Cirrhosis Flashcards
What is cirrhosis? What are the types?
Extensive and irreversible scarring of the liver
Post-Necrotic/Post Hepatic-drugs/toxins/viruses
Laennec’s-Alcohol consumption
Biliary-gallbladder disease/autoimmune
Cardiac- right sided heart failure
What puts an individual at risk for developing cirrhosis?
Alcohol consumption
Hepatitis (C mainly, sometimes B)
RS heart failure
Gallbladder diseases
If uncontrolled, what are some major complications for cirrhosis?
Hepatorenal syndrome
Spontaneous bacterial peritonitis
Hepatopulmonary syndrome
What are s/s of early stage cirrhosis?
Fatigue/weakness Weight loss Anorexia Tender abdomen (URQ and Back) Vomiting
What are a/s of late stage cirrhosis?
Asterixis (hand tremor) Hepatic foetor (bad breath) Jaundice Increased ammonia (resulting in mental status change) Edema in legs (result of low albumin and congested hepatic veins) Varices Decreased appetite Deficient fat soluble vitamins (b13, A, C, D, E, K) Itchy skin Spider angiomas Ascietes Splenomegaly Impotence, infertility
How is cirrhosis diagnosed?
Liver biopsy, liver enzyme labs (AST, ALT), platelet/PT/INR labs, bili levels, Hep b/c dx
What should the nurse consider when caring for/teaching a patient with cirrhosis?
Avoid alcohol and Tylenol
Limit invasive procedures/injections
If Nero system compromised, low protein diet. If not, high in lean protein (no uncooked seafood)
Pt is at risk for activity intolerance
What medications might a cirrhosis pt have on board? Why?
Lactulose-decrease ammonia through diarrhea
Spironalactone/Lasix-decrease fluid load
Vasopressin/Nadalol/nitroglycerin-decreases portal vein pressure and BP in varices
Vanc/metronidazole-antibiotic to treat underlying infection
Ferrous sulfate, folic acid, Vit K-replace vitamins and assist in clotting
What are nursing considerations for a patient who has a paracentesis?
Weigh before and after procedure Elevate head of bed before Encourage pt to void before Measure and describe the drainage Bed rest post
What other interventions might a pt with cirrhosis have?
Liver transplant Administer blood products and Vit K Paracentesis EVL banding Sclerotherapy Balloon tamponade TIPS procedure
