Materiały źródłowe

• #1 Cirrhosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487

  Cirrhosis care at Mayo Clinic […] Although the damage caused by cirrhosis is not reversible, treatment can slow the progression of the disease, alleviate symptoms, and prevent complications. In cases of early cirrhosis, it is possible to minimize damage to the liver by tackling the underlying causes. For instance, treating alcohol addiction, losing weight, and using medications to treat viral hepatitis and other conditions can limit damage to the liver. Once the liver stops functioning, an organ transplant may be an option. During a transplant, surgeons remove the damaged liver and replace it with a healthy working liver. In fact, cirrhosis is one of the most common reasons for a liver transplant. You and your medical team will need to assess if you are an appropriate candidate through a transplant evaluation. Surgery is a big undertaking, one that brings its own risks and complications, and it should always be a decision between you, your family, and your doctors.

• #2 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis of the liver is permanent scarring that damages your liver and interferes with its functioning. It can lead to liver failure. Cirrhosis is the result of persistent liver damage over many years. […] Cirrhosis involves permanent scarring in your liver, which cant be undone. While your liver has great healing powers in general, cirrhosis is a stage of disease where it doesnt have enough healthy cells left to heal itself with. But you may be able to slow or stop cirrhosis from progressing further. This depends on whats causing it, how treatable the cause is, and how well you respond to the treatment. […] Treatment for cirrhosis of the liver includes: Managing the cause, if possible, to slow or reduce the damage. General diet and lifestyle measures to reduce stress on your liver. Managing or screening for complications of cirrhosis. As a last resort, liver transplantation.

• #3 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Cirrhosis is a complex disease that is associated with disturbances in different organs besides the liver, including kidneys, heart, arterial circulation, lungs, gut, and brain. As a consequence, patients develop a number of complications that result in frequent hospital admissions and high morbidity and mortality. Patients with cirrhosis require constant and rigorous monitoring both in and outside the hospital. […] The current article provides a review of nursing care for the different complications of patients with cirrhosis. Nurses with specific knowledge on liver diseases should be incorporated into multidisciplinary teams managing patients with cirrhosis, both inpatient and outpatient. Conclusion: Nurses play an important role in the management and prevention of complications of the disease and improvement in patients quality of life and bridge the gap between clinicians and families, between primary care and hospital care, and provide medical education to patients and caregivers.

• #4 Cirrhosis of the Liver: Symptoms, Causes & Treatments

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/

  Cirrhosis refers to the replacement of normal liver tissue with non-living scar tissue. It is always related to other liver diseases. […] The most common causes of Cirrhosis are Hepatitis C, Alcohol-related Liver Disease, Non-Alcoholic Fatty Liver Disease (now called metabolic dysfunction-associated steatotic liver disease or MASLD), and Hepatitis B. […] Many people with Cirrhosis have no symptoms in the early stages of the disease. […] Alcohol remains the second most common cause of liver Cirrhosis after hepatitis C virus. […] Cirrhosis is the scarring of the liver hard scar tissue replaces soft healthy tissue. It is caused by swelling and inflammation. […] As cirrhosis becomes worse, the liver will have less healthy tissue. If cirrhosis is not treated, the liver will fail and will not be able to work well or at all.

• #5 Liver Cirrhosis Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/liver-cirrhosis/

  Liver cirrhosis is a chronic disease that causes cell destruction and fibrosis (scarring) of hepatic tissue. Complications include hyponatremia, water retention, bleeding esophageal varices, coagulopathy, spontaneous bacterial peritonitis, and hepatic encephalopathy. […] Medical management is based on presenting symptoms. Treatment includes antacids, vitamins, balanced diet, and nutritional supplements; potassium-sparing diuretics (for ascites); avoidance of alcohol. […] Nursing interventions include monitoring fluid intake and output and serum electrolyte levels to prevent dehydration and hypokalemia, which may precipitate hepatic encephalopathy. Maintain some periods of rest with legs elevated to mobilize edema and ascites. Encourage and assist with gradually increasing periods of exercise.

• #6 Hepatic Cirrhosis Nursing Care Management and Study Guide

  https://nurseslabs.com/hepatic-cirrhosis/

  Nursing management for the patient with cirrhosis of the liver should focus on promoting rest, improving nutritional status, providing skin care, reducing risk of injury, and monitoring and managing complications. […] Assessment of the patient with cirrhosis should include assessing for: […] The major goals for a patient with cirrhosis are: […] The patient with cirrhosis needs close observation, first-class supportive care, and sound nutrition counseling. […] Monitor for bleeding and hemorrhage. […] The focus of discharge education is dietary instructions. […] The nurse also instructs the patient and family about symptoms of impending encephalopathy, possible bleeding tendencies, and susceptibility to infection.

• #7 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nurses should evaluate quality-of-life status regularly and educate patients on how to cope with more impaired aspects and prevent complications, particularly falls. […] Accordingly, nurses have an important role in the detection of the impact that stigmatization may have on their patients and seeking solutions to avoid harmful effects. […] In this context, nursing care to both hospitalized and non-hospitalized patients is of utmost importance to help manage and prevent complications of the disease and improve quality of life. Nurses play a pivotal role in the care of patients with cirrhosis not only by bridging the gaps between clinicians and families and between primary and hospital care, but also by providing medical education to patients and caregivers.

• #8 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Despite the global burden of cirrhosis, much less attention has been paid to nursing care of patients with cirrhosis compared to other chronic diseases. Moreover, nursing training in liver diseases has been remarkably limited compared with training in other specialties. Incorporation of nurses into multidisciplinary teams for hospital care of patients with cirrhosis has been insufficient in comparison with other chronic conditions, particularly diabetes, cardiovascular diseases, and neurological diseases. […] The task forces to develop the consensus nursing guidelines were divided into the following areas of care: general care, ascites/edema, gastrointestinal bleeding, hepatic encephalopathy, bacterial infections, acute kidney injury, and quality of life and stigmatization. […] From the nursing care perspective, this classification into two stages is very useful, as approach to care is markedly different.

• #9 8 Liver Cirrhosis (Hepatic Cirrhosis) Nursing Care Plans

  https://nurseslabs.com/liver-cirrhosis-nursing-care-plans/

  The following are the nursing priorities for patients with liver cirrhosis: Manage and monitor liver function in patients with cirrhosis. Address complications associated with cirrhosis, such as portal hypertension or ascites. Provide supportive care to manage symptoms and improve quality of life. Educate patients on dietary modifications and fluid restriction, if necessary. Administer medications to manage symptoms and slow disease progression, if applicable. Monitor for and manage complications like hepatic encephalopathy or variceal bleeding. Offer counseling and support for lifestyle modifications, including alcohol cessation and weight management. […] Assess for the following subjective and objective data: Complaints of fatigue and weakness. Reports of abdominal pain or discomfort. Presence of ascites (abdominal fluid accumulation) evidenced by distension and shifting dullness on percussion. Nausea, vomiting, or changes in appetite. History of alcohol abuse or excessive alcohol consumption. Complaints of jaundice (yellowing of the skin and eyes). Presence of pruritus. Reports of weight loss or changes in body weight. History of coagulation disorders or easy bruising. Signs of hepatic encephalopathy, such as altered mental status, confusion, or asterixis (flapping tremor). Presence of spider angiomas (dilated blood vessels) or palmar erythema (reddening of the palms). Elevated liver enzymes (ALT, AST), bilirubin, and INR (international normalized ratio).

