Cirrhosis Flashcards
- Extensive scarring of the liver caused by necrotic injury or a chronic reaction to inflammation over prolonged period of time
- Repeated destruction of hepatic cells causes the formation of scar tissue.
Cirrhosis
All of the following are s/s of what?
- SHOb
- Jaundice
- Increased Abd girth /pain and bloating
- Enlarged spleen (splenomegaly)
- Elevated liver enzymes
- Increases risk of bleeding
- Thrombocytopenia
- Prolonged PT →↓ PIt’S.
- Hemorrhoids
- Elevated serum ammonia levels
- Change in LOC
- Changes in motor function
- Hyponatremia
- ASTERIXIS
- Infection d/t ↓ WBC’s
- Chronic dyspepsia ( GI upset)
Cirrhosis
Risk factors for cirrhosis
- Alcohol use disorder
- Chronic viral hepatitis (A,B, C)
- Autoimmune disease
- Steatohepatisis
- Damage to liver by meds, substance toxins, infections (hepatoxins)
- Chronic biliary cirrhosis
- Fatty liver
fatty liver disease causing chronic inflammation
Steatohepatitis
bile duct obstruction, bile stasis, hepatic fibrosis
Chronic bilary cirrhosis
Medications used to treat cirrhosis
- Diuretics
- Beta-blocking agents
- lactulose
- Electrolyte replacements
- Neomycin
- Ferrous sulfate and folic acid
- Vitamin K
- Blood products
- FFP
Medication used to decrease excess fluid in cirrhosis patients
diuretics
This medication is used in cirrhosis patients to manage systemic hypertension
Beta blocking agents
Medication used in cirrhosis patients to promote excretion of ammonia through stool
lactulose
flapping tremor of the hand when wrist extended
Asterixis
This medication is used in cirrhosis patients to destroy the bacteria that produces ammonia
neomycin
Why might a cirrhosis patient need potassium replacement
Potassium levels may be low associated with vomiting, diarrhea secondary to treatment for elevated ammonia levels, the use of diuretics, or low dietary intake of potassium-rich foods.
Why might a cirrhosis patient have hypomagnesmia
patients with a history of alcohol abuse is a result of poor nutrition and diarrhea.
Why might a patient with cirrhosis have hypophosphatemia
low phosphate levels, due to alcohol abuse, poor nutrition, use of diuretics
Liver disorders can affect ______ causing cirrhosis patients to need vitamin K or blood products
Clotting factors
Dietary teaching for cirrhosis patients
- Restrict sodium – less than 2grams per day
- Restrict fluid intake as ordered — Prevents fluid accumulation and edema
- Restrict protein intake — Elevated amounts of protein in the diet can raise ammonia levels and lead to hepatic encephalopathy.
- Instructed to eat small, frequent meals
A treatment for cirrhosis that removes several liters of fluid to relieve client’s clinical manifestations of abdominal bloating/pain and SHOB
Paracentesis
A treatment for cirrhosis that involves the placement of a shunt between the portal venous system and the systemic venous system to reduce ascites accumulation by decreasing portal pressure.
Transjugular intrahepatic portosystemic shunt
or
TIPS