Liver cirrhosis is a chronic, irreversible liver disease. Inflammation and fibrosis of liver cells (hepatocytes) lead to formation of scar tissue within the liver, which causes obstruction of hepatic blood flow and impedes proper liver function. This impaired blood flow leads to edema, ascites, esophageal varices, hemorrhoids, and varicose veins, among many other things. Since the liver is responsible for making many of the chemicals required by the body to function, breaking down and detoxifying substances and storing vitamins and minerals, many of the body’s systems fail to function when the liver is damaged.
Liver cirrhosis is primarily caused by diseases that damage the liver and leave scar tissue in place of healthy tissue. Alcoholic liver disease (26%) and Hepatitis C (21%) are the cause behind 47% of liver cirrhosis cases in the United States. Other factors such as nonalcoholic fatty liver disease, Hepatitis B and D, autoimmune disease and chronic heart failure with liver congestion may also result in cirrhosis.
Minimize progressive liver damage, optimize nutrition, maximize hepatic circulation, minimize and prevent respiratory complications
Note impaired gas exchange and compromised respiratory function
Assess for decreased or labored breathing
Coagulation chemicals such as prothrombin and fibrinogen. Damage to the liver may alter the production of these chemicals and increase risk of bleeding.
Impaired liver function can cause the patient to be easily fatigued. Encourage rest periods and cluster care to conserve energy for nutrition and self-care.
If ascites progresses, it may be necessary to perform paracentesis to drain the abdominal fluid. Assist with set-up and positioning of patient, post-procedure site assessments and monitoring.
Malnutrition is often a complication of liver disease but may go unnoticed due to increase in weight. Encourage and education patient to maintain diet low in sodium and fat.
Avoid alcohol, seek treatment for alcohol dependence.
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