• #10 8 Liver Cirrhosis (Hepatic Cirrhosis) Nursing Care Plans

  https://nurseslabs.com/liver-cirrhosis-nursing-care-plans/

  The following are the nursing priorities for patients with liver cirrhosis: Manage and monitor liver function in patients with cirrhosis. Address complications associated with cirrhosis, such as portal hypertension or ascites. Provide supportive care to manage symptoms and improve quality of life. Educate patients on dietary modifications and fluid restriction, if necessary. Administer medications to manage symptoms and slow disease progression, if applicable. Monitor for and manage complications like hepatic encephalopathy or variceal bleeding. Offer counseling and support for lifestyle modifications, including alcohol cessation and weight management. […] Assess for the following subjective and objective data: Complaints of fatigue and weakness. Reports of abdominal pain or discomfort. Presence of ascites (abdominal fluid accumulation) evidenced by distension and shifting dullness on percussion. Nausea, vomiting, or changes in appetite. History of alcohol abuse or excessive alcohol consumption. Complaints of jaundice (yellowing of the skin and eyes). Presence of pruritus. Reports of weight loss or changes in body weight. History of coagulation disorders or easy bruising. Signs of hepatic encephalopathy, such as altered mental status, confusion, or asterixis (flapping tremor). Presence of spider angiomas (dilated blood vessels) or palmar erythema (reddening of the palms). Elevated liver enzymes (ALT, AST), bilirubin, and INR (international normalized ratio).

• #11 Liver Cirrhosis Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/cirrhosis-nursing-diagnosis/

  Liver cirrhosis is a chronic and progressive condition characterized by the replacement of healthy liver tissue with scar tissue, leading to impaired liver function. As a nurse, understanding the nursing diagnoses associated with liver cirrhosis is crucial for providing effective care to patients. […] A thorough nursing assessment is crucial for identifying appropriate nursing diagnoses and developing effective care plans. The assessment should include: Comprehensive health history, Physical examination, Evaluation of laboratory results, Review of diagnostic imaging studies, Assessment of the patients mental status, Evaluation of nutritional status, Skin assessment, Abdominal assessment, Respiratory assessment, Cardiovascular assessment. […] Based on the assessment findings, nurses can identify several nursing diagnoses for patients with liver cirrhosis. Here are five key nursing diagnoses, along with their related factors, interventions, rationales, and desired outcomes: 1. Impaired Liver Function related to chronic liver disease as evidenced by elevated liver enzymes, jaundice, and impaired coagulation.

• #12 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  When assessing an individual with cirrhosis, the primary focus should be on complications. Abdominal girth should be measured to assess for an increase in ascites. Daily weights should also be performed. The individuals mental status should be assessed for changes due to encephalopathy. Observation for signs of abnormal bleeding should be part of the assessment process. […] There are many appropriate nursing diagnoses for the individual with cirrhosis. Some possible nursing diagnoses include: Nutritional deficit, less than body requirements, related to abdominal distention, discomfort, and anorexia; Activity intolerance related to lethargy and fatigue; Disturbed thought process related to increased ammonia levels; Pain related to ascites; High risk for injury related to altered clotting and confusion; Fluid volume excess related to edema and ascites; Ineffective breathing pattern related to ascites; Impaired skin integrity related to edema, pruritus, and jaundice.

• #13 Liver cirrhosis for nursing | PPT

  https://www.slideshare.net/slideshow/liver-cirrhosis-for-nursing/249771132

  Liver cirrhosis is a chronic, progressive disease characterized by widespread fibrosis and nodule formation caused by prolonged liver damage. It has no cure but can be managed. […] The document discusses the definition, types including alcoholic and post-necrotic cirrhosis, risk factors like viral hepatitis and alcohol abuse, clinical manifestations in early and late stages, diagnostic tests, medical and surgical management, complications, and the nurse’s role in assessment, interventions, and education. […] Liver cirrhosis for nursing consequences tissue fibrosis scar tissue regenerative nodules loss of liver function. […] Nursing Assessment Obtain history of precipitating factors, such as alcohol abuse, hepatitis, or biliary disease. Establish present pattern of alcohol intake. Assess mental status through interview and interaction with the patient. Perform abdominal examination, assessing for ascites Observe for bleeding. Assess daily weight and abdominal girth measurements.

• #14 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  When assessing an individual with cirrhosis, the primary focus should be on complications. Abdominal girth should be measured to assess for an increase in ascites. Daily weights should also be performed. The individuals mental status should be assessed for changes due to encephalopathy. Observation for signs of abnormal bleeding should be part of the assessment process. […] There are many appropriate nursing diagnoses for the individual with cirrhosis. Some possible nursing diagnoses include: Nutritional deficit, less than body requirements, related to abdominal distention, discomfort, and anorexia; Activity intolerance related to lethargy and fatigue; Disturbed thought process related to increased ammonia levels; Pain related to ascites; High risk for injury related to altered clotting and confusion; Fluid volume excess related to edema and ascites; Ineffective breathing pattern related to ascites; Impaired skin integrity related to edema, pruritus, and jaundice.

• #15 Liver Cirrhosis [+ Free Cheat Sheet] | Lecturio Nursing

  https://www.lecturio.com/nursing/free-cheat-sheet/liver-cirrhosis-nursing-diagnosis/

  Liver cirrhosis is a serious and potentially life-threatening condition that affects millions of people worldwide. Nursing diagnoses for a client with liver cirrhosis require a comprehensive understanding of its causes, symptoms, and potential complications, as well as the interventions and client education necessary to manage and monitor the disease. […] Management focuses on treating the underlying cause, preventing further liver damage, managing complications, and maintaining quality of life. Nurses play a pivotal role in client education (including dietary guidance), medication administration, symptom monitoring, and emotional support. […] For liver cirrhosis, potential nursing diagnoses include: Chronic confusion: monitor for signs of encephalopathy, provide safe environment; Defensive coping: regarding stopping substance abuse; Fatigue; Imbalanced nutrition: less than body requirements (anorexia and malabsorption; encourage small, frequent meals); Nausea: due to gastric irritation; Chronic pain: liver enlargement; Risk for bleeding: decreased synthesis of clotting factors by the liver and esophageal varices; monitor for signs for bleeding; Risk for injury: with intoxication and delirium tremens.

