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Chronic Liver Failure
Chronic Liver Failure
Under Supervision
Assistant prof / Amal Abdelrazek
A.L / Seham Nassar
: - Outlines
• Introduction
• Definition
• Pathophysiological
• Causes
• Risk factors
• Signs and Symptoms
• Complications
• Diagnosis
• Medical Managements
• Surgical management
• Nursing Management
• Prevention
Introduction
• The liver is a vital organ that helps your body digests food,
removes toxins, metabolizes drugs and alcohol, produces proteins
important for the blood and clotting, and is crucial for nutrition.
Definition-:
Pathophysiology
Chronic liver disease represents a continuous and progressive process of
hepatic fibrosis. When the liver exposure to any insults such as (biliary
disease, viral infection, toxins and any metabolic disease that led to
degeneration of the liver but when the cause determined and treated the
liver will return healthy that called (reversible). on another hand when the
cause untreated the degeneration will increase and formation of (necrosis)
and when increase the insults the retained healthy cell will proliferation
that called (regeneration nodules) and the spaces between these nodules
the(fibrosis) takes place. in this stage the liver become irreversible and
development of cirrhosis.
Causes
1- Viral causes
4- Metabolic
6- Other
Risk factors: -
•
Heavy alcohol use.
•
Obesity Type 2 diabetes.
•
Tattoos or body piercings injecting drugs.
•
Using shared needles.
•
Exposure to other people's blood and body fluids Exposure to
certain
•
chemicals or toxins.
•
Family history of liver disease.
•
Metabolic syndrome including raised blood lipids.
•
Certain prescription medications Viral hepatitis.
• Dark urine
• Jaundice (yellowish skin and eyes)
• Itching all over the body
• Bruising easily or bleeding for a long time
• Swollen abdomen from fluid building up (ascites)
• Brain problems, such as confusion, irritability, unusual sleepiness
during the day or sleeplessness at night (encephalopathy)
Diagnosis
➢ Chronic liver disease takes several years to develop and
the condition may not be recognized unless there is
clinical awareness of subtle signs and investigation of
abnormal liver function tests.
➢ Diagnostic approach starts with a detailed History
including family history.
The liver biopsy is a simple procedure done with a fine thin needle
under local anesthesia. The tissue sample is sent to a laboratory
where it is examined underneath a microscope.
1. Liver Function Tests (LFTs)
2. Serum Bilirubin.
Modest elevation of alt& act indicate ongoing hepatocyte injury
followed by Progressive elevation of bilirubin.
•
Investigations for Liver Function Status.
•
Serum albumin levels.
•
Coagulation Profile.
•
Plasma glucose.
•
Radiology and Imaging Investigations.
•
Liver Ultrasound with Doppler Computed Tomography (CT
Scan).
•
Magnetic Resonance Imaging (MRI).
•
Ultrasonography is a safe and non-invasive imaging
investigation.
Medical Managements (Pharmacological therapy)
• Treatment is designed to remove alleviate the
underlying cause of cirrhosis
Bleeding site
esophageal varices.
encephalopathy.
causes of encephalopathy.
Surgical management
7. Deficient Knowledge
➢ May be related to
Lack of exposure/recall; information misinterpretation
Unfamiliarity with information resources
➢ Possibly evidenced by
Questions; request for information, statement of
misconception
Inaccurate follow-through of instructions/development of
preventable complications
• Sodium restriction.
disease.
thoroughly after you use the bathroom. Also, wash your hands before you
touch any food.
7- Protect your skin from insecticides and other toxic chemicals wear
gloves.