I am by far not a pediatric nurse, but a couple of things come into mind. First of course would be underlying medical conditions such as live size, functioning liver, cardiac failure, and disease processes of the liver.
Some things off the top of my head is checking for patency of liver function such as in size .. which I found this article from one of my books .."The most reproducible method in estimating liver size in neonates is either (1) percussion of the upper and lower borders of (2) percussion of the upper border and palpation of the lower border. The clinical estimate of liver size in a healthy term neonate is 5.65 cm.".....For doing so, remember that neonates are more prone to biliary problems.
Also remember cardiac assessment can be made as well from the liver. Hepatojuglar Reflux (not reflix) can be assessed by palpating the liver for 15-30 seconds and watching jugular distention, indicating possible right side failure.
Most of the medications that we use in the emergency arena are absorbed and distributed through the hepatic system into the circulatory system and diseased liver will decrease the functioning state.
Genetic defects such as Trisomony ( I believe III) will also affect the liver size and are prone to hepatic problems and associated cardiac problems such as enlarged atriums, and increasing problems such as failure. ..
Again, ped.'s are not my bag.. but, interesting thoughts of why they are stressing. I will try to get more info as well.. thanks!
R/r 911
