Cirrhosis Flashcards
Etiology of Cirrhosis
Hep c & alcohol Extreme dieting Genetic Malabsportion Obesity
Early manifestations o
fatigue
enlarged liver
Blood tests may be normal liver function
compensated cirrhosis
Late manifestations
Results from liver failure & portal hypertension
Jaundice peripheral edema Ascites skin lesions hematologic problems
Due to increase in circulating estrogen due to inability of liver to metabolize steroid hormones
Skin lesions
Skin lesions
- Spider angiomas* (telangiectasia or spider nevi)
* Palmar erythema*
Common finding in alcoholic cirrhosis
Peripheral neuropathy
Sensory and motor symptoms
Asterixis: pts have hard time maintaining position
Hepatic Encephalopathy
In men
gynecomastia
In women
amenorrhea or vaginal bleeding
Diagnostic studies
LIVER BIOPSY Liver enzyme tests Alkaline phosphatase AST ALT GGT
Diagnostic studies elevated:
serum bilirubin
Globulin levels
Diagnostic studies decreased:
Cholesterol levels
Complications of cirrhosis
Portal HTN
Esophageal & Gastric varies
Mechanical compression of varices (thru nose or mouth)
Balloon Tamponade
Balloon tamponade care
- Explanation of procedure, Check for patency
2. Position of balloon verified by x-ray
Renal failure with azotemia, oliguria, and intractable ascites
Hepatorenal Syndrome
Hepatorenal Syndrome treat with
liver transplantation
Ascites treatment
c. Sodium restriction
d. Diuretics, fluid removal
e. Albumin
f. Paracentesis Accurate I/O recording
g. Daily weight measurement
h. Extremities measurement
i. Abdominal girth measurement
Neurotoxic effects of ammonia
Hepatic Encephalopathy
Hepatic Encephalopathy symptoms
Impaired consciousness
Inappropriate behavior
Sleep disturbances
trouble concentrated
Hepatic Encephalopathy what is involved?
Asterixis (flapping tremors)
Imparment in writing
Fector hepaticas (musty, sweet odor of breath)
Treatment of a. Hepatic encephalopathy
safety Reduce ammonia Lower dietary protein intake control GI bleeding Remove blood from GI tract
Nursing Management (encephalopathy)
Neuro check every 2 hrs
Monitor LOC prevent constipation encourage fluids
