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CIRRHOSIS

– Chronic disease that affects the liver.

TYPES OF CIRRHOSIS:
Laennec’s
Postnecrotic
Biliary

Hepatic Cirrhosis- scar tissue replaces normal healthy tissue, blocking the flow of blood throughout the liver, therefore preventing it from working.

Assessment
Fatigue
Nausea and Vomiting
Jaundice
Epistaxis
Hepatomegaly

DIAGNOSTICS:
Liver Scan
Blood Test: Low HCT, WBC, HB, High PT, PTT

Liver Biopsy

  • shows elevated bilirubin count
  • Increase in PT

COMPLICATIONS:

Ascites

  • it’s fluid in the peritoneal cavity.
Portal Hypertension (*Most Common)
  • causes splenomegaly
  • distention of veins.
Bleeding Esophageal Varices
  • Blood backs up to the liver and enters the esophageal and gastric vessels and carries it to the systemic circulation.
  • Esophageal Varices– are blister-like spots in the esophagus that is caused by portal hypertension due to cirrhosis
  • A sengstaken-blakemore tube maybe used to control the hemorrhage through the use of a balloon tampondade.
Coagulation Defects
  • Abnormal prolonged PT time.
  • Decrease synthesis of bile in liver.
Portal Systemic Encephalopathy (PSE)
  • Causes neurological  symptoms such as altered mental status and impaired thinking.

INTERVENTION:
Diet: High Calorie, High Carbohydrate and Low Fat
IV Therapy :

Sengstaken- Blakemore tube = Balloon Tamponade of Varices.

Drug Therapy:

  • Lasix and Spironolactane (Aldactone)= helps maintain the NA K+ balance.
  • Non selective beta blocker (Proranolol) helps decrease heart rate.

Paracentesis:

  • drains 1-3 L of ascitic fluid.
  • is done at the bedside
  • pr. will be ask to void
  • HOB is elevated up to 30 degrees.

SURGICAL PROCEDURE:

Peritoneavenous Shunt:

  • There is a one way valve that enable the fluid to flow from abdominal cavity to superior vena cava.
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