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By reading this article and writing a practice profile, you can gain ten continuing education points (CEPs). You have up to a year to send in your practice profile. Guidelines on how to write and submit a profile are featured at the end of this article.
Key words
* Anatomy and physiology
* Hepatitis
* Jaundice
* Liver disorders
These key words are based on subject headings from the British Nursing Index. This article has been subject to double-blind review.
Aims and intended learning outcomes
The aim of this article is to provide an overview of the liver and to examine the assessment and care of patients with liver dysfunction. After reading this article, you should be able to:
* Accurately recall the functions of the liver.
* Describe the investigations that can be used in liver failure.
* Describe the assessment of the patient with liver disease.
* Identify the possible causes of liver disease.
* List the signs and symptoms of acute and chronic liver disease and give the rationale for their occurrence.
* Identify the priorities of care for a patient admitted with acute or chronic liver failure.
Introduction
The liver is vital to life, with a wide functional ability not possessed by other organs. Although liver tissue has a considerable regenerative capacity, it can malfunction under certain conditions. The diversity of reactions taking place in the liver is then made apparent in the widespread effects of abnormal liver function. Because of this, liver failure represents a huge challenge to nurses.
Structure of the liver
The structure of the liver, together with its specialised blood supply, enables this organ to play a central role in metabolism, while also protecting the body from microbes and toxins absorbed via the digestive tract (Figure 1). The liver is the largest glandular organ in the body (Huether and McCance 1996). It makes up 5 per cent of the neonate's body weight, but this proportion changes to 2 per cent (approximately 1.4kg) by adulthood (Mowat 1994). It is located in the abdominal cavity, under the right side of the diaphragm.
The liver is encapsulated within a fibrous coat-- Glisson's capsule. It has four lobes: the left lobe and the larger right lobe, which...