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Clinical case study
Presented by
Mishkat Khalil
(Student Year II- Sem-IV)
1
Liver cirrhosis
Definition:
• Cirrhosis represents the end stage chronic liver disease ,in which much
of the functional liver tissues has been replaced by fibrous tissue.
(Norris 2020)
2
Starting from most
common:
• Chronic hepatitis (B)
• Non-alcoholic liver disease
• Toxic reaction to drugs and chemicals
• Genetic disorder
• Biliary disorder
• Wilson disease(copper)
• Hemochromatosis(iron)
3
Pathophysiology
Abortion (d & c)(use of unsterile
instruments)
• Hepatitis B(Viral infection in
hepatocytes, inflammation,
proliferating hepatocytes encircled
by fibrosis,
Formation of nodules,
Degenerative changes in liver-
scarring
4
GENERAL SIGN AND
SYMPTOMS
Sign & Symptoms of assigned patient
• Liver cirrhosis can be asymptomatic.
• Weight loss
• fatigue
• Anorexia
• Diarrhea/constipation
• Jaundice
• Hepatomegaly/abdominal pain
• Nausea /abdominal bloating
• Edema(on foot)
5
Complications
• Ascites
• Portal hypertension
• Jaundice
• Hepatic Encephalopathy
• Esophageal Varices
6
Laboratory findings
• Na 112 (135_145)
• Albumin 2.44 (3.5_5.2)
• Lfts
• AST 71.2 (0_30)
• ALT 52.9 (0_35)
• ALP 96 (35_104)
• Alpha Feto protein 13.60 (less than 8.7)
7
Normal vs liver cirrhosis scan
8
Medical management
• Albumin 20 percent injection (TID)
• Non Adrenaline
• 3%dextrose
• Vancomycine 1000mg (BID)
9
C-MAP
10
Nursing care plan-1
11
Nursing care plan-ii
12
Patient education
Teach regarding:
• diet plan that is avoidance of extra salt in the diet.
• fluid intake restriction (less than 800 ml).
• weight monitoring regularly.
• daily abdominal girth measurement.
13
References
• Porth Pathophysiology by Tommie L Norris 2020
• Brunner and Sudarhth 2015
14

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