Liver Cancer and Transplantation Worksheet PDF

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Liver Cancer and Transplantation Worksheet (from Lewis text)

1. _____________________ liver cancer originates in the liver. 2. Liver cancer is the most common cause of death in patient with ________________. 3. Hepatitis ___ is the most common cause of hepatocellular carcinoma in the United States; followed by __________________ cirrhosis. 4. Primary liver cancer commonly metastasizes to the _____________. 5. Metastasis to the liver is more than primary liver cancer because the liver has a high rate of _____________ flow and an extensive ___________________ network. 6. Clinical manifestation in early liver cancer can be ________________ or subtle. 7. What are 2 of the symptoms the patient may present with? 8. In late stages, patient may have manifestations like fever/chills, ____________________, anorexia, weight loss, palpable mass, and _____________________________. Diagnostics 9. Diagnostics and screening for liver cancer include __________________, CT, and MRI? What are the two major risks associated with a percutaneous biopsy? 10. ________________________ of liver cancer focused on identifying and ______________ chronic hepatitis B and C. 11. Screening involved CT, MRI, ultrasound and what serum blood work? 12. Treatment varies widely and depends on many factors. _________________ _______________ resection offers the best change for cure, but only able 15% have enough healthy tissue for this be an option. 13. For patients who are diagnosed early and have impaired liver function, liver _________________ offers another solution. 14. What happens during an ablation? What are two complications of ablation? 15. TACE works by _______________________ off blood supply to the tumor and exposing tumor cells to chemotherapy. TARE works by ___________________ releasing __________________ material directly into the side of the tumor. 16. In advanced stages, __________________, is the first line treatment. This blocks tumor cell growth and slows progression. 17. Nursing interventions focus on keeping the patient as ___________________ as possible. Early screening and surveillance programs for patients with _______________________ ______________ and/or ___________________________ are critical for early detection and treatment. 18. Without treatment, patient deaths most commonly result from what two things? Liver Transplantation 19. Liver transplantation has becoming a practical option. Liver disease related to ________________ hepatitis is the leading indication for liver transplant.

20. Liver transplant candidates much go through a _______________________ transplant evaluation. Potential candidates are counseled regarding _____________________ smoking and __________________ abstinence. 21. Liver transplant is performed using both deceased ______________ and liver donor livers. Live liver donation poses several risks to the donor, 3 of which are? 22. Due to the limited number of donor livers, sometimes a ________________ ______________ transplant can be performed in which a donor liver is split and implanted into two matching recipients. 23. Post-operative complications include _____________________, infection, and ________________. 24. However, the liver is subject to _______________ aggressive immunologic attack (when compared to other organs). Immunosuppression is still required. Triple therapy is used; combining a ________________________ (like prednisone), a calcineurin inhibitor (like ____________________ or tacrolimus), and an antiproliferative agent. 25. After 80% of liver transplant patients survive more than _________ years after transplant. Patient who had Hepatitis B or C are subject to ________________________ of the transplanted liver. 26. Patients with hepatitis C have the ___________ survival rates post-transplant. However, direct acting antiviral have the potential to cure hepatitis C and could decrease the need for transplant in this patient population. 27. What does post-operative care include? 28. What is one common respiratory problem after surgery? 29. The first _________ ____________________ are critical for monitoring for infection. ______________ may be only sign of infection in these patients.

Answers. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

Primary Cirrhosis C; alcoholic Lung Blood; capillary Absent Hepatomegaly; fatigue, ascites Jaundice, right upper quadrant pain Ultrasound; bleeding and potential tumor cell seeding Prevention; treating Serum alpha fetoprotein (this is elevated in nearly 60% of cases) Surgical liver Transplantation A thin needle is inserted into the core of tumor; substances and temperature probes are injected to destroy the tumor; infection and bleeding

15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29.

Shunting; slowly; radioactive sorafenib (Nexavar) comfortable; chronic hepatitis; cirrhosis hepatic encephalopathy; or massive blood loss via GI bleed chronic rigorous; cigarette; alcohol cadaver; biliary problems; wound infection; pneumothorax split liver; bleeding; rejection less; corticosteroid; cyclosporine 5; reinfection Lowest Assess neuro status; prevent pulmonary complications; monitor for signs of hemorrhage Pneumonia 2 months; fever...