Liver cirrhosis is the end stage of chronic liver disease where functional liver tissue is replaced by scar tissue. It has many potential causes including viral hepatitis, non-alcoholic fatty liver disease, drugs/toxins, genetic disorders, and biliary disorders. Symptoms may include fatigue, weight loss, nausea, abdominal pain, and edema. Complications include ascites, portal hypertension, jaundice, and hepatic encephalopathy. Laboratory findings for the patient presented showed low sodium and albumin levels as well as elevated liver enzymes and alpha-fetoprotein. Treatment focuses on albumin injections, antibiotics, fluid restriction, and patient education about diet and symptom monitoring.

1. Clinical case study
Presented by
Mishkat Khalil
(Student Year II- Sem-IV)
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2. 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of the functional liver tissues has been replaced by fibrous tissue.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)
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3. 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)
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4. 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
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5. 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)
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6. Complications
• Ascites
• Portal hypertension
• Jaundice
• Hepatic Encephalopathy
• Esophageal Varices
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7. 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)
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8. Normal vs liver cirrhosis scan
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9. Medical management
• Albumin 20 percent injection (TID)
• Non Adrenaline
• 3%dextrose
• Vancomycine 1000mg (BID)
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10. C-MAP
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11. Nursing care plan-1
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12. Nursing care plan-ii
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13. 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.
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14. References
• Porth Pathophysiology by Tommie L Norris 2020
• Brunner and Sudarhth 2015
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