Ch. 61 Liver problemsSeveral learning outcomes for this chapter. Quite of bit of detail and information I know you get to this point in nursing, you have had to look up lab values and things of this nature. Some of these things you have come into contact with after you have had clients with multiple issues. So we’re going to be identifying risk factors for cirrhosis and hepatitis, teaching always going to be of importance for us as nurses not just the clients but of course their families. And in the course formulating correct nursing and appropriate nursing diagnosis and collaborative problems that we might work with other disciplines on caring for your clients.The word cirrhosis means extensive scarring of the liver. It’s usually caused by a chronic reaction to hepatic inflammation and or necrosis. This process causes the tissue to become nodular. Inflammation caused by either toxins or disease processes will result in extensive degeneration and of course the cells of the liver. Complications are going to be related to the amount of damage to the liver and definitely thetime in which an intervention is put into place. so that we can of course prohibit or stave off the time from when progression really starts to take over the liver itself. We talk about compensated vs. decompensated cirrhosis. Compensated of course means that the liver has complied to the inflammationand necrotic changes that has taken place; it is still functional. Decompensated of course function is going to be impaired with obvious signs of liver failure. So that patient of course going to be symptomatic and have definite signs some of the signs and symptoms and lab values and assessment things that we are going to be talking about are definitely going to be applicable to have decompensatedcirrhosis where they have not acclimated to their change in status.Talk about classification and causes of cirrhosis. One that might particularly come to mind when we talk about the reasoning by someone developing cirrhosis in their lifetime is alcohol ingestion or abuse of alcohol. Alcohol has a direct toxic effect on the hepatocytes. It causes liver inflammation. Cirrhosis can also be classified as postnecrotic and this occurs after viral hepatitis diagnosis or incubation period. Hep. C is the leading cause of cirrhosis in the US. You have inflammation which in turn leads to infection, which in turn leads to scarring. People live with hepatitis for years and years and years a lot of times before they have any real in particular Hep. C before they have any real deficits or compromises as a result of it. Another classification is going to be biliary caused by an obstruction that goes untreated. Then finally, cardiac which is going to be caused by heart failure, can also cause cirrhosis in those types of patients.
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- Winter '16
- Nursing, liver disease, Ascites, Hepatology