Cirrhosis of Liver

The abnormal liver condition known as cirrhosis causes the liver to permanently scar. Although there are numerous other potential causes, chronic excessive alcohol consumption, viral hepatitis B and C, and fatty liver disease are the main culprits.

Cirrhosis patients may experience itching, jaundice (a yellowing of the skin, eyes, and tongue), and extreme fatigue.

Pathophysiology

Structure changes and degenerative changes brought on by the accumulation of diffuse bands of fibrotic connective tissue that damage hepatic cells widely, impair liver function, and obstruct blood flow through the liver.

• Compensated cirrhosis:
  • Even with severe scarring, the liver can still function for a while, although metabolic irregularities like starvation and clotting problems happen.
• Decompensated cirrhosis:
  • Progression of failure with serious side effects, including encephalopathy, ascites, peritonitis, hepatorenal syndrome, and portal hypertension with bleeding variations.

 Causes

• Fatty liver linked to diabetes and obesity.
• Hepatic viral infections that persist throughout time (hepatitis types B, C, and D; Hepatitis D is extremely rare).
• Blockage of the bile duct, which transports bile produced in the liver to the intestines to aid in fat digestion, can occur in infants with biliary atresia, a condition in which bile ducts are absent or damaged, resulting in bile buildup in the liver. Adults with primary biliary cholangitis, another liver condition, may develop inflamed, obstructed, or scarred bile ducts.
• Repeated episodes of cardiac failure with hepatic fluid accumulating.
• Certain inherited diseases such as:
  • Cystic fibrosis
  • Glycogen storage diseases, in which the body is unable to process glycogen, a form of sugar that is converted to glucose and serves as a source of energy for the body.
• Alpha 1 antitrypsin deficiency, an absence of a specific enzyme in the liver.
• Wilson's disease, which is brought on by the aberrant accumulation of copper in the liver, and hemochromatosis, a disorder in which excessive iron is absorbed and deposited in the liver and other organs.

 Symptoms

• Abdomen fills up with fluid, giving the patient a large tummy (ascites).
• Accelerated heartbeat.
• Altered personality (as blood toxins build up and affect the brain).
• Bleeding gums.
• Body and upper arms lose mass.
• Body finds it harder to process alcohol.
• Body finds it harder to process drugs.
• Confusion.
• Dizziness.
• Fluid buildup in ankles, feet, and legs (edema).
• Hair loss.
• Higher susceptibility to bruising...
• Jaundice (yellowing of the skin, whites of the eyes, and tongue).
• Loss of libido (sex drive).
• Memory problems.
• More frequent fevers (susceptibility to infections).
• Muscle cramps.
• Nosebleeds.
• Pain on the right shoulder.
• Panting (breathlessness).
• Stools become black and tarry, or very pale.
• Urine becomes darker.
• Vomiting blood.
• Walking problems (staggering).

 Treatment

• To arrest the evolution of cirrhosis in cases of alcohol abuse-related cirrhosis, the individual must quit drinking alcohol.
• In order to lessen liver cell damage in hepatitis patients, the doctor may provide steroids or antiviral medications.
• Treatment options differ depending on whether cirrhosis was brought on by autoimmune disorders, Wilson's disease, or hemochromatosis.
• Medications may be administered to manage the cirrhosis symptoms. Reducing salt in the diet is part of the treatment for edema (fluid retention) and ascites (fluid in the belly). To eliminate extra fluid and stop edema from returning, doctors often prescribe medications known as diuretics. The decreased mental function that cirrhosis might cause can be helped by dietary changes and medication treatments. To aid in the absorption of toxins and hasten their elimination from the intestines, laxatives like lactulose may be used.
• Some persons with severe cirrhosis may require a liver transplant.

Nursing management

• Position the bed to maximize breathing efficiency and, if necessary, supply oxygen.
• Start preventing vascular, circulatory, and respiratory problems.
• Encourage the patient to gradually increase activity and schedule rest periods that include light activities.
• Give your child a healthy, high-protein diet that is complemented by vitamins like A, C, and K as well as the B-complex.
• Motivate the sufferer to eat: Consider the patient's preferences, serve modest, frequent meals, and, if necessary, give them protein supplements.
• If a patient becomes agitated or restless, use padded side rails.
• To reduce agitation, orient to time, place, and processes.
• Some persons with severe cirrhosis may require a liver transplant.
• Keep an eye out for bleeding and bleeding.
• Keep a watchful eye on the patient's mental state and report any changes so that encephalopathy treatment may start right away.
• Maintain careful watch over serum electrolyte levels and make any necessary corrections.
• If oxygen desaturation occurs, administer oxygen; keep an eye out for fever or abdominal pain, which could indicate the beginning of bacterial peritonitis or another illness.
• Evaluate the patient's cardiovascular and respiratory health; if necessary, administer diuretics; impose fluid restrictions; and improve patient placement.
• Keep an eye on your intake and output, daily weight variations, changes in your belly's size, and the development of edema.
• Keep an eye out for nocturia and, later, oliguria, as both symptoms point to a worsening liver disease.

 Complications

• Kidney failure
• Reduced oxygen in the blood
• Diabetes
• Changes in blood counts
• Increased risk of infections
• Excessive bleeding and bruising
• Breast enlargement in men
• Premature menopause
• Loss of muscle mass

References

• bestonlinemd.com/cirrhosis-of-the-liver-stages-symptoms-treatments/
• e-pao.net › education › Health Issue
• fitnesswomanmagazine.com › Health Tips
• healthemetric.com/2013/10/
• imgrum.net/user/nextlevelrn/3037381794
• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
• my.clevelandclinic.org/health/articles/cirrhosis-of-the-liver
• superstitionmtnhikes.com/ccfa-liver-disease-and-ibd/
• webmd.com/digestive-disorders/cirrhosis-liver
• weight-loss-skin-firming-creams.weight-loss-online.bid/weight-loss-and-cirrhosis.html
• vk.com/pages?oid=-131484513&p=Signs_of_liver_failure_in_adults