Explain causes, signs and symptoms, and treatment of liver cirrhosis

Explain causes, signs and symptoms, and treatment of liver cirrhosis

Liver Cirrhosis

The following questions relates to the patient within the first 24 hours:

  1. Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family
  2. List five (5) common signs and symptoms of the identified condition; for each provide a link to the underlying pathophysiology
  3. This can be done in the form of a table – each point needs to be appropriately referenced
  4. Describe two (2) common classes of drugs used for patients with the identified condition including physiological effect of each class on the body
  5. This does not mean specific drugs but rather the class that these drugs belonviral infectiong to.
  6. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours post admission for this patient

Case study 3

Mr Nathan James is a 48 year old male who was admitted to the high dependency unit for investigation of jaundice and ascites. He is an interstate truck driver and is married with 2 children. Mr James is a current smoker and known to consume 2 of beer per day. He has a previous (15 years ago) history of recreational drug use and was diagnosed with Hepatitis C 10 years ago.

On assessment:

Mr James is lethargic but orientated to time, place and person and slightly irritable. He is slightly tachypnoeic with moderate use of accessory muscles. His wife reported that Mr James has been spitting blood stained sputum for the last few weeks with no associated cough or shortness of breath. Mr James reports that he has lost 9 kilos in weight which he attributed simply to a lack of appetite. No changes were reported with his urine output. On examination his sclera is mildly jaundiced and has some “unexplained” bruises on his arms and legs. His abdomen is tight and distended and pitting oedema noted on his ankles.

Observations: BP: 115/60mmHg, HR: 110 bpm, RR: 24 bpm, SpO2: 88% on RA, 95% on 6L via Hudson Mask, Temp: 37.8C

Impression: Liver Cirrhosis

Laboratory Findings: Result Normal Values
RBC 4.0 million/mm3 2.6 to 5.9 million/mm3
WBC 3500/mm3 4300 to 10800/mm3
Platelets 75000/mm3 150000 to 350000/mm3
Serum Ammonia 110 μm/dl 35 to 65 μm/dl
Total Bilirubin 4.9 mcg/dl 0.1 to 1.0 mcg/dl
Sodium 150 mEq/L 135 to 145 mEq/L
Potassium 3.4 mEq/L 3.7 to 5.5 mEq/L
Haemoglobin 85 g/L 120-170 g/L
Albumin 24 g/L 35-50 g/L
Liver Enzymes Slightly elevated
BUN 22 mg/dl 7-18 mg/dl
Creatinine 154 ml/min 88 to 137 ml/min

 

 

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