Pathophysiology & Causes
What happens to the liver tissue in cirrhosis?
It becomes fibrotic, nodular, and hardened, blocking blood and lymph flow.
Early symptoms of cirrhosis often include what two things?
Fatigue and hepatomegaly
What is portal hypertension
Increased venous pressure in the portal circulation.
What position helps relieve dyspnea from ascites?
Semi-Fowler’s or high-Fowler’s.
A patient with ascites and dyspnea—what should the nurse do first?
high fowlers/semi high fowlers
What are the main causes of cirrhosis?
Hepatitis B, C, D, NAFLD, and chronic alcohol use.
What lab values increase with cirrhosis?
AST, ALT, ALP, LDH, bilirubin, PT/INR, and ammonia.
Name two complications of decompensated cirrhosis.
Ascites, peripheral edema and hepatic encephalopathy.
What medication decreases ammonia levels in hepatic encephalopathy?
Lactulose
What finding shows lactulose is effective?
decreased ammonia
Which hepatitis is the leading cause of cirrhosis in the U.S.?
Hepatitis C.
What lab values decrease with cirrhosis?
Albumin, RBCs, H/H, and platelets.
What causes hepatic encephalopathy?
increased ammonia levels
What procedure creates a shunt to lower portal pressure?
TIPS
What is the priority if a patient with ascites reports increased pain and chills?
Assess for abdominal rigidity and check temperature.
Which hepatitis types are the most common causes worldwide?
Hepatitis B and D.
What causes jaundice in cirrhosis?
buildup of bilirubin.
What is the biggest risk with esophageal varices?
hemmorhage
What is important before a paracentesis?
Have the patient empty their bladder.
What should patients with varices avoid? (3 things)
Alcohol, aspirin, and NSAIDs.
What two vessels supply the liver with blood?
The hepatic artery (oxygen-rich) and portal vein (nutrient-rich).
What skin symptom occurs from excess estrogen due to liver dysfunction?
spider veins
What is asterixis and fetor hepaticus?
Asterixis is flapping tremors; fetor hepaticus is a musty, sweet odor of the breath.
Name two diuretics commonly used for ascites.
spirolactone and furosemide
What is the primary goal for managing cirrhosis?
Prevent complications and maintain fluid and electrolyte balance.