Cirrhosis is a chronic disease of the liver characterized by alteration in structure, degenerative changes and widespread destruction of hepatic cells, impairing cellular function and impeding blood flow through the liver. Causes include malnutrition, inflammation (bacterial or viral), and poisons (e.g., alcohol, carbon tetrachloride, acetaminophen). Cirrhosis is the fourth leading cause of death in the United States among people ages 35 to 55 and represents a serious threat to long-term health.

Below are 8 nursing care plans for liver cirrhosis.

NURSING DIAGNOSIS: Knowledge Deficit 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 Desired Outcomes Verbalize understanding of disease process/prognosis, potential complications. Correlate symptoms with causative factors. Identify/initiate necessary lifestyle changes and participate in care. Nursing Interventions & Rationale [...]

NURSING DIAGNOSIS: Self-Esteem/Body Image disturbed May be related to Biophysical changes/altered physical appearance Uncertainty of prognosis, changes in role function Personal vulnerability Self-destructive behavior (alcohol-induced disease) Possibly evidenced by Verbalization of change/restriction in lifestyle Fear of rejection or reaction by others Negative feelings about body/abilities Feelings of helplessness, hopelessness, or powerlessness Desired Outcomes Verbalize understanding of changes and acceptance of [...]

NURSING DIAGNOSIS: Confusion, risk for acute Risk factors may include Alcohol abuse Inability of liver to detoxify certain enzymes/drugs Desired Outcomes Maintain usual level of mentation/reality orientation. Initiate behaviors/lifestyle changes to prevent or minimize recurrence of problem. Nursing Interventions & Rationale Nursing Interventions Rationale  Observe for changes in behavior and mentation, e.g., lethargy, confusion, drowsiness, slowing/slurring of speech, and irritability [...]

NURSING DIAGNOSIS: Injury, risk for [hemorrhage] Risk factors may include Abnormal blood profile; altered clotting factors (decreased production of prothrombin, fibrinogen, and factors VIII, IX, and X; impaired vitamin K absorption; and release of thromboplastin) Portal hypertension, development of esophageal varices Desired Outcomes Maintain homestasis with absence of bleeding Demonstrate behaviors to reduce risk of bleeding. Nursing Interventions & Rationale [...]

NURSING DIAGNOSIS: Breathing Pattern, risk for ineffective Risk factors may include Intra-abdominal fluid collection (ascites) Decreased lung expansion, accumulated secretions Decreased energy, fatigue Desired Outcomes Maintain effective respiratory pattern; be free of dyspnea and cyanosis, with ABGs and vital capacity within acceptable range. Nursing Interventions & Rationale Nursing Interventions Rationale  Monitor respiratory rate, depth, and effort.  Rapid shallow respirations/dyspnea may [...]

NURSING DIAGNOSIS: Skin Integrity, risk for impaired Risk factors may include Altered circulation/metabolic state Accumulation of bile salts in skin Poor skin turgor, skeletal prominence, presence of edema, ascites Desired Outcomes Maintain skin integrity. Identify individual risk factors and demonstrate behaviors/techniques to prevent skin breakdown. Nursing Interventions & Rationale Nursing Interventions Rationale  Inspect skin surfaces/pressure points routinely. Gently massage bony [...]

NURSING DIAGNOSIS: Fluid Volume excess May be related to Compromised regulatory mechanism (e.g., syndrome of inappropriate antidiuretic hormone [SIADH], decreased plasma proteins, malnutrition) Excess sodium/fluid intake Possibly evidenced by Edema, anasarca, weight gain Intake greater than output, oliguria, changes in urine specific gravity Dyspnea, adventitious breath sounds, pleural effusion BP changes, altered CVP JVD, positive hepatojugular reflex Altered electrolyte levels [...]