Chapter: Medical Surgical Nursing: Assessment and Management of Patients With Hematologic Disorders

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Liver Disease - Acquired Coagulation Disorders

With the exception of factor VIII, most blood coagulation factors are synthesized in the liver.

Acquired Coagulation Disorders

LIVER DISEASE

With the exception of factor VIII, most blood coagulation fac-tors are synthesized in the liver. Therefore, hepatic dysfunction can result in diminished amounts of the factors needed to maintain coagula-tion and hemostasis. Prolongation of the PT, unless it is caused by vitamin K deficiency, may indicate severe hepatic dysfunction. Although minor bleeding is common (eg, ecchymoses), these pa-tients are also at risk for significant bleeding, related especially to trauma or surgery. Transfusion of fresh frozen plasma may be re-quired to replace clotting factors and to prevent or stop bleeding. Patients may also have life-threatening hemorrhage from peptic ulcers or esophageal varices. In these cases, replacement with fresh frozen plasma, PRBCs, and platelets is usually required.

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