Where it is
Right upper quadrant under the diaphragm, protected by the lower ribs. It receives blood from the hepatic artery and from the hepatic portal vein, which brings nutrient-rich blood from the gut.
What it does
Produces bile, clotting factors and albumin; stores glycogen, iron and vitamins; metabolizes drugs and alcohol; converts ammonia to urea.
Clinical relevance
- Liver failure causes bleeding (fewer clotting factors), edema and ascites (low albumin), jaundice and encephalopathy (high ammonia).
- Many drugs are hepatotoxic, including acetaminophen in overdose.
- A liver biopsy is followed by lying on the right side to compress the puncture site.
Nursing focus
- Teach clients to keep acetaminophen under the maximum daily dose and avoid alcohol.
- In hepatic encephalopathy, give lactulose as prescribed and expect 2–3 soft stools per day.