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    Liver Failure

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    Shriram Singh

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    © All Rights Reserved
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    Liver Failure

    Uploaded by

    Shriram Singh
    11 views22 pages

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    © © All Rights Reserved

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    Copyright:

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    Download as pptx, pdf, or txt
    11 views22 pages

    Liver Failure

    Uploaded by

    Shriram Singh

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    LIVER FAILURE

    PRESENTED BY-
    MS. EKATA SINGH
    NURSING TUTOR
    OBSTETRIC & GYNEACOLOGY
    NURSING
    INTRODUCTION

     Liver failure is when the liver is losing or has lost all its function. It
    is life threating condition that requires immediate medical care.
     Liver failure can be chronic or acute . In people with acute liver
    failure, the liver rapidly loses its function . In people with chronic
    liver failure ,the liver loses function over a longer period.
    DEFINATION

     Liver failure is an uncommon condition in which rapid


    deterioration of liver function result in coagulopathy and alteration
    in the mental status( encephalopathy)
     Liver failure indicates that liver has sustained injury.
    TYPES
     FULMINANT HEPATIC FAILURE: Encephalopathy start within
    8 weeks.
     NON FULMINANT HEPATIC FAILURE : Encephalopathy starts
    between 8 to 26 weeks.
     ACUTE HEPATIC FAILURE : It is loss of liver function that
    occurs rapidly in days or weeks usually in a person who has no pre
    existing liver disease.
     CHRONIC HEPATIC FAILURE: Over six month latent period
    INCIDANCE

     In develop country incidence is 10 cases per million people per year.


     It accounts for 6% of all deaths due to liver disease.
     It is moor common in women than in men.
    ETIOLOGY

    VIRAL DRUG INDUCED TOXIN RELATED


    HEPATITIS HEPATOTOXICITY HEPATOTOXICITY

    VASCULAR METABOLIC
    CAUSES CAUSES
    PATHOPHYSIOLOGY

    Due to etiological factors

    Hepatocytes and non –parenchymal cells damaged

    Sever disturbance of liver function

    Degeneration ,necrosis and fibrosis of liver tissue

    Hepatic insufficiency

    Hepatic failure
    CLINICAL MANIFESTATION
     Hepatic Encephalopathy
     Jaundice
     Pain and tenderness in the upper right side
     Nausea
     Vomiting
     Ascites
     Ankle edema
     Drowsiness
     Muscle tremors
     Bleeding
    CONT….

     Cerebral edema
     Coma
     Hypotension
     Tachycardia
     Hematemesis
    DIAGNOSTIC EVALUVATION
     History collection
     Physical examination
     CBC
     Prothrombin time
     SGOT,SGPT
     Serum bilirubin level, Serum ammonia level
     ABG
     Serum creatinine level
     Blood culture
    CONT…

     Viral serology
     EEG
     Autoimmune markers
    MANAGEMENT

     Treatment of acute liver failure consists of drugs and liver


    transplantation.
     Pharmacological management include certain antidotes to revers the
    effect of ALF and various medication to reduce ICP.
     Low protein, high carbohydrate diet to correct.
     Lactulose to reduce ammonia blood levels.
    TREATMENT RELATED TO ASCITES

     Salt restriction and potassium-sparing diuretics to increase water


    excretion, potassium supplements to reverse the effects of high
    aldosterone.
     Paracentesis to remove ascitic fluid and alleviate abdominal
    discomfort.
     Shunt placement to aid in removal of ascitic fluid and alleviate
    abdominal discomfort.
    PHARMACOLOGICAL INTERVENTION

     Penicillin G.
     Activated charcoal
     N- Acetyl cysteine
     Osmotic Diuretic
     Barbiturate
     Benzodiazepine
     Anesthetic agents
    LIVER TRANSPLANTATION

     When acute liver failure can not be reversed , the only treatment may
    be liver transplant.
     During a liver transplant ,a surgeon removes patient’s damaged liver
    and replace with a healthy liver.
    CONT….
     PORTAL HYPERTENSION, TREATMENT: Shunt placement between
    the portal vein and another systemic vein to divert blood flow and relieve
    pressure
     VARICEAL BLEEDING, TREATMENT INCLUDES: Vasoconstrictor
    drugs to decrease blood flow balloon tamponade to control bleeding by
    exerting pressure on the varices with the use of a balloon catheter.
     Vitamin K to control bleeding by decreasing prothrombin time.
    COMPLICATION

    Kidney Cerebral
    failure edema

    Bleeding
    Infection
    disorder
    OTHER INTERVATION

     Forcoagulopathy/GIT bleeding vitamin k can be given to treat


    abnormal PT.
     Hypotension should be treated with fluids.
     Pulmonary complication mechanical ventilation may be required .
     Head of the patient should be elevated to 30 degree.
     Neurological status should be monitored regularly.
    NURRSING DIAGNOSIS

    1. Fluid volume excess related to portal hypertension(ascites).


    2. Imbalance nutrition less than body requirements related to
    disinterest in food.
    3. Acute pain related to abdominal pressure.
    4. Risk for disturbed thought process related to elevated ammonia
    level.
    5. Risk for infection related to impaired immune responses.

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