• #16 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  Nursing intervention will vary based on an individuals symptoms. Some of the most common nursing interventions include: Promote rest; Provide oxygen, if needed; Consult with a dietitian; Provide and encourage small frequent meals; Explain all procedures to minimize agitation; Instruct individual to ask for assistance before getting up; Evaluate all injuries for signs of internal bleeding; Provide electric razor to prevent cuts; Provide soft toothbrush for safety; Monitor for bleeding or hemorrhage; Monitor labs, as ordered; Report changes in mental status promptly; Monitor intake and output; Administer medications, as ordered; Assess cardiovascular and respiratory status; Provide protective skin care; Provide IV fluids, as ordered. […] Expected Outcomes: Maintains normal fluid balance; Performs activities of daily living; Verbalizes fears and anxieties; Experiences no signs or symptoms of bleeding. […] Condition, treatment, and expected outcomes; Dietitian recommendations, including fluid and sodium restriction; Medications, as ordered; Importance of avoiding alcohol; Referral to Alcoholics Anonymous or counseling, as needed; Recommended follow-up with healthcare providers.

• #17 8 Liver Cirrhosis (Hepatic Cirrhosis) Nursing Care Plans

  https://nurseslabs.com/liver-cirrhosis-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with liver cirrhosis may include: Assess respiratory status, noting increased respiratory rate, and dyspnea. These signs can be indicative of pulmonary congestion. […] Closely assess for signs and symptoms of GI bleeding: check all secretions for frank or occult blood. Observe the color and consistency of stools, NG drainage, or vomitus. The esophagus and rectum are the most usual sources of bleeding because of their mucosal fragility and alterations in hemostasis associated with cirrhosis. […] Observe the presence of petechiae, ecchymosis, and bleeding from one or more sites. Subacute disseminated intravascular coagulation (DIC) may develop secondary to altered clotting factors. Bruising, melena, and hematemesis are signs of bleeding. Altered vital signs, irritability, air hunger, pallor, and weakness are signs of significant bleeding and necessitate prompt intervention. […] Administer medications to manage symptoms and slow disease progression, if applicable.

• #18 8 Liver Cirrhosis (Hepatic Cirrhosis) Nursing Care Plans

  https://nurseslabs.com/liver-cirrhosis-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with liver cirrhosis may include: Assess respiratory status, noting increased respiratory rate, and dyspnea. These signs can be indicative of pulmonary congestion. […] Closely assess for signs and symptoms of GI bleeding: check all secretions for frank or occult blood. Observe the color and consistency of stools, NG drainage, or vomitus. The esophagus and rectum are the most usual sources of bleeding because of their mucosal fragility and alterations in hemostasis associated with cirrhosis. […] Observe the presence of petechiae, ecchymosis, and bleeding from one or more sites. Subacute disseminated intravascular coagulation (DIC) may develop secondary to altered clotting factors. Bruising, melena, and hematemesis are signs of bleeding. Altered vital signs, irritability, air hunger, pallor, and weakness are signs of significant bleeding and necessitate prompt intervention. […] Administer medications to manage symptoms and slow disease progression, if applicable.

• #19 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Despite the global burden of cirrhosis, much less attention has been paid to nursing care of patients with cirrhosis compared to other chronic diseases. Moreover, nursing training in liver diseases has been remarkably limited compared with training in other specialties. Incorporation of nurses into multidisciplinary teams for hospital care of patients with cirrhosis has been insufficient in comparison with other chronic conditions, particularly diabetes, cardiovascular diseases, and neurological diseases. […] The task forces to develop the consensus nursing guidelines were divided into the following areas of care: general care, ascites/edema, gastrointestinal bleeding, hepatic encephalopathy, bacterial infections, acute kidney injury, and quality of life and stigmatization. […] From the nursing care perspective, this classification into two stages is very useful, as approach to care is markedly different.

• #20 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care should also include education about the complications of cirrhosis, prevention (if possible), and early detection through specific symptoms. […] The main roles of nurses in the assessment of patients with cirrhosis and ascites/edema are to evaluate patients history, check current status of ascites and edema, and plan future care to prevent recurrence. […] Other key aspects for patients with ascites and/or edema include education of the patient and caregiver on a low-sodium diet, importance of adherence to prescribed diuretics, avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs), periodic evaluation of body weight, leg wrap application, and contact with the nurse when alarm signs are present, particularly a significant increase in body weight. […] Inpatient nursing care of patients with cirrhosis and GI bleeding includes vital signs monitoring, particularly supine and standing blood pressure and heart rate, insertion of a peripheral intravenous (IV) line, and monitoring of mental status, skin color and temperature, and stool characteristics.

• #21 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care should also include education about the complications of cirrhosis, prevention (if possible), and early detection through specific symptoms. […] The main roles of nurses in the assessment of patients with cirrhosis and ascites/edema are to evaluate patients history, check current status of ascites and edema, and plan future care to prevent recurrence. […] Other key aspects for patients with ascites and/or edema include education of the patient and caregiver on a low-sodium diet, importance of adherence to prescribed diuretics, avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs), periodic evaluation of body weight, leg wrap application, and contact with the nurse when alarm signs are present, particularly a significant increase in body weight. […] Inpatient nursing care of patients with cirrhosis and GI bleeding includes vital signs monitoring, particularly supine and standing blood pressure and heart rate, insertion of a peripheral intravenous (IV) line, and monitoring of mental status, skin color and temperature, and stool characteristics.

• #22 Liver Cirrhosis Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/liver-cirrhosis/

  Liver cirrhosis is a chronic disease that causes cell destruction and fibrosis (scarring) of hepatic tissue. Complications include hyponatremia, water retention, bleeding esophageal varices, coagulopathy, spontaneous bacterial peritonitis, and hepatic encephalopathy. […] Medical management is based on presenting symptoms. Treatment includes antacids, vitamins, balanced diet, and nutritional supplements; potassium-sparing diuretics (for ascites); avoidance of alcohol. […] Nursing interventions include monitoring fluid intake and output and serum electrolyte levels to prevent dehydration and hypokalemia, which may precipitate hepatic encephalopathy. Maintain some periods of rest with legs elevated to mobilize edema and ascites. Encourage and assist with gradually increasing periods of exercise.

• #23 Liver Cirrhosis Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/liver-cirrhosis/

  Ascites is the accumulation of fluid in the peritoneal cavity due to portal hypertension and hypoalbuminemia. While it increases the risk of infection (spontaneous bacterial peritonitis) and can impair breathing if severe, it is not as acutely life-threatening as ruptured esophageal varices. […] Esophageal varices represent the most serious and potentially life-threatening condition. They are dilated veins in the esophagus caused by portal hypertension. These varices are fragile and can rupture, leading to massive gastrointestinal hemorrhage. […] The primary reason for increased bleeding risk in cirrhosis is dysfunction in the clotting mechanism, which occurs due to the liver’s impaired ability to produce clotting factors. […] Nurses should educate patients and caregivers on the importance of bleeding precautions and strategies to prevent bleeding in daily life.

