CIRRHOSIS OF THE LIVER
It is a chronic disease characterized by scarring of the liver although viral hepatitis, biliary obstruction, and severe right-sided heart failure may cause cirrhosis, alcohol is the most frequent cause .
¨ Monitor the vital signs of the patient: Blood pressure, temperature, pulse and respirations.
¨ Give psychological support to the patient and his/her family.
¨ Assess for presence of ascitis and measure abdominal girth daily.
¨ Weight and size the patient.
¨ Obtain weight history.
¨ Check for dullness on percussion.
¨ Assess for signs of portal hypertension.
¨ Provide dietary management: Dietary/pharmacology vitamin supplementation high in calories.
¨ Schedule small frequent meals.
¨ Restrict fluid and sodium intake as ordered.
¨ Monitor glucose levels. Patients with cirrhosis may be hypoglycemic as the liver fails to perform glicolisis.
¨ Monitor coagulation profile. Several coagulation factors are made by the liver. Patients with cirrhosis frequently have coagulopathy severe enough to precipitate bleeding.
¨ Monitor for hematemesis (vomited blood), hematochezia (Bright red blood per rectum), melena (dark stool).
¨ Administer medication prescribed by the doctor on time: Sedatives as prescribed.
¨ Prevent over sedation that precipitates coma .
¨ Administer nonabsorvable antibiotics (Neomycin, Kanamycin) as prescribed.
¨ Pipe a vein as ordered.
¨ Administer IV fluids and /or blood products as prescribed.
¨ If gastrointestinal bleeding occurs, increase IV fluids to prevent complications of hypovolemia.
¨ Assess for change in orientation and/or behavior.
¨ Keep skin clean and well moisturized.
¨ If the patient is alcoholic refer him/her to alcohol rehabilitation program.