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Cirrhosis (Definition (This is a chromic progressive disease which is…
Cirrhosis
Definition
This is a chromic progressive disease which is characterized by extensive degeneration and destruction of the parenchymal cells of the liver.
Pathophysiology
In cirrhosis the liver varies in appearance. The most prominent feature is nodular consistency with brands of fibrous scar tissue and small areas of regenerating tissue. The fibrotic changes in the liver distort the hepatic structures, resulting in the obstruction of splanchnic veins and portal blood flow. This obstruction causes problems such as fluid retention, increasing oedema, ascites and hydrothorax. The portal pressure increases and these together with congestion of splanchnic veins results in splenomegaly and altered function of the spleen which can cause leukopenia.
Causes
Alcoholic liver disease, bile duct obstruction, inherited diseases, exposure to certain drugs and chemicals
Assessment findings
A variety of signs and symptoms may be sesn in patients with cirrhosis and these reflect the diminishing capacity of the liver to work well. The most common early symptoms occur in the gastrointestinal tract, while later symptoms may be severe and result from liver failure and portal hypertension. Later symptoms include skin lesions and skin neuropathisies.
Health education
• Patients should be advised to avoid over the counter medications as some of these could be hepatotoxic. Patients should avoid alcohol consumption as this can futher liver damage. They should also avoid spicy, rough foods as well as activities that increase portal pressure such as coughing, sneezing,retching and vomiting. They should be told to eat a balanced diet
Surgical management
A liver transplant is considered when complications of cirrhosis can not be controlled by treatment.
Nursing management
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• Carefully balance fluid intake to maintain kidney perfusion without overloading the cardiovascular system.
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