• #24 Liver Cirrhosis Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/liver-cirrhosis/

  Ascites is the accumulation of fluid in the peritoneal cavity due to portal hypertension and hypoalbuminemia. While it increases the risk of infection (spontaneous bacterial peritonitis) and can impair breathing if severe, it is not as acutely life-threatening as ruptured esophageal varices. […] Esophageal varices represent the most serious and potentially life-threatening condition. They are dilated veins in the esophagus caused by portal hypertension. These varices are fragile and can rupture, leading to massive gastrointestinal hemorrhage. […] The primary reason for increased bleeding risk in cirrhosis is dysfunction in the clotting mechanism, which occurs due to the liver’s impaired ability to produce clotting factors. […] Nurses should educate patients and caregivers on the importance of bleeding precautions and strategies to prevent bleeding in daily life.

• #25 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care should also include education about the complications of cirrhosis, prevention (if possible), and early detection through specific symptoms. […] The main roles of nurses in the assessment of patients with cirrhosis and ascites/edema are to evaluate patients history, check current status of ascites and edema, and plan future care to prevent recurrence. […] Other key aspects for patients with ascites and/or edema include education of the patient and caregiver on a low-sodium diet, importance of adherence to prescribed diuretics, avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs), periodic evaluation of body weight, leg wrap application, and contact with the nurse when alarm signs are present, particularly a significant increase in body weight. […] Inpatient nursing care of patients with cirrhosis and GI bleeding includes vital signs monitoring, particularly supine and standing blood pressure and heart rate, insertion of a peripheral intravenous (IV) line, and monitoring of mental status, skin color and temperature, and stool characteristics.

• #26 Ascites: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/ascites-nursing-diagnosis-care-plan/

  Ascites is the accumulation of fluid in the peritoneal cavity. Several diseases cause the condition, but more than half of cases are attributed to liver cirrhosis. […] Cirrhosis is the most prevalent condition that leads to ascites in patients. […] Common ascites risk factors are: Liver cirrhosis, Viral infections like hepatitis B or hepatitis C, Excessive alcohol use over time. […] Nursing interventions and care are essential for the patients recovery. […] The cause of fluid retention determines the best course of treatment for ascites. […] The goal of therapy in ascites patients is to reduce peripheral edema and ascites fluid volume without depleting intravascular volume. […] Paracentesis allows the removal of large volumes of extra fluid with a needle into the abdomen. […] For patients who are resistant to diuretics, a transjugular intrahepatic portosystemic shunt (TIPS) procedure places a stent from the jugular vein to the hepatic vein to relieve the pressure of blood flowing through the liver and the buildup of fluid.

• #27 Ascites: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/ascites-nursing-diagnosis-care-plan/

  Sodium restriction minimizes fluid retention in extravascular spaces. […] Patients can be instructed to monitor their weight at home and to contact their healthcare team for a significant weight gain in a week or symptoms of shortness of breath, bloating, or swelling in dependent extremities. […] Ascites may lead to an abdominal infection causing increased abdominal pressure and impaired tissue perfusion. […] Administering antibiotics as prescribed destroys the pathogen and prevents worsening complications.

• #28 Liver Cirrhosis Nursing Care Plan & Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/liver-cirrhosis/

  Ascites is the accumulation of fluid in the peritoneal cavity due to portal hypertension and hypoalbuminemia. While it increases the risk of infection (spontaneous bacterial peritonitis) and can impair breathing if severe, it is not as acutely life-threatening as ruptured esophageal varices. […] Esophageal varices represent the most serious and potentially life-threatening condition. They are dilated veins in the esophagus caused by portal hypertension. These varices are fragile and can rupture, leading to massive gastrointestinal hemorrhage. […] The primary reason for increased bleeding risk in cirrhosis is dysfunction in the clotting mechanism, which occurs due to the liver’s impaired ability to produce clotting factors. […] Nurses should educate patients and caregivers on the importance of bleeding precautions and strategies to prevent bleeding in daily life.

• #29 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care should also include education about the complications of cirrhosis, prevention (if possible), and early detection through specific symptoms. […] The main roles of nurses in the assessment of patients with cirrhosis and ascites/edema are to evaluate patients history, check current status of ascites and edema, and plan future care to prevent recurrence. […] Other key aspects for patients with ascites and/or edema include education of the patient and caregiver on a low-sodium diet, importance of adherence to prescribed diuretics, avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs), periodic evaluation of body weight, leg wrap application, and contact with the nurse when alarm signs are present, particularly a significant increase in body weight. […] Inpatient nursing care of patients with cirrhosis and GI bleeding includes vital signs monitoring, particularly supine and standing blood pressure and heart rate, insertion of a peripheral intravenous (IV) line, and monitoring of mental status, skin color and temperature, and stool characteristics.

• #30 Cirrhosis Nursing Management

  https://rnspeak.com/cirrhosis-nursing-management/

  Cirrhosis Nursing Management […] Monitor vital signs, intake and output, and electrolyte levels to determine fluid volume status. […] Maintain some periods of rest with legs elevated to mobilize edema and ascites alternate rest periods with ambulation. […] To assess fluid retention, measure, and record abdominal girth every shift. Weigh the patient daily and document his weight. […] Administer diuretics, potassium, and protein or vitamin supplements as ordered. Restrict sodium and fluid intake as ordered. […] Observe and document for bleeding gums, ecchymoses, epistaxis, petechiae and degree of sclerae, and skin jaundice. Remain with the patient during the hemorrhagic episodes. […] Inspect stools for amount, color, and consistency. Test stools and vomitus for occult blood as ordered. […] Watch for signs of anxiety, epigastric fullness, restlessness, and weakness. […] Observe closely for signs of behavioral or personality changes. Report increasing stupor, lethargy, hallucinations, or neuromuscular dysfunction. Arouse the patient periodically to determine the level of consciousness. Watch for asterixis, a sign of developing encephalopathy. […] Allow the patient to express his feelings about having Cirrhosis. Offer psychological support and encouragement when appropriate.

• #31 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care of patients hospitalized with HE includes evaluation of mental status, prevention of aspiration pneumonia, assessment of potential triggers of HE (particularly bacterial infections and GI bleeding), nutritional support, prevention of skin breakdown, and bowel cleansing. […] The most important aspect of nursing care of patients hospitalized with bacterial infections involves prevention of infection, especially in patients with HE or leg edema, monitoring for signs of infections, early identification of possible complications of the disease, development of signs of systemic inflammatory response syndrome or sepsis, minimizing invasive procedures as much as possible, and antibiotic administration. […] Nursing care of patients hospitalized with AKI involves monitoring of urine volume and characteristics, serum creatinine and electrolytes, early identification of potential associated complications, particularly HE, and early detection of signs of metabolic acidosis and cardiopulmonary congestion.

