CIRRHOSIS NCLEX Review
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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