ETIOLOGY

Modifiable:
-Age
-Male
-infection with hepatitis B virus (HBV)

Precipitating Factors:
-pain in the upper abdomen on the right side
-a lump in the upper abdomen
-weight loss

DISEASE PROCESS
Arises from the liver parenchymal cells (hepatocellular carcinoma)

Damage to hepatocellular DNA

BBV (blood borne virus) and aflatoxins damage

the tumor interferes with normal hepatic function leading to biliary obstruction and jaundice,
portal hypertension and metabolic disruptions.

Grow rapidly and metastasize

SIGNS AND SYMPTOMS
-the white of your eyes turn yellow (jaundice)
-fatigue and malaise
-weakness or having no energy
-unexplained weight loss
-vomiting

DIAGNOSTIC EVALUATION/ TOOLS

A. Medical Diagnosis
• Imaging Test - to help find suspicious areas that might be cancer.
• Ultrasound - the first test to use to look at the liver.
• Computed Tomography Scan - It can give specific information about the size, shape, and
location of any tumors in the liver.
• MRI - to detect a liver tumor.
• Angiography - to show the arteries that supply blood to a liver cancer.
• Bone Scan - help look for cancer that has spread (metastasized) to bones

B. Nursing Diagnosis (NANDA)

• Imbalance Nutrition
• Chronic Pain related to liver enlargement
• Risk for Deficient Fluid Volume
• Risk for infection
• Risk for impaired Skin Integrity
• Activity Intolerance related to weakness or fatigue
• Social isolation related to treatment- imposed isolation
• Ineffective Health maintenance related to deficient knowledge
• Fatigue related to malnutrition
Management
a. Medical Management
• Chemotherapy: Using drugs to kill cancer cells or stop them from reproducing. Chemotherapy
may be systemic (pills or injections that travel through the entire body).
• Targeted therapy: Using drugs that zero in on the cancer genes or tissue. Targeted therapy is
different than chemotherapy.
• Immunotherapy: Using drugs that direct the body’s immune system to kill cancer cells.
• Loco-regional therapy: Injecting beads that give off radiation into the blood vessel that is
feeding the tumor (radio embolization).

b. Pharmacological Management
 Doxazosin (Cardura)- to stimulate central alpha- receptors, decreases sympathetic
outflow from the central nervous system.
 Simvastatin (Zocor)- inhibiting the formation of HMG-CoA reductase, an enzyme that is
required for the liver to synthesize cholesterol.
 Warfarin Sodium (Coumadin)- to disrupts the coagulation cascade.

c. Nursing Management
• Encourage clients with risk factors to avoid alcohol and other substances that may damage the
liver
• Regular screening for liver tumor (serum AFP)
• To increase venous return and prevent edema, elevate the patient’s legs whenever possible.
• Provide meticulous skin care.
• Monitor the patient for fluid retention and ascites.
• Monitor respiratory function.
• Explain the treatments to the patient and his family, including adverse reactions the patient
may experience.
If not treared
Liver Cancer can lead to:
• Increase in symptoms
• Complication such as anemia, bleeding and hypercalcemia that may lead to death.
* Bad Prognosis

If treated
• Early detection or diagnosis of the disease
✓ Imaging Test
✓ Ultrasound
✓ Computed Tomography Scan
✓ MRI
✓ Angiography
✓ Bone Scan
• Administration of prescribed medication for disease modification and for symptom
management.
* Good Prognosis

REFERENCES:

https://www.cancer.org/cancer/liver-cancer/detection-diagnosis-staging/how-
diagnosed.html
https://nandanursingdiagnosis.blogspot.com/2011/08/nursing-diagnosis-for-
hepatocellular.html
https://www.mayoclinic.org/diseases-conditions/liver-cancer/diagnosis-treatment/drc-
20353664
https://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-
liver-cancer.html
https://www.cancerresearchuk.org/about-cancer/liver-cancer
8th edition book of Gary D. Hammer and Stephen J. McPhee
11th Edition Nursing Diagnosis Handbook (Betty J. Ackley, Gail B. Ladwig, Mary Beth
Flynn Makic)
10th Edition Lehne’s Pharmacology for Nursing Care (Jacqueline RosenJack Burchum,
Laura D. Rosenthal)