Cirrhosis - Clotting defects noted in lab findings: elevated bilirubin, AST, ALT, alkaline phosphatase, PT,

and ammonia; decreased Hgb, Hct, electrolytes, and albumin

Ammonia - Not broken down as usual in the damaged liver; therefore this serum level rises

Complications of cirrhosis - Ascites, edema; portal hypertension; esophageal varices; encephalopathy;

respiratory distress; ccoagulation defects

Esophageal varices - May rupture and cause hemorrhage. Immediate management includes insertion of
an esophagogastric balloon tamponade (Blakemore-sengstaken or Minnesota tube) along with
vasopressors, vitamin K, coagulation factors, and blood transfusions

Nursing plans and interventions with cirrhosis - Eliminate causative agent; administer vitamin
supplements; observe mental status frequently; avoid initiating bleeding and observe for bleeding
tendencies; provide special skin care; monitor fluid and electrolyte status; monitor dietary intake
carefully, especially protein; dietary restrictions: low sodium, low potassium, low fat, high carbohydrate
diet

Esophageal varices management - Esophagogastric balloon tamponade (Blakemore tube), sclerotherapy,

portal systemic shunts

Hepatitis - A widespread inflammation of liver cells, usually caused by a virus

Nursing assessment of a patient with hepatitis - Known exposure to hepatitis; recent transfusions or
hemodialysis; fatigue, malaise, weakness; anorexia, NV; jaundice, dark urine, clay-colored stools;
myalgia, joint pain; dull headaches, irritability, depression; abdominal tenderness in the right upper
quadrant; fever; elevations in liver enzymes and bilirubin

Hepatitis nursing plans and interventions - Assess client's response to activity; assist client with care as
needed; provide high calorie, high carbohydrate diet with moderate fats and proteins; small, frequent