CIRRHOSIS = a chronic liver disease characterized by fibrotic changes and the formation of

dense connective tissue within the liver, subsequent degenerative changes, and loss of function
cells.
= is a chronic disease characterized by replacement of normal liver tissue and with
diffuse fibrosis that disrupts the st5ructure and function of the liver.

THREE (3) TYPES OF CIRRHOSIS OR THE SCARING OF THE LIVER

1. Alcohol cirrhosis = in which the scar tissue characteristically surrounds the portal
areas. This is roost frequently due chronic alcoholism and is the most common type
of cirrhosis.
2. Post necrotic cirrhosis = which there are broad bands of scar tissue as a late result of a
previous bout of acute viral hepatitis.
3. Biliary cirrhosis = which scarring occurs in the liver around the bile ducts. This type
usually is the result of chronic biliary obstruction and infection (cholangitis), it is
much less common than the other two types of cirrhosis.

 The portion of the liver chiefly involved in cirrhosis consist of the portal and the
periportal spaces ,where the bile canaliculi of each lobule communicate to form the liver
ducts.these areas become the sites of inflammation ,and the bile ducts become occluded
with inspissated thicken bile and pus .the liver attempts to form a new bile channels; this
is an overgrowth of tissue made up largely of disconnected ,ne4wly formed bile ducts abd
surrounde by scar tissue.

CLINICAL MANIFERSTATIONS:
-include intermittent jaundice and fever. Initially the liver is enlarge, hard, and irregular
but eventually it atrophies.
COMPENSATED DECOMPENSATED
-intermittent mild fever -ascites
-vascular spiders -jaundice
-palmar erythema(redde3ned palms) -weakness
-unexplained epistaxis -weight loss
-ankle edema -continuous mild fever clubbing of fingers
-vague morning indigestion -Purpura (due to decreased platelet count)
-flatulent dyspepsia -spontaneous brushing
-abdominal pain -epitasis
-firm enlarge fever -hypotension
-splenomegaly - white nails
- gonodal atrophy

Nursing diagnosis
1. Activity intolerance related to fatigue ,general ability, muscle wasting and discomfort
2. Imbalanced nutrition, less than body requirement, related to chronic gastritis, decreased
GI mobility and anorexia.
3. Impaired skin integrity related to compromised immunologic status, edema and poor
nutrition
4. Risk for injury and bleeding related to altered clotting mechanisms.
Complications;

Cirrhosis can cause many serious complications including:

 Ascites (fluid buildup in the abdomen)

 Variceal hemorrhage, severe bleeding from varices (enlarged veins in the esophagus and
upper stomach)
 Spontaneous bacterial peritonitis, a severe infection of the abdominal fluid
 Hepatic encephalopathy, damage to the brain caused by buildup in the body of toxins
such as ammonia
 Hepatocellular carcinoma, a type of liver cancer
 Hepatorenal syndrome, when kidney failure occurs along with severe cirrhosis

Treatment

Cirrhosis is an irreversible condition. Treatment focuses on slowing the progression of liver

damage and reducing the risk of further complications. Your doctor will treat any underlying
medical conditions that are the cause of your cirrhosis. If liver damage progresses to liver
failure, patients may be candidates for liver transplantation. Liver donations can come from
either a cadaver or from a living donor. Patients with cirrhosis who have a liver transplant
have very good chances for survival.

Dietary and Lifestyle Changes

All patients with cirrhosis can benefit from certain lifestyle interventions. These include:

 Stop drinking alcohol.

 Restrict dietary salt.
 Eat a nutritious diet.
 Get vaccinations for influenza, hepatitis A and B, and pneumococcal pneumonia (if
recommended by your doctor).
 Inform your doctor of all prescription and nonprescription medications, and any herbs
and supplements, you take or are considering taking.

Interventions;

1. Providing rest
2. Improving nutritional status
3. Providing skin care
4. Reducing risk of injury monitoring and managing of complications promoting home and
Common -Based Care