Liver Cirrhosis
Liver Cirrhosis
- Liver cells are destroyed and replaced by scar tissue.
- Liver cannot synthesize albumin, clotting factors, detoxify the body, and metabolize drugs.
- Causes: #1 alcohol, Hepatitis C and B, autoimmune, hepatotoxic drugs, toxins, and fat collection in liver due to obesity.
Complications
Portal Hypertension
Persistent increased in pressure of portal vein that develops due to obstructed flow.
Ascites
Accumulation of fluid in peritoneal cavity
Esophageal Varices
Spider-like. Fragile, thin-walled esophageal veins that may rupture. GI bleeding can occur.
Clotting Problems
Liver makes clotting factors and decreased synthesis of bile salts prevents absorption of fat soluble vitamins (ADEK vitamins). Without vitamin K clients are prone to bleeding.
Jaundice
Liver is unable to metabolize bilirubin and it accumulates. The accumulation of bilirubin causes itchy skin
Encephalopathy
End-Stage hepatic failure causing CNS alterations (ALOC, impaired thinking, neurological symptoms).
Splenomegaly
Hepatorenal Syndrome
Signs and Symptoms
- Asterixis (liver flap)
- Ascites
- Edema
- Abdominal Pain
- Chronic Dyspepsia (GI upset)
- Itchy skin
- Jaundice
- ↑ Bilirubin and ammonia
- ↓ Platelets (bleeding)
- Infection risk
Treatment
- Stop ALCOHOL
- Paracentesis for ascites
- Monitor weight
- Low protein, low sodium, low fluids
- Diuretics
- Neomycin and lactulose for increased ammonia and hepatic encephalopathy
- HOB elevated
- Supplemental vitamins
- NG tube or balloon tamponade for bleeding esophageal varices
- Liver transplant
- Bleeding precautions
- use electric razor
- soft-bristled toothbrush
- hold pressure on scrapes/cuts/IV’s that are discontinued
NCLEX Alert: Liver Cirrhosis
NCLEX Alert: Liver Cirrhosis
