Question

nursing diagnosis, goals ,interventions and evaluation for liver cirrhosis patient in a table form

Answer 1

Liver cirrhosis, also known as hepatic cirrhosis, is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. As necrotic tissues yields to fibrosis, the diseases alters the liver structure and normal vasculature, impairs blood and lymph flow, and ultimately causing hepatic insufficiency. Causes include malnutrition, inflammation (bacterial or viral), and poisons (e.g., alcohol, carbon tetrachloride, acetaminophen). Cirrhosis is the fourth leading cause of death in the United States among people ages 35 to 55 and represents a serious threat to long-term health.

LNursing care plans for

liver cirrhosis:

1. Imbalanced Nutrition: Less Than Body Requirements
2. Excess Fluid Volume
3. Risk for Impaired Skin Integrity
4. Ineffective Breathing Pattern
5. Risk for Injury
6. Risk for Acute Confusion
7. Disturbed Body Image
8. Deficient Knowledge

Nursing Interventions	Rationale
Measure dietary intake by calorie count.	Provides important information about intake, needs and deficiencies.
Weigh as indicated. Compare changes in fluid status, recent weight history, skinfold measurements.	It may be difficult to use weight as a direct indicator of nutritional status in view of edema and/or ascites. Skinfold measurements are useful in assessing changes in muscle mass and subcutaneous fat reserves.
Encourage patient to eat; explain reasons for the types of diet. Feed patient if tiring easily, or have SO assist patient. Include patient in meal planning to consider his/her preferences in food choices. Im Provide tube feedings, TPN, lipids if indicated. Maintain NPO status when indicated. L Refer to dietitian to provide diet high in calories and simple carbohydrates, low in fat, and moderate to high in protein; limit sodium and fluid as necessary. Provide liquid supplements as indicated Promote undisturbed rest periods, especially before meal Recommend cessation of smoking. Provide teaching on the possible negative effects of smoking Suggest soft foods, avoiding roughage if indicated	Improved nutrition and diet is vital to recovery. Patient may eat better if family is involved and preferred foods are included as much as possib Patient may pick at food or eat only a few bites because of loss of interest in food or because of nausea, generalized weakNes Initially, GI rest may be required in acutely ill patients to reduce demands on the liver and production of ammonia and urea in the GI tract. L High-calorie foods are desired inasmuch as patient intake is usually limited. Carbohydrates supply readily available energy. Fats are poorly absorbed because of liver dysfunction and may contribute to abdominal discomfort. Proteins are needed to improve serum protein levels to reduce edema and to promote liver cell regeneration. Note: Protein and foods high in ammonia (gelatin) are restricted if ammonia level is elevated or if patient has clinical signs of hepatic encephalopathy. In addition, these individuals may tolerate vegetable protein better than meat protein. Conserving energy reduces metabolic demands on the liver and promotes cellular regeneration Reduce excessive gastric stimulation and risk of irritation and may lead to bleeding Hemorrhage from esophageal varices may occur in advanced cirrhosis