Nursing Intervention Stop drinking alcohol completely.

. Alcohol can harm liver cells, and chronic alcohol use is one of the major causes of cirrhosis Restricting salt and using fluid pills (diuretics) reduce edema and abdominal swelling Avoid eating raw oysters or other raw shellfish. Raw shellfish can harbor bacteria (Vibrio vulnificus) that cause severe infections in people with cirrhosis Encourage patient to increase activity gradually and plan rest with activity and mild exercise Do not take any medications, including those you can buy without a prescription such as vitamins and herbal supplements, without discussing them with your doctor. Cirrhosis makes your liver sensitive to certain medications Change position frequently Position bed for maximal respiratory efficiency Try to keep your weight in the normal range. Being overweight can make several liver diseases worse Provide small, frequent meals, consider patient preference, and encourage patient to eat: provide protein supplements Provide nutritious, high-protein diet supplement by B-complex vitamins and others, including A, C, and K and folic acid Provide safety measures to prevent injury or cuts

Summary Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver. Alcohol and viral hepatitis B and C are common causes of cirrhosis, although there are many other causes. Cirrhosis can cause weakness, loss of appetite, easy bruising, yellowing of the skin (jaundice), itching, and fatigue. Diagnosis of cirrhosis can be suggested by the history, physical examination and blood tests, and can be confirmed by liver biopsy. Complications of cirrhosis include edema and ascites, spontaneous bacterial peritonitis, bleeding from varices, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, hypersplenism, and liver cancer. Treatment of cirrhosis is designed to prevent further damage to the liver, treat complications of cirrhosis, and preventing or detecting liver cancer early. Transplantation of the liver is becoming an important option for treating patients with advanced cirrhosis.

Liver Cirrhosis

Liver - largest gland of the body, can be considered a chemical factory that manufactures, stores, alters and excretes a large number of substances involved in the metabolism. - produces bile that flows through bile ducts glucose energy and metabolizes many drugs used in into the intestine where it helps to digest food. Cirrhosis - (scarring of liver) characterized by replacement of normal liver tissue with diffuse fibrosis that disrupts the structure and function of the liver

Some drugs, toxins, and infections Blocked bile ducts, the tubes that carry bile from the liver Some inherited diseases such as o Hemochromatosis, a disease that occurs when the body absorbs too much iron and stores the excess iron in the liver, pancreas, and other organs o Wilson disease, which is caused by the buildup of too much copper in the liver o Protoporphyria, a disorder that affects the skin, bone marrow, and liver

Gallstones abnormal metabolism of bile pigment. Because of this, gallstones develop twice as often in cirrhosis patients as in those without the disorder Coagulation Defects certain proteins that help clot blood. When these proteins are deficient, excessive or prolonged bleeding happens. Mental Function Change liver processes toxins from the intestine. When these substances escape into the bloodstream, as occurs in severe cases of cirrhosis, a variety of changes in mental function can develop. Esophageal Vein Bleeding intestinal blood bypasses the liver and flows up and around the esophagus (the food tube) to the heart. The veins in the esophagus dilate (widen) and may rupture, causing slow or massive intestinal bleeding.

3 Types 1. Alcoholic - most frequently due to chronic alcoholism 2. Postnecronotic most common, and a late result of a previous acute viral hepatitis 3. Biliary result of chronic obstruction and infection Causes Alcohol abuse (Alcoholic liver disease) Chronic viral hepatitis (Hepatitis b, c, or d) Autoimmune hepatitis, which is destruction of liver cells by the bodys immune system Nonalcoholic fatty liver disease or nonalcoholic steatohepatitis (NASH), which is fat deposits and inflammation in the liver

Diagnostic Examinations Physical Examination Complete Blood Count Liver Function Test Computed tomography (CT) of the abdomen Magnetic resonance imaging (MRI) of the abdomen Endoscopy to check for abnormal veins in the esophagus or stomach Ultrasound of the abdomen Liver Biopsy Signs and Symptoms Fluid retention in the legs and abdomen causing edema (fluid accumulation) and swelling Jaundice bile normally flows into the intestine but with advanced cirrhosis, bile can back up into the blood, causing the skin and eyes to turn yellow and the urine to darken Intense Itching Treatment Hospitalization Vaccination of Hepa A. B, C Nutrition therapy Surgery Liver Transplant