• #32 Cirrhosis NCLEX Review

  https://www.registerednursern.com/cirrhosis-nclex-review/

  As a nursing student, you must be familiar with cirrhosis along with how to care for a patient experiencing this disease. […] Nursing Interventions for Cirrhosis: Monitor for bleeding (PT and INR) […] Monitor Esophageal varices […] Check reflexes, mental status very closely (mental status change, irritability, confusion), hepatic encephalopathy, and for flapping of the hands asterixis […] Diet: If neuro system is compromised: low protein diet: protein breaks down into ammonia […] If neuro system NOT compromised: high lean protein (fish, poultry) NO ETOH, or raw seafood (oysters.contain bacteria that the immune system is too weak to fight and detoxify from the body), fluid restriction, needs vitamin (administer PO vitamins per MD order) […] Monitor blood glucose levels (hyperglycemia and hypoglycemia)

• #33 Cirrhosis NCLEX Review

  https://www.registerednursern.com/cirrhosis-nclex-review/

  Assessing sclera and skin color for Jaundice along with urine color: very dark […] Monitor Is and Os very closely, daily weight, and measuring abdominal girth (monitor ascites) and swelling in extremities […] Activity intolerance, difficulty breathing (no supine), at risk for skin breakdown (turning every 2 hours), elevating feet […] Administering Lactulose per MD order: decreases ammonia levels.

• #34 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care of patients hospitalized with HE includes evaluation of mental status, prevention of aspiration pneumonia, assessment of potential triggers of HE (particularly bacterial infections and GI bleeding), nutritional support, prevention of skin breakdown, and bowel cleansing. […] The most important aspect of nursing care of patients hospitalized with bacterial infections involves prevention of infection, especially in patients with HE or leg edema, monitoring for signs of infections, early identification of possible complications of the disease, development of signs of systemic inflammatory response syndrome or sepsis, minimizing invasive procedures as much as possible, and antibiotic administration. […] Nursing care of patients hospitalized with AKI involves monitoring of urine volume and characteristics, serum creatinine and electrolytes, early identification of potential associated complications, particularly HE, and early detection of signs of metabolic acidosis and cardiopulmonary congestion.

• #35 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  Nursing intervention will vary based on an individuals symptoms. Some of the most common nursing interventions include: Promote rest; Provide oxygen, if needed; Consult with a dietitian; Provide and encourage small frequent meals; Explain all procedures to minimize agitation; Instruct individual to ask for assistance before getting up; Evaluate all injuries for signs of internal bleeding; Provide electric razor to prevent cuts; Provide soft toothbrush for safety; Monitor for bleeding or hemorrhage; Monitor labs, as ordered; Report changes in mental status promptly; Monitor intake and output; Administer medications, as ordered; Assess cardiovascular and respiratory status; Provide protective skin care; Provide IV fluids, as ordered. […] Expected Outcomes: Maintains normal fluid balance; Performs activities of daily living; Verbalizes fears and anxieties; Experiences no signs or symptoms of bleeding. […] Condition, treatment, and expected outcomes; Dietitian recommendations, including fluid and sodium restriction; Medications, as ordered; Importance of avoiding alcohol; Referral to Alcoholics Anonymous or counseling, as needed; Recommended follow-up with healthcare providers.

• #36 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nursing care of patients hospitalized with HE includes evaluation of mental status, prevention of aspiration pneumonia, assessment of potential triggers of HE (particularly bacterial infections and GI bleeding), nutritional support, prevention of skin breakdown, and bowel cleansing. […] The most important aspect of nursing care of patients hospitalized with bacterial infections involves prevention of infection, especially in patients with HE or leg edema, monitoring for signs of infections, early identification of possible complications of the disease, development of signs of systemic inflammatory response syndrome or sepsis, minimizing invasive procedures as much as possible, and antibiotic administration. […] Nursing care of patients hospitalized with AKI involves monitoring of urine volume and characteristics, serum creatinine and electrolytes, early identification of potential associated complications, particularly HE, and early detection of signs of metabolic acidosis and cardiopulmonary congestion.

• #37 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  Nursing intervention will vary based on an individuals symptoms. Some of the most common nursing interventions include: Promote rest; Provide oxygen, if needed; Consult with a dietitian; Provide and encourage small frequent meals; Explain all procedures to minimize agitation; Instruct individual to ask for assistance before getting up; Evaluate all injuries for signs of internal bleeding; Provide electric razor to prevent cuts; Provide soft toothbrush for safety; Monitor for bleeding or hemorrhage; Monitor labs, as ordered; Report changes in mental status promptly; Monitor intake and output; Administer medications, as ordered; Assess cardiovascular and respiratory status; Provide protective skin care; Provide IV fluids, as ordered. […] Expected Outcomes: Maintains normal fluid balance; Performs activities of daily living; Verbalizes fears and anxieties; Experiences no signs or symptoms of bleeding. […] Condition, treatment, and expected outcomes; Dietitian recommendations, including fluid and sodium restriction; Medications, as ordered; Importance of avoiding alcohol; Referral to Alcoholics Anonymous or counseling, as needed; Recommended follow-up with healthcare providers.

• #38 8 Liver Cirrhosis (Hepatic Cirrhosis) Nursing Care Plans

  https://nurseslabs.com/liver-cirrhosis-nursing-care-plans/

  Goals and expected outcomes may include: The client will demonstrate progressive weight gain toward a goal with the client-appropriate normalization of laboratory values. The client will experience no further signs of malnutrition. The client will demonstrate stabilized fluid volume, with balanced IO, stable weight, vital signs within the clients normal range, and absence of edema. The client will maintain skin integrity. The client will verbalize reduced itching or the ability to tolerate itching without scratching. The client will identify individual risk factors and demonstrate behaviors/techniques to prevent skin breakdown. The client will maintain an effective respiratory pattern; be free of dyspnea and cyanosis, with ABGs and vital capacity within the acceptable range. The client will maintain homeostasis in absence of bleeding. The client will demonstrate behaviors to reduce the risk of bleeding. The client will maintain the usual level of mentation/reality orientation. The client will initiate behaviors/lifestyle changes to prevent or minimize the recurrence of the problem. The client will verbalize understanding of changes and acceptance of self in the present situation. The client will identify feelings and methods for coping with a negative perception of self. The client will verbalize understanding of the disease process/prognosis, and potential complications. The client will identify/initiate necessary lifestyle changes and participate in care.

• #39 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  Nursing intervention will vary based on an individuals symptoms. Some of the most common nursing interventions include: Promote rest; Provide oxygen, if needed; Consult with a dietitian; Provide and encourage small frequent meals; Explain all procedures to minimize agitation; Instruct individual to ask for assistance before getting up; Evaluate all injuries for signs of internal bleeding; Provide electric razor to prevent cuts; Provide soft toothbrush for safety; Monitor for bleeding or hemorrhage; Monitor labs, as ordered; Report changes in mental status promptly; Monitor intake and output; Administer medications, as ordered; Assess cardiovascular and respiratory status; Provide protective skin care; Provide IV fluids, as ordered. […] Expected Outcomes: Maintains normal fluid balance; Performs activities of daily living; Verbalizes fears and anxieties; Experiences no signs or symptoms of bleeding. […] Condition, treatment, and expected outcomes; Dietitian recommendations, including fluid and sodium restriction; Medications, as ordered; Importance of avoiding alcohol; Referral to Alcoholics Anonymous or counseling, as needed; Recommended follow-up with healthcare providers.

