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transcript
8/8/2019 GIT 7 (Liver)
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Conditions of Accessory
Digestive Organs
Medical-Surgical Nursing
NCM - 102
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Liver Cirrhosis
Irreversible chronic
inflammatory disease Massive degeneration and
destruction of hepatocytes
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Types
1. Laennec¶s cirrhosis
2. Postnecrotic cirrhosis
3. Biliary cirrhosis
± Primary
± Secondary
4. Cardiac cirrhosis
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Etiology
Post-infection, Alcohol,
Cardiac diseases,Schistosoma, Biliary
obstruction
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Liver physiology and Pathophysiology
Normal Function Abnormality in function
1. Stores glycogen = Hypoglycemia
2. Synthesizes proteins = Hypoproteinemia
3. Synthesizes globulins =Decreased Antibody
formation
4. Synthesizes Clotting factors = Bleeding tendencies
5. Secreting bile = Jaundice and pruritus
6. Converts ammonia to urea =Hyperammonemia
7. Stores Vit and minerals =Deficiencies of Vit and min
8. Metabolizes estrogen = Gynecomastia, testicular
atrophy
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PathoPhysiology
Development of collateral vessels
± Esophageal varices
± Caput medusae ± Hemorrhoid
Portal hypertension
± Ascites Decreased albumin production
± Anasarca
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Assessment Findings
1. Anorexia and weight
loss
2. Jaundice
3.Fatigue
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Nursing Interventions
1. Monitor VS, I and O,
Abdominal girth, weight, LOC
and Bleeding
2. Promote rest. Elevated the
head of the bed to minimizedyspnea
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Nursing Interventions
3. Provide Moderate toLOW-protein (1 g/kg/day)and LOW-sodium diet
4. Provide supplemental
vitamins (especially K)and minerals
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Nursing Interventions
5. Administer prescribed
Diuretics= to reduce ascites and
edema
Lactulose= to reduce NH4 in thebowel
Antacids and Neomycin= tokill bacterial flora that cause NHproduction
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Nursing InterventionsNursing Interventions Rationale
1. Low sodium Diet To reduce edema
2. Low protein diet To reduce NH production
3. Benadryl and mild soap To relieve pruritus
4. Pressure onto injection site To prevent bleeding
5. Assist in paracentesis Done to relieve abdominal
pressure
6. Administer Medications:
±Diuretics, Neomycin,
Lactulose
±Albumin, Amino acid
±Vitamin K (menadione)
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Nursing Interventions
6. Avoid hepatotoxic
drugsParacetamol
Anti-tubercular drugs
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Nursing Interventions
7. Reduce the risk of injury
±Side rails reorientation
±Assistance in ambulation
±Use of electric razor and
soft-bristled toothbrush
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Nursing Interventions
8. Keep equipments ready
including Sengstaken-
Blakemore tube, IV fluids,
Medications to treat
hemorrhage