Nursing Interventions for Cirrhosis


Cirrhosis is severe scarring of the liver and poor liver function seen at the end of chronic liver disease. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.

According to the National Institutes of Health (NIH) cirrhosis is the 12th leading cause of death due to disease in America. It is more likely to affect men than women.

Some of the symptoms include:
  • decreased appetite
  • nose bleeds
  • small spider-shaped arteries underneath the skin
  • weight loss
  • weakness
More serious symptoms include:
  • confusion and difficulty thinking clearly
  • yellow skin color (jaundice caused by buildup of bilirubin in the blood)
  • abdominal swelling (ascites)
  • swelling of the legs (edema)
  • impotence
  • males can start to develop breast tissue (gynecomastia)


Nursing Interventions for Cirrhosis

1. Imbalanced Nutrition Less Than Body Requirements related to anorexia.

Goal: Nutrition clients are met.
Expected outcomes: The client is able to exhibit a lifestyle to improve or maintain an appropriate body weight, showed weight gain goals with laboratory values, and freely sign of malnutrition.

Interventions:

1. Observation vital signs.
Rationale: To determine the general state of the client.

2. Provide oral care before meals.
Rationale: Eliminate sense, it can not increase the appetite.

3. Monitor dietary intake, or the number of calories and provide little in the frequency often.
Rationale: Eat a lot harder when the client anorexia. Anorexia is also the worst during the day, make food intake difficult in the afternoon.

4. Monitor blood glucose.
Rationale: hyperglycemia or hypoglycemia can occur require changes in diet or insulin administration.

5. Collaboration: Consultation with a dietitian to provide a diet in accordance with the client's needs with the input of fat and protein as tolerated.
Rationale: Allows to create a diet program for individual needs. Protein restriction is indicated in severe diseases like hepatitis.



2. Self-Care Deficit related to fatigue and the presence of ascites.

Goal: The client is able to care for themselves.
Expected outcomes: The client is able to show self-care activities.

Interventions :

1. Give the rest during the acute phase.
Rationale: Increased rest and tranquility providing the energy that is used for healing.

2. If the client is tired, limit visits of family or friends.
Rationale: Increase rest and tranquility providing the energy that is used for healing.

3. Give light activity during bed rest.
Rationale: Bed rest time, can reduce the ability, this is precisely the case due to the limited activities that disrupt the rest period.



3, Risk for Impaired tissue integrity related to bed rest, ascites and edema.

Goal: Do not damage the integrity of the skin.

Expected outcomes: Identify the risk factors and shows the behavior or technique to prevent skin damage.

Interventions:

1. Elevate the lower extremities.
Rationale: Improves venous return and decrease edema in the extremities.


2. Cut fingernails to short, and give the gloves if desired.
Rationale: Prevent clients from injury to the skin, especially at bedtime.

3. Keep the sheets dry and free of creases.
Rational: Humidity increase pruritus and improve skin damage.

4. Give the massage at bedtime.
Rational: Beneficial to improve sleep by reducing skin irritation.

Source :
http://www.nandahealth.com/2015/09/nursing-diagnosis-and-interventions-for.html