Disorders of the Gastrointestinal System, 2nd Edition
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Cirrhosis Cirrhosis occurs when the liver becomes scarred and damaged, which prevents normal function and blood flow. Often, symptoms are vague or absent and go un- noticed until extensive irreversible dam- age has occurred (Wolf, 2020). Cirrhosis accounts for 3.5% of deaths worldwide, and prevalence and mortality continue to increase, even in younger people (Moon et al., 2020). Risk factors include alcohol abuse, certain medications (methotrex- ate, alpha methyldopa, amiodarone), and type 2 diabetes (Wolf, 2020). Cirrhosis can cause many complications extending to nearly every other body sys- tem. Some of the following conditions can be caused by cirrhosis (Goldberg & ● Skin changes, including jaundice, nail changes, contractures, speckled and mottled palms, and spider veins. ● Liver failure. ● Bacterial infections. ● Esophageal, stomach, or intestinal varices that occur when liver damage Chopra, 2021): ● Liver cancer. causes portal hypertension and weakening of the vessels in this area; this can ultimately lead to uncontrolled bleeding and even death. ● Ascites and edema related to the body’s inability to filter and remove fluid and toxins. ● Hepatic encephalopathy is caused by a buildup of toxins that results in confusion or mental status changes. ● Skin changes such as jaundice, bleeding and bruising, and rashes. ● Type 2 diabetes. ● Malnutrition and problems with the absorption of nutrients.
some cases, IV hydration, maintaining a safe environment during periods of con- fusion, nutritional support, antiviral med- ications, and other measures are neces- sary. Treatment is now available to cure HCV using interferon and ribavirin (Dha- wan, 2019), although it is not guaranteed to be successful in all cases. Unfortunate- ly, no other form of viral hepatitis can be consistently cured at this time, but anti- virals may be useful in stopping the pro- gression of HBV (Murakami, 2021). | NURSING CONSIDERATION Patients with liver disease may expe- rience urticaria (a rash and itchiness). A rash can also present for several other reasons, such as an allergic re- action to medications or treatments. Nurses should ensure they do all they can to keep the patient comfortable while assessing for all possible causes to advocate for the appropriate treat- ment or remove the causative factor (Dhawan, 2019). Prevention of hepatitis focuses on avoiding activities associated with expo- sure to the virus and varies based on the strain. HAV and HEV can be prevented with good hand washing, avoiding con- taminated food and water, and avoiding raw and undercooked meat and fish (NYU Langone Health, 2022). HBV and HCV can be prevented by practicing safe sex, avoiding sharing needles or devices that come in contact with bodily fluids, and obtaining immediate care and treatment if exposure occurs. Vaccines also exist to prevent HAV and HBV and are widely used in the United States. Many health - care providers are required to obtain them before employment (NYU Langone Health, 2022).
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