• #40 Cirrhosis: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/cirrhosis/?srsltid=AfmBOopROCkBAOTPzhPvAFhyvBUEtCFJUHCfInKRdexm2T91fe3KBVRt

  Nursing intervention will vary based on an individuals symptoms. Some of the most common nursing interventions include: Promote rest; Provide oxygen, if needed; Consult with a dietitian; Provide and encourage small frequent meals; Explain all procedures to minimize agitation; Instruct individual to ask for assistance before getting up; Evaluate all injuries for signs of internal bleeding; Provide electric razor to prevent cuts; Provide soft toothbrush for safety; Monitor for bleeding or hemorrhage; Monitor labs, as ordered; Report changes in mental status promptly; Monitor intake and output; Administer medications, as ordered; Assess cardiovascular and respiratory status; Provide protective skin care; Provide IV fluids, as ordered. […] Expected Outcomes: Maintains normal fluid balance; Performs activities of daily living; Verbalizes fears and anxieties; Experiences no signs or symptoms of bleeding. […] Condition, treatment, and expected outcomes; Dietitian recommendations, including fluid and sodium restriction; Medications, as ordered; Importance of avoiding alcohol; Referral to Alcoholics Anonymous or counseling, as needed; Recommended follow-up with healthcare providers.

• #41 Cirrhosis Nursing Management

  https://rnspeak.com/cirrhosis-nursing-management/

  Patient teaching […] To minimize the risk of bleeding, warn the patient against taking non-steroidal anti-inflammatory drugs, straining to defecate and blowing his nose, or sneezing too vigorously. Suggest using an electric razor and a soft toothbrush. […] Advise the patient that rest and good nutrition conserve energy and decrease metabolic demands on the liver. Urge him to eat frequent, small meals. Teach him to alternate periods of rest and activity to reduce oxygen demand and prevent fatigue.

• #42 Cirrhosis Nursing Management

  https://rnspeak.com/cirrhosis-nursing-management/

  Patient teaching […] To minimize the risk of bleeding, warn the patient against taking non-steroidal anti-inflammatory drugs, straining to defecate and blowing his nose, or sneezing too vigorously. Suggest using an electric razor and a soft toothbrush. […] Advise the patient that rest and good nutrition conserve energy and decrease metabolic demands on the liver. Urge him to eat frequent, small meals. Teach him to alternate periods of rest and activity to reduce oxygen demand and prevent fatigue.

• #43 Cirrhosis Nursing Management

  https://rnspeak.com/cirrhosis-nursing-management/

  Patient teaching […] To minimize the risk of bleeding, warn the patient against taking non-steroidal anti-inflammatory drugs, straining to defecate and blowing his nose, or sneezing too vigorously. Suggest using an electric razor and a soft toothbrush. […] Advise the patient that rest and good nutrition conserve energy and decrease metabolic demands on the liver. Urge him to eat frequent, small meals. Teach him to alternate periods of rest and activity to reduce oxygen demand and prevent fatigue.

• #44 Cirrhosis of the Liver: Symptoms, Causes & Treatments

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/

  Treatment options for cirrhosis depend on the cause and the level of liver damage. Depending on the disease causing cirrhosis, medications or lifestyle changes may be used for treatment. The goals of treatment are to prevent further liver damage and reduce complications. […] When cirrhosis cannot be treated, the condition is known as End-Stage Liver Disease, or ESLD. ESLD includes a subgroup of patients with cirrhosis who have signs of decompensation that is generally irreversible with medical management other than transplant. […] It is possible to prevent further liver damage with proper management of cirrhosis. […] Maintain a healthy lifestyle (eat a healthy diet and exercise regularly) […] Limit salt in your diet to prevent or reduce fluid buildup […] Avoid raw shellfish […] Stop drinking alcohol

• #45 Cirrhosis of the Liver: Symptoms, Causes & Treatments

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/

  Talk to your doctor about all of the medications, vitamins and supplements you take. […] Talk to your doctor about hepatitis A and hepatitis B vaccinations […] Practice safe sex […] Use clean needles for tattoos or piercings […] Do not share needles, razors, toothbrushes or other personal items with others.

• #46

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12474

  Cirrhosis occurs when healthy tissue in your liver gets scarred. This keeps the liver from working well. It usually happens after a liver has been inflamed for years. […] Treatment can’t completely fix liver damage. But you may be able to slow or prevent more damage if you don’t drink alcohol or take medicines, drugs, or natural health products that harm your liver. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Do not drink any alcohol. It can harm your liver. Talk to your doctor if you need help to stop drinking. […] Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

• #47

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12474

  Talk to your doctor before you take any other medicines. These include over-the-counter medicines and herbal products. […] Be careful taking acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). These can sometimes cause more liver damage. Talk with your doctor if you’re not sure which medicines are safe. […] If your cirrhosis causes extra fluid to build up in your body, try not to eat a lot of salt. Use less salt when you cook and at the table. Don’t eat fast foods or snack foods with a lot of salt. Extra fluid in your belly, legs, and chest can cause serious problems. […] Work with your doctor or a dietitian to be sure you eat the right amount of carbohydrate, protein, fat, and sodium (salt). It’s very important to choose the best foods for the health of your liver.

• #48 Cirrhosis

  https://www.nhs.uk/conditions/cirrhosis/treatment/

  Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse. […] You usually also have treatment to help prevent and treat complications of cirrhosis. This may include: laxative medicine to help remove toxins from your body, medicines such as beta blockers to reduce bleeding, medicine to make you pee more and help reduce swelling, antibiotics to help treat or prevent infections and treat internal bleeding, treatment for weakened bones, a liver transplant, if your cirrhosis is very severe. […] It’s also strongly recommended to make healthy lifestyle changes, including to stop drinking alcohol. […] You’ll be supported by different healthcare professionals. This may include a liver specialist (hepatologist), digestive system specialist (gastroenterologist), nutrition specialists (nutritionist or dietician), and alcohol support services. […] If you have cirrhosis, you will be supported by a group of specialists.

• #49 Cirrhosis

  https://www.nhs.uk/conditions/cirrhosis/

  Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse. […] You’ll be supported by different healthcare professionals. This may include a liver specialist (hepatologist), digestive system specialist (gastroenterologist), nutrition specialists (nutritionist or dietician), and alcohol support services. […] There are some things you can do that may help stop your cirrhosis getting worse and help you to stay healthy. […] If you have cirrhosis, you will be supported by a group of specialists. […] British Liver Trust provides information and support for anyone affected by liver disease.

