
• Laparoscopy is also used to perform guided liver biopsy, to determine the cause of ascites, and to diagnose and stage tumors of the liver and other abdominal organs.
• Liver fibrosis and other liver diseases can be identified, evaluated and monitored with a variety of other noninvasive studies.
• The nurse must have a understanding of technologic advances in the management of hepatic disorders.
• Liver disorders are common and may result from a virus, obesity, insulin resistance, or exposure to toxic substances, such as alcohol, or tumors.
• The liver, the largest gland of the body and a major organ, can be considered a chemical factory that manufactures, stores, alters, and excretes a large number of substances involved in metabolism.
• The location of the liver is essential because it receives nutrient-rich blood directly from the gastrointestinal (GI) tract and then either stores or transforms these nutrients into chemicals that are used elsewhere in the body for metabolic needs.
• The liver is especially important in the regulation of glucose and protein metabolism.
• These alterations necessitate careful medication administration and monitoring; if appropriate, reduced dosages may be needed to prevent medication toxicity.
• Metabolism of medications by the liver decreases in the older adult, but such changes are usually accompanied by changes in intestinal absorption, renal excretion, and altered body distribution of some medications secondary to changes in fat deposition.
• If liver function test results are abnormal, the patient is evaluated for liver disease.
• Liver function tests do not normally change with age; abnormal results in older patients indicate abnormal liver function and are not a result of the aging process itself.
• The bioavailability of an oral medication can be decreased if the medication is metabolized to a great extent by the liver before it reaches the systemic circulation, a process known as first-pass effect.
• IV or injection drug use, sexual practices, and foreign travel are all potential risk factors for liver disease.
• In the older adult, the most common change in the liver is a decrease in size and weight, accompanied by a decrease in total hepatic blood flow.
• The patient's occupational, recreational, and travel history may assist in identifying exposure to hepatotoxins (e.g., industrial chemicals, other toxins).
• The patient's history of alcohol and drug use, including but not limited to the use of intravenous (IV) or injection drugs, provides additional information about exposure to toxins and infectious agents.
• A thorough medication history should address all current and past prescription medications, over the-counter (OTC), medications, herbal remedies, illicit drugs, and dietary supplements.
• The health history focuses on previous exposure of the patient to hepatotoxic substances or infectious agents.
• Lifestyle behaviors that increase the risk of exposure to infectious agents are identified.
• Some medications have such a large first-pass effect that their use is essentially limited to the parenteral route, or oral doses must be substantially larger than parenteral doses to achieve the same effect.
• Enlargement of the liver is an abnormal finding that requires evaluation.
• Serum aminotransferases are sensitive indicators of injury to the liver cells and are useful in detecting acute liver disease such as hepatitis.
• Tenderness of the liver indicates recent acute enlargement with consequent stretching of the liver capsule.
• A wide range of diagnostic studies may be performed in patients with hepatic disorders.