Pathophysiology: The Hepatobiliary System
Course #38910 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
The liver, the gallbladder, and the exocrine pancreas are classified as accessory organs of the gastrointestinal tract and digestion. They introduce digestive hormones and enzymes into the alimentary canal, ensuring that the nutrients critical to life can be absorbed selectively by the small intestines into the bloodstream. In addition to producing digestive secretions, the liver and the pancreas have other important functions. The exocrine pancreas, for example, supplies the insulin and glucagon needed in cell metabolism, whereas the liver synthesizes glucose, plasma proteins, and blood clotting factors and is responsible for the degradation and elimination of drugs and hormones, among other functions. The liver and gallbladder perform several regulatory functions essential to the maintenance of homeostasis. The liver synthesizes a number of substances, including coagulation factors that are vital to life. The gallbladder plays an important role in the digestive process, in particular the digestion of fats. Although the human body can survive the loss of the gallbladder, survival without a liver is not possible. This course focuses on functions and disorders of the liver, the biliary tract, and the gallbladder.
- INTRODUCTION
- STRUCTURAL AND FUNCTIONAL INTER-RELATIONSHIPS
- PATHOPHYSIOLOGIC INFLUENCES AND EFFECTS
- RELATED SYSTEMS INFLUENCES AND EFFECTS
- PSYCHOSOCIAL/LIFESTYLE INFLUENCES AND EFFECTS
- NURSING ASSESSMENT: ESTABLISHING THE DATA BASE
- NURSING DIAGNOSES
- NURSE PLANNING AND IMPLEMENTATION
- NURSING EVALUATION
- CONGENITAL DISORDERS
- DISORDERS OF MULTI-FACTORIAL ORIGIN
- INFECTIOUS AND INFLAMMATORY DISORDERS
- NEOPLASTIC AND OBSTRUCTIVE DISORDERS
- LIVER TRANSPLANTATION
- CONCLUSION
- CASE STUDIES
- Works Cited
- Evidence-Based Practice Recommendations Citations
This course is designed for nurses in all practice settings.
As health care becomes more complex, it is essential that the theoretical concepts of the basis of illness (pathophysiology) be well understood. The purpose of this course is to reinforce the scientific rationales for the interventions nurses perform and the decisions nurses make as patients move through the ever-changing struggle with their illness.
Upon completion of this course, you should be able to:
- Identify and describe the anatomical structure of the liver.
- Explain the liver's functions, integrating how these processes inter-relate with the hepatic and biliary systems.
- Describe the anatomical location and structure and regulatory mechanisms of the gallbladder.
- Discuss the pathophysiologic effects of hepatobiliary dysfunction, including how these conditions impact overall health and clinical management.
- Review the impact of hepatobiliary dysfunction on the integumentary, cardiovascular, and neurologic systems.
- Analyze how psychosocial and lifestyle factors influence the risk and progression of hepatobiliary disorders.
- Conduct a comprehensive nursing assessment by effectively gathering and analyzing subjective and objective data related to hepatobiliary function.
- Outline and interpret various diagnostic studies for hepatobiliary disorders, including the purpose, procedure, and nursing implications for advanced diagnostic tests.
- Identify and formulate nursing diagnoses for patients with hepatic or biliary dysfunction based on comprehensive assessments.
- Outline a comprehensive nursing care plan for patients with hepatobiliary dysfunction.
- Differentiate between congenital disorders of the hepatic and biliary systems, specifically Gilbert syndrome and Alagille syndrome.
- Discuss cirrhosis, including demonstrating an ability to apply appropriate therapeutic measures for managing complications and execute specific nursing interventions.
- Differentiate between various forms of alcohol-induced liver disease.
- Evaluate the role of metabolic dysfunction in the development of metabolic dysfunction-associated steatotic liver disease (MASLD).
- Compare and contrast primary and secondary biliary cholangitis, including approaches to management.
- Identify and differentiate between various infectious and inflammatory disorders of the hepatobiliary system.
- Describe the various neoplastic and obstructive disorders affecting the hepatobiliary system.
- Outline the key criteria for liver transplantation candidacy and the processes involved in donor organ selection and transplantation.
Jane C. Norman, RN, MSN, CNE, PhD, received her undergraduate education at the University of Tennessee, Knoxville campus. There she completed a double major in Sociology and English. She completed an Associate of Science in Nursing at the University of Tennessee, Nashville campus and began her nursing career at Vanderbilt University Medical Center. Jane received her Masters in Medical-Surgical Nursing from Vanderbilt University. In 1978, she took her first faculty position and served as program director for an associate degree program. In 1982, she received her PhD in Higher Education Administration from Peabody College of Vanderbilt University. In 1988, Dr. Norman took a position at Tennessee State University. There she has achieved tenure and full professor status. She is a member of Sigma Theta Tau National Nursing Honors Society. In 2005, she began her current position as Director of the Masters of Science in Nursing Program.
Mary Franks, MSN, APRN, FNP-C, is a board-certified Family Nurse Practitioner and NetCE Nurse Planner. She works as a Nurse Division Planner for NetCE and a per diem nurse practitioner in urgent care in Central Illinois. Mary graduated with her Associate’s degree in nursing from Carl Sandburg College, her BSN from OSF Saint Francis Medical Center College of Nursing in 2013, and her MSN with a focus on nursing education from Chamberlain University in 2017. She received a second master's degree in nursing as a Family Nurse Practitioner from Chamberlain University in 2019. She is an adjunct faculty member for a local university in Central Illinois in the MSN FNP program. Her previous nursing experience includes emergency/trauma nursing, critical care nursing, surgery, pediatrics, and urgent care. As a nurse practitioner, she has practiced as a primary care provider for long-term care facilities and school-based health services. She enjoys caring for minor illnesses and injuries, prevention of disease processes, health, and wellness. In her spare time, she stays busy with her two children and husband, coaching baseball, staying active with her own personal fitness journey, and cooking. She is a member of the American Association of Nurse Practitioners and the Illinois Society of Advanced Practice Nursing, for which she is a member of the bylaws committee.
Contributing faculty, Jane C. Norman, RN, MSN, CNE, PhD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Contributing faculty, Mary Franks, MSN, APRN, FNP-C, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Margo A. Halm, RN, PhD, NEA-BC, FAAN
The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.