Liver Cirrhosis

NURSING MANAGEMENT

: Promoting Activity Tolerance Encourage alternating periods of rest and ambulation. Maintain some periods of bed rest with legs elevated to mobilize edema and ascites. Encourage and assist with gradually increasing periods of exercise. Improving Nutritional Status Encourage patient to eat high calorie, moderate protein meal and to have supplementary feedings. Suggest small, frequent feedings and attractive meals in an aesthetically pleasing setting at meal time. Encourage and assist withgradually increasing periods of exercise.

NURSING MANAGEMENT
Protecting Skin Integrity Note and record degree of jaundice of skin and sclerae and scratches on the body. Encourage frequent skin care, bathing without soap, and massage with emollient lotions. Advise patient to keep fingernails short. Patient Education and Health Maintenance Stress the necessity of giving up alcohol completely. Urge acceptance of assistance from a substance abuse program. Provide written dietary instructions. Encourage daily weighing for self-monitoring of fluid retention depletion. Discuss adverse effects of diuretic therapy. Emphasize the importance of rest, a sensible lifestyle, and an adequate, wellbalanced diet. Involve the person closest to the patient because recovery usually is not easy and relapses are common. Stress the importance of continued follow up for laboratory test and evaluation by a health care provider

Cholelithiasis

Pancreatitis

Alcohol | Protein rich, viscous pancreatic juice | Precipitation to form plugs Alcohol | | Obstruction of ductules Decrease secretion of lithostatin Calcification + glandular ischaemia | Progressive acinar ectasia and atrophy Pancreatic insufficiency