NSG315 Hepatic Cirrhosis Case Study

NSG315 Hepatic Cirrhosis Case Study

NSG315 Hepatic Cirrhosis Case Study

 

1. Identify risk factors for developing hepatic cirrhosis.

Liver cirrhosis refers to a shrunken scarred and hardened liver with potential for deterioration of liver function, … Wilson disease, hemochromatosis and other rare inherited liver disease (NIH.gov, 2018)

2. Identify signs and symptoms of patient with cirrhosis.

Signs and symptoms of liver disease include skin and eyes that appear yellowish (jaundice), abdominal pain and swelling, swelling in the legs and ankles, itchy skin, dark urine color, pale stool color or bloody or tar-colored stool, chronic fatigue, nausea or vomiting, loss of appetite, tendency to bruise easily (Ignatavicius, 2016)

3. Determine patient’s problems and prioritize care.

This patient problem was non-compliant with his medication, as the nurse …

 

4. Describe laboratory and treatments for patients with cirrhosis of the liver.

People with early stage cirrhosis of the liver usually don’t have symptoms, but it is first detected through a routine blood test or checkup. Some of the laboratory test that may suggest a problem with the liver such as cirrhosis include:

• Liver function – …
• Kidney function – …
• Tests for hepatitis B and C – …
• Biopsy – …

Treatment for cirrhosis include:

• Treatment for alcohol dependency –
• Weight loss –
• Medication to control hepatitis –
• Medications to control other causes and symptoms of cirrhosis –
• Excess fluid in your body –
• Paracentesis may help alleviate ascites and the Sengstaken-Blakemore or Minnesota tube may also help control hemorrhage by apply pressure on the bleeding site. Trans jugular intrahepatic portosystemic shunt (TIPS) is a surgical procedure used for the management of hepatic cirrhosis (Ignatavicius, 2016)

5. Identify emergency interventions for the patient with bleeding esophageal varices

Bleeding varices are life-threatening and immediate interventions is essential, these are some of the treatment used to stop bleeding and in some case reverse the effects of blood loss:

• Using elastic bands to …
• Restoring blood volume …
• Preventing infection … (Ignatavicius, 2016)

6. Develop an evidenced-based collaborative plan of care for the patient with late-stage cirrhosis.

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     Evidenced-based collaborative plan of care for a patient with late-state cirrhosis would include:

• Maintaining a positive nitrogen balance because we don’t need further loss of muscle mass and meet nutritional requirements
• Decrease potential risk for pressure ulcer development and breaks in skin integrity and reduce the risk of injury by changing patient’s position frequently, providing lotion to soothe irritated skin
• Verbalized feelings consistent with improvement of body image and self-esteem and increase level of comfort
• Improve mental status, maintain safety and restore normal fluid volume and improve respiratory status by positioning bed for maximal respiratory efficiency and provide oxygen if needed
• Provide nutrition that is high in protein with B-complex vitamins and other vitamins including A, C, and K, if the patient cannot swallow their food provide nutrients by feeding tube or TPN. Also provide patient who have fatty stools with water-soluble vitamins and give folic acid and iron to prevent anemia (Ignatavicius, 2016).

7. Explain and describe Paracentesis procedure.

Paracentesis is a procedure intended to remove fluid  …

The fluid is then drains into the container, the procedure usually takes 20 to 30 minutes (ucsd.edu, 2018)

References:

Ignatavicius, D., & Workman, L.M. (2016). Medical-Surgical Nursing: Patient-Centered Collaborative Care. 8^th ed. Saint Louis: Elsevier

Integration of Palliative Care in End-Stage Liver Disease and Liver Transplantation – NCBI – NIH. Retrieved from: https://www.ncbi.nlm.nih.gov/articles

Nursing Care for End-Stage Liver Disease – Clinical-UC San Diego Health. Retrieved from: https://www.health.ucsd.edu/documents/SP_pdf