my ppt liver chirrosis
TRANSCRIPT
DEFINITION- CIRRHOSIS IS A CONDITION IN WHICH THE LIVER SLOWLY DETERIORATES AND MALFUNCTIONS DUE TO CHRONIC INJURY. SCAR TISSUE REPLACES HEALTHY LIVER TISSUE, PARTIALLY BLOCKING THE FLOW OF BLOOD THROUGH THE LIVER
PHYSIOLOGY- Metabolism / Detoxification
• Metabolizes products of digestion
• Glucose regulation
• Vitamin storage
• Metabolizes drugs
• Breaks down bilirubin
Synthesis and Secretion
• Components of clotting factors
• Cholesterol, triglyceride synthesis
• Bile production
• Other proteins and hormones
Storage and Filtration of Blood
• Acts as a blood reservoir
• Contains phagocytic cells
• Part of the reticuloendothelial system.
CAUSES-
MORE COMMON- Hepatitis B or C
infection Alcohol abuse Intrahepatic
cholestasis or obstruction of bile ducts
Hepatic congestion
LESS COMMON- Autoimmune
hepatitis Bile duct disorders Some medicines Hereditary diseases Non-alcoholic fatty
liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
CONT…
INCREASED AMMONIA
HEPATIC ENCEPHALOPATHY
OSMOTIC SHIFTS
ASCITIS
INCREASED PRESSURE RESSISTANCE
ENLARGEMENT OF ESOPHAGEAL, UMBILICAL,
RECTAL VEINS
BLEEDING VARICES
PORTAL HYPERTENSION
CLINICAL MANIFESTATIONS-
-Anorexia -Dyspepsia -Flatulence -Fatty stools -Nausea and
vomiting -Diarrhea or
constipation -Jaundice -Peripheral edema -Spider angioma -Spleenimegaly -Ascitis
EARLY SIGNS
LATE SIGNS
DIAGNOSTIC STUDIES-
1) History and physical examination 2) Liver function studies In cirrhosis there are abnormalities in most of the liver
function studies. As a result of release of enzyme from damaged liver cells initially enzymes are elevated.
Alkp (alkaline phosphatage) AST ALT GGT (gamma glutamyl transpeptidase) Total protein Albumin Serum bilirubin Globulin Cholesterol level
3) Complete blood count 4) Prothrombin time is prolonged. 5) Liver biopsy (percutaneous needle) to
identify liver cell changes and alteration in lobular structure.
6) Liver ultrasound 7) CT scan 8) Esophagogastroduodenoscopy 9) Angiography 10) Serum electrolytes 11) Testing of stool for occult blood 12) Upper GI barium swallows.
DRUG THERAPY- Vasopressin ( Pitressin) Propranolol (Inderal ) Lactulose (Cephulac ) Neomycin sulfate Magnesium sulfate
Vitamin K H2 receptor blockers
(Ranitidine) Proton pump inhibitors
(Pantoprazole) Diuretics(Spironolactone) Chlorothizide (Diuril) Frusemide (Lasix )
NURSING MANAGEMENT-
1.Imbalanced Nutrition, less than body requirements related to insufficient intake to meet metabolic demands secondary to anorexia, nausea, vomiting as evidenced by abdominal pain/cramping, loss of weight; poor muscle tone.
2. Fluid Volume deficient related to excessive losses through vomiting and diarrhoea as evidenced by decreased skin turgor, sunken eyes and weak peripheral pulse.
3. Excess fluid volume related to retention of fluids secondary to decreased serum albumin, increased sodium and water and portal hypertension as evidenced by dependent edema, weight gain and ascites.
CONT…
4. Low Self-Esteem, related to confinement/isolation, secondary to length of illness/recovery period as evidenced by verbalization of change in lifestyle, feelings of helplessness.
5. Risk for infection related to immunosuppression & malnutrition.
6. Fatigue related to decreased metabolic energy production as evidenced by reports of lack of energy/inability to maintain activity of daily living.
CON……
7.Risk for impaired Skin/Tissue Integrity, related to chemical substance: bile salt accumulation in the tissues.
8.Knowledge, deficient regarding condition, prognosis, treatment, self-care, and discharge needs related to lack of information as evidenced by frequent questioning.
PATIENT & FAMILY TEACHING GUIDE-
CONTINUE HEALTH CARE
AVOID ALCOHOL
AVOID ASPIRIN
AVOID FATTY SPICY FOOD
SEEKMEDICAL
ATTENTION