The liver plays a vital role by providing multiple functions such as metabolism , carbohydrates, proteins and fats storing fat- soluable vitamins,b12, copper and iron synthesis of blood clotting factors, amino acids, albumin, globulins, detoxification of toxic substance and phagocytosis of microorganisms.
It also plays a role in glycolysis and gluconeogenesis. Liver functioning can be which time can no longer perform its normal operation.
Liver disease is becoming more common in the elderly because of increased susceptibility to drugs and other toxic substances. The elderly person is unable to compensate for various metabolic ,infectious and immunologic abuse.
Early hepatic failure present as a type of cirrosis of the liver. Liver becomes inflamed and obstructed which result damage the cells around the central portal vein. When the inflammation decrease, the lobule regenerates and this replaces healthy normal liver tissue. Advance hepatic failure develops when all compensatory mechanisms fail, causing the serum ammonia level to rise.
The already-damaged liver is unable to synthesize normal product, so acidosis, hypoglycemia or blood dyscrasias develop and the patient become comatose.
Acute liver failure also known as fulminant hepatic failure, may be precipitated by a stress factor that aggravates a pre-existing chronic liver disease. Some stress factors include alcohol intake, ingestion of amanita mushrooms, large amounts of dietary protein, gastrointestinal bleeding and portcaval shunt surgery.
An acute type of liver failure may occur as a result of viral or toxic hepatitis, biliary obstruction, cancer,acute infective, processess, drugs such as acetaminophen, isoniazid and rifamficin, severe –dehydration, reye’s syndrome, or shock states.
Laboratory: CBC – used to identify anemias and white blood cell counts helps to identify hypersplenism or infection, thrombocytopenia may occur secondary to alcoholic bone marrow suppression.
Used to identify biliary obstruction or dilatation of bile ducts,
hepatomegaly, intrahepatic tumors and changes or portal hypertension.
May be used to detect degenerative cirrhosis changes or to identify focal liver disease.
COMMON NURSING DIAGNOSES
Deficient Volume related to: Gasrointestinal bleeding, Osmotic changes, Hydrostatic pressure changes, ascites