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 .

 

 

NURSING INTERVENTIONS:

 

      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.