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Cirrhosis of the Liver Nursing Care Management Symptoms NCLEX

RegisteredNurseRN・29 minutes read

Cirrhosis is a liver disease caused by factors like viral infections, alcohol consumption, obesity, and bile duct issues, leading to liver cell damage and impaired liver function. The liver plays vital roles in filtering blood, metabolizing substances, producing bile, clotting factors, and storing essential components, but cirrhosis disrupts these functions, causing complications like jaundice, liver cancer, and renal failure, requiring careful monitoring, diet management, and treatment options like liver transplant or shunting surgery.

Insights

  • Cirrhosis is a liver disease caused by factors like viral infections, alcohol consumption, obesity, and bile duct issues, leading to liver cell damage and scarring that impairs essential liver functions like blood filtration, substance metabolism, and detoxification.
  • Liver dysfunction in cirrhosis results in symptoms such as jaundice, glucose metabolism issues, fluid accumulation causing ascites, and decreased clotting factors, highlighting the importance of avoiding certain medications and alcohol to maintain liver health, as well as managing complications like portal hypertension and ascites to prevent severe outcomes.

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Recent questions

  • What is cirrhosis?

    Liver disease causing scarring and impaired function.

  • What are the symptoms of cirrhosis?

    Tremors, yellowing skin, loss of appetite, and more.

  • How is cirrhosis diagnosed?

    Liver biopsy, imaging tests, blood tests for enzymes.

  • What are the complications of cirrhosis?

    Portal hypertension, ascites, liver cancer, and more.

  • How is cirrhosis treated?

    Liver transplant, diuretics, dietary considerations, and more.

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Summary

00:00

Understanding Cirrhosis: Liver Damage and Function

  • Cirrhosis is a liver disease where liver cells are replaced by fibrosis tissue, causing scarring and hindering liver function.
  • Common causes of cirrhosis include viral infections like hepatitis C or B, heavy alcohol consumption, increased fat accumulation in the liver due to obesity, long-term hyperlipidemia, diabetes, bile duct issues, and autoimmune conditions.
  • The liver works in conjunction with the gallbladder to produce bile, which aids in digesting fats. Any obstruction in the bile duct can lead to bile backflow, damaging liver cells over time and causing cirrhosis.
  • The liver's crucial functions include filtering blood, metabolizing substances, detoxifying harmful elements, storing essential substances like bile and proteins, and producing vital components such as clotting factors.
  • The liver receives blood from the hepatic portal vein, rich in nutrients but low in oxygen, and the hepatic artery, providing oxygenated blood. These blood supplies are essential for the liver's survival and function.
  • The liver's lobules contain hepatocytes that filter blood, with the hepatic portal vein and artery flowing into sinusoids and eventually draining into the central vein for circulation back to the heart.
  • Hepatocytes produce bile, which contains bilirubin, a byproduct of red blood cell breakdown. Bilirubin is metabolized in the liver and excreted in bile, giving stool its characteristic color.
  • In cirrhosis, damaged hepatocytes lead to bilirubin leakage into the blood, causing jaundice with yellowing of the skin and eyes. Clay-colored stools result from the absence of bilirubin in the stool due to liver dysfunction.
  • Liver dysfunction in cirrhosis affects glucose metabolism, leading to hyperglycemia or hypoglycemia, impairs lipid and protein metabolism, causing ammonia buildup and neurological issues, and disrupts vitamin storage and absorption, impacting bone health and clotting abilities.
  • Cirrhosis also results in decreased albumin production, leading to decreased oncotic pressure in capillaries, fluid accumulation in tissues causing ascites and edema, and reduced clotting factors, increasing the risk of bleeding.

15:36

Understanding Cirrhosis: Liver Function and Complications

  • Medications help reduce harm to the body, emphasizing the importance of good liver function for patients taking drugs.
  • Patients with severe liver disease and cirrhosis should avoid certain drugs like sedatives and Tylenol, as well as alcohol due to the liver's role in metabolizing substances.
  • The liver aids in removing hormones like estrogen, but in cirrhosis patients, estrogen levels can rise, leading to symptoms like gynecomastia, itchy red palms, and spider angiomas.
  • Complications of cirrhosis include portal hypertension, splenomegaly, esophageal and gastric varices, leading to increased risk of bleeding and infection.
  • Ascites, fluid volume overload, can occur in cirrhosis patients, leading to swelling in the legs and abdomen, increasing infection risk due to compromised immune systems.
  • Jaundice, clay-colored stools, renal failure, hepatic encephalopathy, asterixis, and hepatic fetor are late-stage complications of cirrhosis.
  • Cirrhosis can also lead to liver cancer, bone fractures, diabetes, and multi-organ failure, affecting the brain and renal system.
  • Signs and symptoms of cirrhosis include tremors, hepatic fetor, eye and skin yellowing, loss of appetite, increased bilirubin and ammonia levels, varices, edema, reduced platelets, and white blood cells.
  • Itchy skin, spider angiomas, splenomegaly, confusion/coma, ascites, red palms, renal failure, enlarged breasts in men, and vitamin deficiencies are also symptoms of cirrhosis.
  • Diagnosis of cirrhosis involves liver biopsy, imaging tests, blood tests for liver enzymes, platelets, clotting factors, and hepatitis B or C presence, while nursing interventions focus on glucose monitoring, bleeding risks, varices management, toxin buildup monitoring, and dietary considerations for hepatic encephalopathy.

30:47

Diet and Monitoring for Cirrhosis Patients

  • For patients with confusion due to hepatic encephalopathy, a low protein diet is recommended to reduce the production of ammonia in the liver. Conversely, those without confusion should follow a high lean protein diet to compensate for the liver's inability to produce proteins. Additionally, a low sodium diet is advised to manage fluid retention, while alcohol and raw seafood, like oysters, should be avoided due to the risk of infection and the liver's compromised detoxification abilities.
  • To address fluid volume overload in cirrhosis patients, strict intake and output monitoring is crucial, along with measuring abdominal girth, daily weights, and turning every two hours to prevent skin breakdown. Patients should avoid lying supine due to pressure on the lungs and heart, and activity intolerance puts them at risk for falls. Treatment options include liver transplant, shunting surgery, diuretics, beta blockers, nitrates, blood products, vitamin K administration, and paracentesis to alleviate ascites.
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