• #50 Cirrhosis

  https://www.nhs.uk/conditions/cirrhosis/treatment/

  Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse. […] You usually also have treatment to help prevent and treat complications of cirrhosis. This may include: laxative medicine to help remove toxins from your body, medicines such as beta blockers to reduce bleeding, medicine to make you pee more and help reduce swelling, antibiotics to help treat or prevent infections and treat internal bleeding, treatment for weakened bones, a liver transplant, if your cirrhosis is very severe. […] It’s also strongly recommended to make healthy lifestyle changes, including to stop drinking alcohol. […] You’ll be supported by different healthcare professionals. This may include a liver specialist (hepatologist), digestive system specialist (gastroenterologist), nutrition specialists (nutritionist or dietician), and alcohol support services. […] If you have cirrhosis, you will be supported by a group of specialists.

• #51 Patient perceived quality of cirrhosis care– adjunctive nurse-based care versus standard medical care: a pragmatic multicentre randomised controlled study | BMC Nursing | Full Text

  https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01934-9

  To meet patients varied needs in cirrhosis illness, a multi-disciplinary care approach that involves nursing care is recommended. […] This study compared patient-perceived quality of cirrhosis care after receiving either adjunctive RN-based care (QLiNCaM) or standard medical care in a Swedish outpatient setting. The results of our study disclose a need for structured RN-based clinics in outpatient cirrhosis care. Importantly, patients in the intervention group stated there was improved accessibility to outpatient cirrhosis care. […] RNs have a role in cirrhosis outpatient care to improve patient-perceived quality of care and to realise a person-centred care approach. RNs should therefore be considered as a resource in caring for the growing cirrhosis population, and be part of the interdisciplinary cirrhosis care team.

• #52 Patient perceived quality of cirrhosis care– adjunctive nurse-based care versus standard medical care: a pragmatic multicentre randomised controlled study | BMC Nursing | Full Text

  https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01934-9

  In comparison to standard medical care, this study indicates that adjunctive RN-based care improves patient-perceived quality of care by increasing patients involvement in their healthcare, and by improving access to cirrhosis outpatient care. Patients express appreciation for personalised information. Altogether, we believe that structured RN involvement have a potential to play an important role and make a difference for patients sense of safety in the continuum of cirrhosis care.

• #53 Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7154704/

  Nurses should evaluate quality-of-life status regularly and educate patients on how to cope with more impaired aspects and prevent complications, particularly falls. […] Accordingly, nurses have an important role in the detection of the impact that stigmatization may have on their patients and seeking solutions to avoid harmful effects. […] In this context, nursing care to both hospitalized and non-hospitalized patients is of utmost importance to help manage and prevent complications of the disease and improve quality of life. Nurses play a pivotal role in the care of patients with cirrhosis not only by bridging the gaps between clinicians and families and between primary and hospital care, but also by providing medical education to patients and caregivers.

• #54 Nursing care for patients with cirrhosis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36754211/

  Cirrhosis represents a major cause of morbidity and mortality, leading to a marked impairment in the quality of life of patients and their caregivers, and resulting in a major burden on healthcare systems. Currently, in most countries, nurses still play a limited role in the care of patients with cirrhosis, which is mainly restricted to the care of patients hospitalised for acute complications of the disease. […] In the hospital setting, specialised nurses should become an integral part of interprofessional teams, helping to improve the quality of care and outcomes of patients with cirrhosis. In the primary care setting, nurses should play an important role in the care of patients with compensated cirrhosis and also facilitate early diagnosis of cirrhosis in those at risk of liver diseases. This review calls for an improved global liver disease education programme for nurses and increased awareness among all healthcare providers and policymakers of the positive impacts of advanced or specialist nursing practice in this domain.

• #55 Nursing care for patients with cirrhosis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36754211/

  Cirrhosis represents a major cause of morbidity and mortality, leading to a marked impairment in the quality of life of patients and their caregivers, and resulting in a major burden on healthcare systems. Currently, in most countries, nurses still play a limited role in the care of patients with cirrhosis, which is mainly restricted to the care of patients hospitalised for acute complications of the disease. […] In the hospital setting, specialised nurses should become an integral part of interprofessional teams, helping to improve the quality of care and outcomes of patients with cirrhosis. In the primary care setting, nurses should play an important role in the care of patients with compensated cirrhosis and also facilitate early diagnosis of cirrhosis in those at risk of liver diseases. This review calls for an improved global liver disease education programme for nurses and increased awareness among all healthcare providers and policymakers of the positive impacts of advanced or specialist nursing practice in this domain.

• #56 Palliative Care and Symptom-Based Management in Decompensated Cirrhosis | AASLD

  https://www.aasld.org/practice-guidelines/palliative-care-and-symptom-based-management-decompensated-cirrhosis-0

  Palliative care is defined as multidisciplinary, specialized medical care that addresses the physical, spiritual, and psychosocial needs of patients with serious illness and their caregivers. […] The benefits of palliative care are increasingly recognized across disease states and for patients with decompensated cirrhosis (DC). […] Although palliative care can be considered regardless of the stage of cirrhosis, this guidance document predominantly addresses issues pertinent to adult patients with DC because this group bears considerable physical, psychosocial, and financial burden. […] We specifically focus on topics that are not covered in existing AASLD practice guidelines/guidance documents and thus refer the readers to the AASLD practice guidelines for specific recommendations for the diagnosis and management of ascites, hepatic encephalopathy (HE), hepatocellular carcinoma (HCC), and portal hypertension.

• #57 Palliative care for patients with end-stage liver disease – UpToDate

  https://www.uptodate.com/contents/palliative-care-for-patients-with-end-stage-liver-disease

  Palliative care for patients with end-stage liver disease […] Palliative care is an interdisciplinary medical specialty that focuses on preventing and relieving suffering, and on supporting the best possible quality of life for patients facing serious illness and their families. The primary tenets of palliative care are symptom management; establishing goals of care that are in keeping with the patient’s values and preferences; consistent and sustained communication between the patients and all those involved in their care; and psychosocial, spiritual, and practical support both to patients and their family caregivers. Palliative care is applicable early in the course of terminal illness in conjunction with other therapies that are intended to prolong life; it is not limited to end-of-life care. Palliative services, including setting patient-centered achievable goals for medical care and aggressive symptom management, should be routinely offered alongside curative and disease-modifying treatments for patients with serious illnesses (the simultaneous care model).

• #58 Palliative Care and Symptom-Based Management in Decompensated Cirrhosis | AASLD

  https://www.aasld.org/practice-guidelines/palliative-care-and-symptom-based-management-decompensated-cirrhosis-0

  Palliative care is defined as multidisciplinary, specialized medical care that addresses the physical, spiritual, and psychosocial needs of patients with serious illness and their caregivers. […] The benefits of palliative care are increasingly recognized across disease states and for patients with decompensated cirrhosis (DC). […] Although palliative care can be considered regardless of the stage of cirrhosis, this guidance document predominantly addresses issues pertinent to adult patients with DC because this group bears considerable physical, psychosocial, and financial burden. […] We specifically focus on topics that are not covered in existing AASLD practice guidelines/guidance documents and thus refer the readers to the AASLD practice guidelines for specific recommendations for the diagnosis and management of ascites, hepatic encephalopathy (HE), hepatocellular carcinoma (HCC), and portal hypertension.

