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OR Nurse:
doi: 10.1097/01.ORN.0000428351.85726.22
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Preparing for your patient's liver resection

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INSTRUCTIONS Preparing for your patient's liver resection

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Preparing for your patient's liver resection

GENERAL PURPOSE: To provide nurses with information about caring for patients undergoing liver resection. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Explain the indications for and the procedures used in liver resection. 2. Discuss the perioperative considerations surrounding liver resection.

1. Which statement is correct about liver resection for malignancies?

a. Resection is the treatment of choice in the absence of cirrhosis.

b. In patients with cirrhosis, significantly more parenchyma must be removed.

c. The extent of resection is determined by the surgical approach.

d. Surgical resection isn't recommended for metastatic lesions from colorectal cancer.

2. The maximum percentage of parenchyma that can be safely removed from a normal liver is

a. 35%.

b. 50%.

c. 65%.

d. 80%.

3. The Milan criteria for liver transplantation include the presence of

a. a single tumor with a maximum size of 8 cm (3.1 inches).

b. four or fewer tumors less than 2 cm (0.8 inches) in size.

c. three or fewer tumors each less than 3 cm (1.2 inches) in size.

d. five or fewer tumors less than 1 cm (0.4 inches) in size.

4. The most prevalent benign liver tumor is

a. hepatic adenoma.

b. focal nodular hyperplasia.

c. hemangioma.

d. hepatocellular hyperplasia.

5. Which statement about hepatic adenoma isn't accurate?

a. It has a risk for malignant degeneration.

b. It's associated with use of oral contraceptives.

c. It's a common benign tumor of the liver.

d. It presents a risk for intraperitoneal hemorrhage.

6. A living donor's liver regenerates to full size within as little as

a. a few weeks.

b. 3 months.

c. 6 months.

d. 9 months.

7. Antibiotics covering Gram-positive and Gram-negative organisms should be given to the liver resection patient

a. 8 hours preoperatively.

b. 1 hour preoperatively.

c. intraoperatively.

d. 1 hour postoperatively.

8. Which isn't a function of the liver?

a. fat metabolism

b. synthesis of clotting factors

c. conversion of ammonia to urea

d. conversion of glycogen to glucose

9. A central line placed for liver resection surgery is primarily used for

a. monitoring venous oxygen saturation.

b. blood sampling during surgery.

c. measuring volume status intraoperatively.

d. continuous BP monitoring.

10. The liver comprises

a. 8 segments.

b. 9 segments.

c. 10 segments.

d. 11 segments.

11. Metastatic liver disease is determined through a biopsy of the

a. diaphragm.

b. lymph nodes.

c. abdominal wall.

d. spleen.

12. Total vascular exclusion is used with patients undergoing

a. total lobectomy.

b. left hepatectomy.

c. resection of segments IV through VII.

d. resection of large masses near major veins.

13. A major benefit of the two laparoscopic approaches to liver resection is

a. lower patient mortality.

b. the ability to perform a hemihepatectomy.

c. allowing the resection of tumors with difficult access.

d. allowing the resection of large tumors.

14. Robotic-assisted liver resection has revolutionized

a. the removal of large masses.

b. right hepatectomy.

c. right lobectomy.

d. minimally invasive surgery.

15. After an uncomplicated liver resection, most patients go home in

a. 3 to 4 days.

b. 5 to 7 days.

c. 8 to 9 days.

d. 10 to 12 days.

16. Postoperative ascites most often occurs in patients with

a. the removal of large masses.

b. right hepatectomy.

c. cirrhosis.

d. hemihepatectomies.

17. Mortality from liver resection in patients with preexisting liver disease is

a. 10%.

b. 13%.

c. 16%.

d. 19%.

18. A postoperative biloma can be recognized by

a. increased bilirubin levels.

b. anorexia.

c. jaundice.

d. bile in the surgical drain.

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