Liver Cirrhosis Flashcards
is a chronic disease characterized by replacement of normal liver tissue with diffuse fibrosis that disrupts the structure and function of the liver.
Cirrhosis
Most common causes of Liver Cirrhosis
Alcoholic Liver Disease
NAFLD
Non-alcoholic fatty liver
Risk factors of Non-Alcoholic Fatty Liver Disease (NAFLD)
-Obesity
- Hyperlipidemia
- Diabetes Mellitus
Autoimmune Risk factors
-Primary Biliary Cirrhosis
- Primary Sclerosing Cholangitis
Causes an abnormally high iron absorption from the GI Tract
Hereditary Hemochromatosis
Causes copper accumulation
Wilson Disease
Alcoholic Cirrhosis also known as
Laennec’s Cirrhosis
Rubor
Redness
Tumor
Swelling
Dolor
Pain
Calor
Warm
What are the cardinal signs of inflammation?
Rubor
Tumor
Dalor
Calor
functio laessa
loss of function
is a progressive decline in function for six or more months
Chronic Liver Disease
Small, dilated blood vessels with a bright red center point and spider-like branches
Spider Angiomas
Red area that blanches with pressure
Palmar Erythema
Clinical Manifestation of Hepatic Encephalopathy
-Decreasing LOC
- Asterixis
-Apraxia
- Fector Hepaticus
- Hyperventilation, hypothermia
Means flapping tremors
Asterixis
inability to
construct simple figures
Apraxia
Must, sweet breath
Fector hepaticus
Early Manifestation of Liver Cirrhosis
F- fever
R- Rapid, unexpected weight loss
A- Anorexia
W- Weakness
N- Nausea
Medical Management of Liver Cirrhosis
-Avoidance of alcohol
- S- adenosylmethionine (SAM-e)
-Halt or slow down the progression
-Colchicine
- Angiotension system inhibitors
- Statins
- Diuretics (Spirinolactone)
- Immunosuppresants
- Glitazones
The symptomatic treatment of ASCITES
-Sodium-restriction
- Diuretics, as ordered
-Furosemide + Spironolactone
The risk factors of Non-Alcoholic Fatty Liver, Chronic Viral Hepatitis and genetics is manifested in
Post-Necrotic Cirrhosis
Temporary removal of ascitic fluid from the peritoneal cavity
Paracentesis
Position of Paracentesis
Sitting or High-Fowlers position
Prevent bleeding and hemorrhage
Esophageal Varices
What’s the screening test of Esophageal Varices
Upper GI endoscopy
The medical Management of Esophageal Varices
-Propanolol (inderal)
- Avoid (aspirin, NSAIDS, Alcohol)
Management of Bleeding Esophageal Varices
-Ensure patent airway
- Assist in stopping the bleeding
- Administer Octreotide (Sandostatin), as ordered (first line)
-Administer vasopressin + Nitroglycerin, as ordered (second line)
-Endoscopy
- Ballon tamponade, if bleeding cannot be controlled through endoscopy (sengstaken-blakemore tube and minnesota tube)
What’s the nursing responsibilities of sengstaken- blakemore tube?
- Prepare scissors at bedside
- Label each lumen to avoid confusion
- Deflate the balloon for 5 minutes every 8- 12 hours per institutional policy
How many ports does the Sengstaken- blakemore tube have?
3 ports
How many ports does the Minnesota tube have?
4 ports
A non surgical procedure wherein a shunt is created between the systemic and portal venous system to redirect portal blood flow
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
What is contraindicated of TIPS?
- Severe hepatic encephalopathy
- Hepatocellular CA
What is the management goal of Hepatic Encephalopathy?
Reduce ammonia function
Management of Hepatic Encephalopathy
-Lactulose (Duphalac)- first line
- Rifamixin- second line
This medication has a laxative effect that expels ammonia with stool and also trap ammonia in the GI Tract
Lactulose (Duphalac)
This medication is used in patients who do not respond to lactulose
Rifaximin
Diet Therapy for Liver Cirrhosis
-“Butterball Diet” (High-calorie diet (3000 cal/day) with high CHO content and moderate to low levels of fat
- Protein restriction only if with hepatic encephalopathy
-Low sodium diet if with ascites and edema
