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1431 of WONG)
a liver disease characterized by permanent
scarring of the liver that interferes with its
normal functions
Osteoporosis
Heart Problems.
Cirrhosis is divided into two stages: Compensated
and Decompensated.
Muscle weakness
Lethargy
Edema
GI bleeding
Anemia
Abdominal pain
Past health history
Physical examination (firm, often enlarged and rock-hard)
Laboratory evaluation
Liver function tests:
Bilirubin
Aminotransferase
Ammonia
Albumin
Cholesterol
Prothrombin time
Imaging Tests
Magnetic resonance imaging (MRI)
computed tomography (CT) scan
Liver biopsy (Transjugular Liver Biopsy, Percutaneous Liver
Biopsy and laparoscopy)
***liver biopsy can cause internal bleeding that’s why
monitoring vital signs and laboratory values, especially
hematocrit, is very important to check for any signs of
hemorrhage or shock.
Doopler ultrasonography of the liver and spleen ( to check
for ascites)
Monitor liver function and manage specific
complications such as esophageal varices and
malnutrition
Nutritional support
IV fluids
Blood products
Vasopressin
Gastric lavage
Balloon tamponade with a Sengstaken-Blakemore tube
( to control bleeding )
Endoscopic sclerotherapy
Endoscopic banding ligation
Diuretics ( potassium –sparring)
Albumin administration or paracentesis ( for ascites )
Limit the ammonia formation and absorption by
administering neomycin and lactulose.
Treatment for cirrhosis depends on the cause of cirrhosis.
Chronic Hepatitis. Many types of antiviral drugs are used to treat chronic hepatitis B,
including pegylated interferon, nucleoside analogs, and nucleotide analogs. Patients
with chronic hepatitis C are treated with combination therapy with pegylated interferon
and ribavarin. [For more information, see In-Depth
Bile Duct Disorders. Ursodeoxycholic acid (Actigall), also known as ursodiol or UDCA,
is used for treating primary biliary cirrhosis but does not slow the progression. Itching is
usually controlled with cholesterol drugs such as cholestyramine (Questran) and
colestipol (Colestid). Antibiotics for infections in the bile ducts and drugs that quiet the
immune system (prednisone, azathioprine, cyclosporine, methotrexate) may also be
used. Several surgical procedures may also be tried to open up the bile ducts.
Alcohol is restricted.
Sedatives should b avoided. Acetaminophen is
especially hapatotoxic, particularly when combined
with alcohol.
To minimize the the risk of bleeding, warn the patient
against taking non-steroidal anti-inflammatory drugs,
straining to defecate, and blowing his nose or
sneezing too vigorously. Suggest using an electric
razor and a soft toothbrush.
Advise the patient tot ake adequate rest because it
decreases the metabolic demands of the liver.
Teach the patient to have small frequent meals.
Teach him to alternate periods of rest and activity to
reduce the oxygen demand and prevent fatigue.
Tell the patient to avoid stress and to avoid exposure
to infection.
Emotional support for the family of the child (to
reduce anxiety in preparation for liver transplantation
or unexpected death)