NURSING MANAGEMENT

OF
LIVER CIRRHOSIS
MAJ JEEJA
JOHN
NOI/C TT
SCHOOL
BASE HOSPITAL
LUCKNOW
 AIMS OF MANAGEMENT

1. SLOW FURTHER DAMAGE TO THE LIVER

2. TREAT SYMPTOMS
3. PREVENT AND TREAT COMPLICATIONS
ALCOHOLIC LIVER DISEASE
 Stop drinking alcohol
 De – addiction center treatment
 Alcohol anonymous self – help groups
CHRONIC HEPATITIS
 Anti – viral medications

NON-ALCOHOLIC FATTY LIVER DISEASE

 Lose weight
 Follow healthy diet
 Do exercise
 Treat DM 2
 MEDICAL MANAGEMENT
 Bed Rest
 Avoid Up – Right Position
 Head – End Elevation Only Upto 45 Degree
 Intravenous Administration Of Glucose To Minimize Protein Breakdown
 Administration Of Vitamins To Correct Deficiencies
 Correction Of Electrolyte Imbalances (Especially Potassium With Potclor)
 Blood Transfusion
 Neurologic Status Is Assessed Frequently
 Foley’s Catheterisation
 Stop Alcohol Intake
 Paracentesis
 Balloon Tamponade
 Esophageal Banding Therapy
 Transjugular Intrahepatic Portosystemic Shunting
 PHARMACOLOGICAL MANAGEMENT

 DIURETICS Eg: Spironolactone

 VITAMINS Eg: K,A,D,E
 STEROIDS To Improve Liver Functions
 VASOPRESSIN To Reduce Portal Hypertension
 SOMATOSTATIN To Reduce UGI Bleeding.
 Lactulose Syrup To Absorb Toxins In The Blood That Resul From Hepatic
Encephalopathy And Flush It Out From Body.
 SURGICAL MANAGEMENT

 LIVER TRANSPLANTATION
DIETARY MANAGEMENT

 EAT A HEALTHY WELL BALANCED DIET

 MONITOR WT LOSS
 CHECK FOR EDEMA/ MUSCLE WASTAGE
 LOW FAT AND LOW SODIUM DIET
 AVOID SALTED FOODS, JUNK FOODS, CANNED FOODS
 PROTEIN – RICH DIET EXCEPT FOR HEPATIC COMA PATIENTS
 HEPATIC COMA PATIENTS : Low-protein diet: 1.0 and 1.5 g/kg or up to 0.5g/kg)
 RESTRICT EXCESS FLUID INTAKE
 HEALTHY LIVER PRACTICES
 AVOID HIGH – RISK BEHAVIOR THAT CAN LEAD TO INFECTION WITH
HEPATITIS B OR C, SUCH AS SHARING NEEDLES FOR ILLEGAL DRUG USE OR
HAVING UNPROTECTED SEX
 GET VACCINATED AGAINST HEP B
 PNEUMONIA VACCINE
 AVOID NSAIDS (BRUFEN, INDOMETHACIN, ASPIRIN, HIGH DOSES OF PCM)