About
Damage and ischemia of the liver. Common causes are long-term alcohol abuse and hepatitis.
Assess
Hx of alcoholism, liver disease, IV drug use, exposure to toxins; fatigue, weight change, itching, spider angiomas, jaundice, ascites, GI complaints, lever tenderness, hepatomegaly, anemia, portal hypertension
Complications
Ascites
Hemorrhage
Portal systemic hypertension
Liver transplant; death
Diagnosis
- Chronic pain related to enlarged liver
- Fatigue related to malnutrition
- Disturbed thought processes related to accumulation of ammonia as disease progresses
- Chronic sorrow related to chronic illness
Goals
- The client will identify components of disease treatment plan.
- The client will be free from injury.
Interventions
- Monitor fluid balance, vital signs, pulse oximetry, intakes/ outputs, daily weight, and electrolytes.
- Monitor for complications, including neurological changes.
- Monitor for signs/ symptoms of active bleeding ( hypotension, tachycardia, bruising, petechiae, purpura, etc.).
- Monitor clotting factors and ammonia levels.
- Monitor for esophageal varices.
- Administer medications, as ordered.
- Monitor for drug accumulation and toxicity since liver metabolism may be compromised.
- Assist with procedures ( balloon tamponade, shunts, etc.) as indicated.
- Teach client about disease management and treatment strategies.
- Teach client s/s of complications related to disease.
- Teach home care strategies to manage disease including diet, medicines, abstention from alcohol.
- Monitor for signs/ symptoms of complications.
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