Management of patients with advanced liver cirrhosis

Abstract

This article provides an overview of liver cirrhosis. The pathophysiology, common investigations and the nursing management of patients with advanced liver cirrhosis are examined.

Specific Nursing Care Rendered In Hepatic Encephalopathy: Contemporary Review and New Clinical Insights

“…Passing an arterial cannula in Gr IV HE patients with acute liver failure should be particularly emphasized, since it allows for a continuous monitoring not only of blood oxygen saturation, but also of lactate and bicarbonate blood levels. The arterial cannulation gives as a clear-cut, always accessible arterial blood pH, without repeated punctures of arteries [22]. When noticing that pH curve is shifting it should alarm the nursing staff that with it hemoglobin oxygen saturation curve shifts as well prompting doctors evaluation and therapeutic intervention.…”

“…The use of diuretics and abdominal centhesis leads to positive response in 90% of patients, with the decrease in total body weight being the best indicator of diuretic, nutritional-dietetic and interventional therapy. However, the decrease in total bodyweight must not exceed 10% during a weekly period [22]. The hepatorenal syndrome (HRS) may insidiously overcome compensatory mechanisms and administered therapy and is characterized by acute renal failure with decrease in total urine output.…”

“…Receiving therapy and abdomen ascites centhesis leads to change in abdominal girth and total body weight. Patient should loose from 0.3 to 0.5kg per day, however, if weight loss is greater it can lead to renal failure, since kidneys become more hypo perfused and sensitive to hemodynamic alterations [22]. Multimodality monitoring is tracking of multiple parameters of brain activity (monitoring intracranial pressure, EEG waves).…”

Identifying a Research-Based Post-Procedure Observation Period for Outpatients Undergoing Percutaneous Liver Biopsy

“…Ultrasound-guided liver biopsies are commonly used for diagnosing and staging many chronic liver diseases (CLDs; Bicknell, Richenberg, Cooperberg, Tiwari, & Halperin, 2002;Mills, 2006;Montalto, Soresia, Carroccioa, Basconea, & Tripibet al, 2001;Riemann, Menzel, Schiemann, Domschke, & Konturek, 2000;Sargent, 2006;Terjung, Lemnitzer, Dumuolin, Effenberg, 2006). Many experts, consider liver biopsy to be the best way to diagnose and stage many CLDs (Montalto et al, 2001;Sargent, 2006).…”

“…Many experts, consider liver biopsy to be the best way to diagnose and stage many CLDs (Montalto et al, 2001;Sargent, 2006). Because of the usefulness of this procedure as a diagnostic tool, many ultrasoundguided liver biopsies are performed in interventional radiology (IR) departments across the country every year.…”