Etiology
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The chronic, progressive liver condition known as cirrhosis is defined by the progressive
replacement of healthy liver tissue with fibrous scar tissue, which eventually impairs liver
function. Cirrhosis usually develops as a consequence of chronic liver inflammation and damage
brought on by a variety of underlying etiological causes. Chronic alcohol misuse, viral hepatitis
(including hepatitis B and C), autoimmune liver illnesses, non-alcoholic fatty liver disease
(NAFLD), and other uncommon ailments are among the prevalent sources.
The liver forms fibrous tissue in an effort to heal itself as a result of ongoing exposure to
these harmful substances. Scar tissue builds up as time passes, impairing the liver's structural
integrity and functional capacity (Wiegand & Berg, 2013). The liver's ability to digest nutrition,
detoxify toxic chemicals, and produce vital proteins such as clotting factors and albumin is all
Usually, there are multiple phases of cirrhosis progression, each signifying a higher level of liver
impairment:
1. Compensated cirrhosis: Regardless of the fibrosis, the liver continues to carry out the
majority of its activities in this initial phase. Many people with compensated cirrhosis
might not exhibit serious symptoms at all, and screening or diagnostic procedures may
2. Decompensated Cirrhosis: The liver's ability to operate normally decreases as the fibrosis
These difficulties may consist of jaundice (yellowing of the skin and eyes), variceal
cavity).
3. End-Stage Cirrhosis: Patients with this significant liver impairment and increased risk of
potentially fatal consequences are suffering from an advanced stage of cirrhosis. Patients
syndrome), and even hepatocellular carcinoma (a type of liver cancer) as a result of liver
failure, which represents a serious issue. As a final resort, end-stage cirrhosis frequently
B. Diagnostic Tests
The objectives of these tests are to assess liver function, find underlying reasons, and spot
problems. Liver function tests, imaging studies, and liver biopsies are common diagnostic
procedures. Liver function tests are used to evaluate the liver's capacity to carry out vital
processes. These tests measure the quantity of enzymes such as alanine transaminase (ALT) and
aspartate transaminase (AST), bilirubin, albumin, and clotting factors. Computed tomography
(CT), magnetic resonance imaging (MRI), and ultrasound are imaging modalities that provide
precise images of the liver and can identify lesions, cirrhosis, and problems including ascites
(Wiegand & Berg, 2013). A liver biopsy is the process of taking a little sample of liver tissue for
microscopic analysis, which enables a final diagnosis and an evaluation of the degree of liver
fibrosis. As a whole, these diagnostic tests help medical professionals track the course of
The extent and phase of the illness can have a significant impact on the clinical
symptoms of cirrhosis. Subtle or nonspecific signs, such as exhaustion, mild stomach pain, and
unanticipated weight loss, can be indicators of early-stage cirrhosis. More severe symptoms and
indicators, such as jaundice, abdominal pain, abdominal swelling, easy bruising and hepatic
encephalopathy, may appear as cirrhosis advances. According to Wiegand and Berg (2013),
patients may also have spider angiomas and gynecomastia. Determining these clinical signs is
D. Nursing Evaluation
Nurses need to carry out a comprehensive assessment starting with the medical history
comprising details such as the cause for primary liver disorder, alcohol intake, and past
interventions. Physical examinations should be significant, considering that they look at the liver
size, tenderness, and presence of ascites. Checking vital parameters like blood pressure, heart
rate, and respiratory rate is crucial, particularly in looking for signs of complications that may
arise from cirrhosis, such as hemorrhage or liver failure (Olave et al., 2020). Hepatic
encephalopathy is another essential condition that should be considered. This might appear as
distension, tenderness, and fluid wave tests. Finally, it is essential to evaluate for markers of
portal hypertension, including the presence of varices or ascites, towards informing nursing
intervention.
E. Nursing Interventions
changing their diet and quitting alcohol. Treatments for patients with decompensated cirrhosis 5
may involve medication administration to control symptoms such as hepatic encephalopathy and
ascites. According to Olave et al. (2020), diuretics can be administered to control retention of
fluids, and lactulose can be used to lower ammonia levels in cases of hepatic encephalopathy. In
order to control ascites, nurses should inform patients about sodium dietary limitations and offer
Nurses are vital in providing rapid evaluation, starting measures such as arranging for an
endoscopy or giving vasoactive medicine, and keeping an eye out for consequences in instances
of bleeding from esophageal varices. Individuals with ascites need to have their vital signs and
fluid balance checked often in order to avoid breathing problems and renal impairment. Because
cirrhosis patients run the risk of developing spontaneous bacterial peritonitis, nurses should also
look for indicators of infection. Clinicians can also educate patients and their families and offer
emotional support, stressing the value of adherence to medication and periodic check-ups.
F. Complications
Esophageal or gastric varices may develop as a result of portal hypertension, and they
have the potential to burst and produce potentially fatal hemorrhage. It is important for nurses to
be ready to quickly evaluate and handle these circumstances. Hepatic encephalopathy patients
may show signs of altered mental status, disorientation, or even coma. In addition to monitoring
neurologic function, nurses can deliver drugs such as lactulose. Another issue that needs to be
identified and treated with antibiotics right once is spontaneous bacterial peritonitis (Olave et al.,
2020). Additionally, nurses need to watch out for symptoms of hepatorenal syndrome, a
consequence of kidney failure that calls for monitoring and maybe renal replacement therapy.
G. Discharge Teaching 6
To enable patients and their families to handle cirrhosis at home and lower the risk of
ascites, hepatic encephalopathy, and variceal hemorrhage, nurses should offer thorough
effects (Olave et al., 2020). It is important to inform patients and their families about the early
indications and signs of complications and when to seek emergency care. It is crucial to make
sure patients comprehend the significance of their follow-up sessions for liver function
monitoring. Additionally, nurses can provide patients and their relatives with emotional support. 7
References
Olave, M. C., Gurung, A., Mistry, P. K., Kakar, S., Yeh, M., Xu, M., ... & Jain, D. (2020).
Wiegand, J., & Berg, T. (2013). The etiology, diagnosis and prevention of liver cirrhosis: part 1
