Liver Function Tests: Liver Enzymes – Blood Tests for Cholecystitis (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Gallbladder Cholecystitis Lab Work Diagnostics.pdf
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    00:01 Now, let's take a look at the liver function tests.

    00:03 Okay.

    00:04 Don't feel overwhelmed.

    00:06 That's normal when you look at all this like, oh my goodness.

    00:09 How am I going to remember all this? Relax, we've got you covered.

    00:14 Okay these are the four specific enzymes we're going to look at ALT, AST, ALP and GGT, you do notice that it in use those big long fancy names right? Because when we're speaking to each other in the hospital, That's what we call these.

    00:31 Now, you need to understand that they stand for a very long name, but we always use that shortened version when we are communicating with each other.

    00:40 These are four important enzymes that are made in the liver and a few other places in your body that I'll go over as we walk through each one.

    00:49 Keep in mind an enzyme is a protein that helps trigger chemical reaction that your body needs to function.

    00:56 So we're going to break down each one, but what I want you to take away from this slide before we even move forward is that each one of these four important enzymes are looked at together.

    01:08 This is what helps give us a complete clinical picture of what's going on with our patient.

    01:14 Another thing, look at AST and ALT, see this makes me happy because those normal values are the same.

    01:23 So that's a fairly easy one to remember.

    01:26 There are so many lab values to remember, I love it when one seems pretty straightforward, so I want to make sure that you focus on memorizing those normal values and you can use are remembering tools, our spaced repetition tools to help you do that.

    01:44 So let's start with AST.

    01:46 Now, I'm not going to spend a whole lot of time on this one because I got something better for you.

    01:52 But keep in mind we're going to take a look at this, AST, it's an enzyme, its normal value is 0 to 35, but this This is the one I want you to put a star by in your notes, ALT.

    02:06 Now this one is more specific for the, liver.

    02:10 You got it when they do just with my nursing students, I always say okay guys, I know this means loser but it also means liver.

    02:17 So if I'm thinking about AST and ALT, alt is more specific for the liver.

    02:23 Let me help you understand why.

    02:25 ALT is normally found inside the liver cells, but when your liver is damaged or even inflamed you see that itís, the ALT can be released into your bloodstream.

    02:39 That's when we got it because this will cause your serum ALT levels to rise.

    02:45 So when someone calls and draws a blood sample to take it to the lab, an ALT is elevated that means your liver cells have been damaged.

    02:56 Alt has been released into the bloodstream and that's why we're able to detect a level that's higher than normal on lab work.

    03:04 Okay now some other names is goes by you might see it as SGPT, or you might see it as an alanine transaminase test.

    03:12 You've got those other names, but normally you'll hear us refer to it as an ALT.

    03:17 So just a quick review which one is more specific for liver enzymes.

    03:23 AST or ALT? ALT, you got it, It's the liver tests.

    03:29 Now we look at all four of these tests together to get a full picture, but I'm going to tell you the strengths and weaknesses of each one.

    03:38 Now next up, we've got GGT.

    03:40 A normal value, there is nine to 48.

    03:42 Now GGT is concentrated in the liver.

    03:46 Remember I told you these are mostly from the liver but they can come from other parts on your body.

    03:50 Right GGT is an example of that one.

    03:54 It's concentrated in the liver, but it's also present in the gallbladder, the spleen, the pancreas and the kidneys.

    04:02 So GGT blood levels are usually high when the liver is damaged, pair that with an ALT level that's high.

    04:10 Now we're starting to really focus the clinical picture.

    04:14 Now last up the ALP test, this measures the amount of alkaline phosphatase enzyme in your bloodstream.

    04:20 That's why we call it the ALP test.

    04:23 Now your liver is one of the main sources of ALP.

    04:28 But some of its also made in your bones, in your intestines, in your pancreas, and your kidneys.

    04:32 Don't let that get you distracted.

    04:35 So the liver is one of the main sources of ALP and that's really what we're focusing on here.

    04:42 Now, there is a side note, I want to bring to your attention.

    04:45 If a patient is pregnant ALP is also made in the placenta.

    04:50 So just like anything lab values mean nothing unless you compare them to specific variables about your patient, but here's kind of an overview when you're looking at these four important liver enzymes.

    05:02 I want to look at them together to get a full clinical picture.

    05:06 Remember, ALT is more specific than AST, but they share the same value.

    05:11 We're also going to look at the GGT and the ALP to get a complete clinical picture.

    About the Lecture

    The lecture Liver Function Tests: Liver Enzymes – Blood Tests for Cholecystitis (Nursing) by Rhonda Lawes, PhD, RN is from the course Gallstones and Cholecystitis: Diagnosis (Nursing).

    Included Quiz Questions

    1. Aspartate transaminase (AST)
    2. Alanine transaminase (ALT)
    3. Alkaline phosphatase (ALP)
    4. Asparatame peptide (AP)
    5. Acid phosphatase (ACP)
    1. Alanine transaminase (ALT)
    2. Gamma-glutamyl transpeptidase (GGT)
    3. Alkaline phosphatase (ALP)
    4. Aspartate transaminase (AST)
    1. 0–35 units/L
    2. 0–60 units/L
    3. 0–80 units/L
    4. 0–50 units/L

    Author of lecture Liver Function Tests: Liver Enzymes – Blood Tests for Cholecystitis (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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