• #59 Palliative care for patients with end-stage liver disease – UpToDate

  https://www.uptodate.com/contents/palliative-care-for-patients-with-end-stage-liver-disease

  Palliative care has been best studied and implemented among patients with malignancy, and increasingly there is growing evidence of the many benefits of integration of palliative care for a variety of advanced illnesses. End-stage liver disease (ESLD) is a commonly reported cause of death in the United States and guidelines from professional societies highlight the importance of integrating palliative care principles in the care of these patients. […] The American Association for the Study of Liver Diseases (AASLD) and the American Gastroenterological Association (AGA) have published guidance on integrating principles of palliative care for patients with decompensated cirrhosis, and our approach is well-aligned with the guidance statements. […] Palliative care issues in adult patients with ESLD will be reviewed here. An overview of the benefits, services, and models of subspecialty palliative care is provided elsewhere.

• #60 Palliative care for patients with end-stage liver disease – UpToDate

  https://www.uptodate.com/contents/palliative-care-for-patients-with-end-stage-liver-disease

  Cirrhosis represents the irreversible late stage of chronic progressive liver disease; it is characterized by the distortion of hepatic architecture and the formation of regenerative nodules. Patients with cirrhosis who have not developed major complications are classified as having compensated cirrhosis. Patients who have developed complications of cirrhosis, such as variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatocellular carcinoma (HCC), hepatorenal syndrome, or hepatopulmonary syndrome, are considered to have decompensated cirrhosis. These complications are the primary causes of death in ESLD.

• #61 Liver disease 1: nursing care for end-stage liver disease | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/liver-disease-1-nursing-care-for-end-stage-liver-disease-11-07-2014/

  Nurses can ensure patients are entered onto an electronic palliative care coordination system if available. […] Advanced care planning can consider preferred priorities of care, advance decisions to refuse certain treatments, and lasting power of attorney. […] It is important that nurses understand the common causes and complications of liver disease and, as well as the complexities of patient management, they should be aware of the need to improve end-of-life care for people with ELD. […] Nurses have a vital role in developing and promoting high-quality coordinated care for the increasing numbers of people with advanced liver disease.

• #62 Patient education: Cirrhosis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/cirrhosis-beyond-the-basics

  MANAGE SYMPTOMS AND BLOOD ABNORMALITIES […] People with cirrhosis sometimes develop symptoms related to their disease that are distinct from the complications discussed above. They also sometimes have blood abnormalities that require treatment. […] Muscle cramps — People with cirrhosis sometimes get muscle cramps, which can be severe. […] Hyponatremia (too little sodium) — Hyponatremia is the medical term for „too little sodium in the blood.” People with advanced cirrhosis commonly develop hyponatremia, and it can be serious because it can impair brain function and worsen hepatic encephalopathy. […] Blood clotting problems — The blood of people with cirrhosis often does not clot as it should, but sometimes it clots too much. […] LIVER TRANSPLANT FOR CIRRHOSIS […] Liver transplant involves replacing a diseased liver with a healthy liver. It is the definitive treatment for people with advanced cirrhosis. Still, not everyone with advanced cirrhosis is a good candidate for a transplant.

• #63 Patient education: Cirrhosis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/cirrhosis-beyond-the-basics

  More than 80 percent of people will be alive one year after a liver transplant, and the majority of these will be alive five years after the transplant. This is compared with an extremely high death rate in patients with very advanced cirrhosis who do not receive a liver transplant. […] WHERE TO GET MORE INFORMATION […] Your health care provider is the best source of information for questions and concerns related to your medical problem.

• #64 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Healthcare providers recommend liver transplantation when they feel that your health will continue to decline without one. This might be the case if you are in active liver failure, have liver cancer and/or you arent responding to treatment for your liver disease. If you meet the qualifications for a liver transplant, youll join a national waiting list to receive one. Your condition will determine your place on the list. […] Cirrhosis is a serious condition that causes liver damage. At Cleveland Clinic, our experts will help you manage cirrhosis and relieve symptoms.

• #65 Cirrhosis Treatment | Rush

  https://www.rush.edu/services/cirrhosis-care

  Whatever stage of cirrhosis you may have, our caring liver specialists can suggest a diet, medications and other treatments for your chronic liver disease. […] Cirrhosis, or late-stage scarring of the liver, is a chronic, life-threatening condition. […] Hepatologists, gastroenterologists and other cirrhosis specialists at RUSH are here to help you address the cause of your cirrhosis. We can work with you on a cirrhosis treatment program to reduce your risks of developing liver failure. […] We can also help you prevent and manage the complications of cirrhosis, such as ascites (fluid in the abdomen), esophageal varices (enlarged veins in the esophagus), hepatic encephalopathy (loss of brain function) and liver cancer. […] Your cirrhosis treatment at RUSH may include the following strategies: Lifestyle modifications, such as eating a nutritious diet, limiting salt and maintaining a healthy weight; Medications to address the cause of your cirrhosis and manage your symptoms; Liver transplant if your liver is too damaged to function; Help with addiction, including alcohol abuse and use of illegal drugs, when needed.

• #66 Liver Cirrhosis Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/cirrhosis-nursing-diagnosis/

  Nursing care for patients with liver cirrhosis requires a comprehensive understanding of the disease process, potential complications, and appropriate nursing interventions. By identifying and addressing essential nursing diagnoses, nurses can provide targeted care that improves patient outcomes and quality of life. Regular assessment, patient education, and collaboration with the healthcare team are essential components of successful management for patients with liver cirrhosis.

• #67 Cirrhosis Nursing Care Plan & Example | Free PDF Download

  https://www.carepatron.com/templates/cirrhosis-nursing-care-plan

  Nurses play a crucial role in the management of cirrhosis patients, employing a variety of interventions to address symptoms, prevent complications, and promote overall well-being. […] Nurses are essential in administering medications to manage symptoms, prevent complications, and support liver function in cirrhosis patients, including diuretics, lactulose, and beta-blockers. […] An essential nursing function when caring for a patient with cirrhosis is to assess and monitor the patient’s liver function, fluid balance, and mental status regularly, as these are critical indicators of disease progression and complications.

• #68 Nursing Care Plan for Liver Cirrhosis – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-liver-cirrhosis-promoting-liver-health-and-managing-complications/

  Based on the assessment, the following nursing diagnoses may be applicable to individuals with liver cirrhosis: Impaired Liver Function related to liver damage, compromised hepatic circulation, cirrhosis, and hepatocellular damage. […] Monitor liver function tests regularly and report abnormal findings to the healthcare provider. […] Educate the individual about lifestyle modifications, including abstinence from alcohol and avoidance of hepatotoxic medications. […] A comprehensive nursing care plan for liver cirrhosis is crucial in promoting liver health, managing complications, and enhancing the overall well-being of individuals with this condition. By conducting thorough assessments, identifying appropriate nursing diagnoses, and implementing targeted interventions, nurses can play a vital role in improving outcomes and providing the necessary support to individuals and their families.

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