8 Liver Cirrhosis Nursing Care Plans

ADVERTISEMENTS

Liver cirrhosis, also known as hepatic cirrhosis, is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. As necrotic tissues yields to fibrosis, the diseases alters the liver structure and normal vasculature, impairs blood and lymph flow, and ultimately causing hepatic insufficiency. 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.

These are the clinical types of cirrhosis:

  • Laennec’s cirrhosis is the most common type and occurs 30% to 50% of cirrhotic patients. Up to 90% of whom have a history of alcoholism. Liver damage results from malnutrition, especially of dietary protein, and chronic alcohol ingestion. Fibrous tissue forms in portal areas and around central veins.
  • Biliary cirrhosis occurs in 15% to 20% of patients, and results from injury or prolonged obstruction.
  • Postnecrotic cirrhosis stems from various types of hepatitis.
  • Pigment cirrhosis results from disorders such as hemochromatosis.
  • Idiopathic cirrhosis, has no known cause.
  • Noncirrhotic fibrosis may results from schistosomiasis or congenital hepatic fibrosis or may be idiopathic.

Nursing Care Plans

Nursing care planning for patients with liver cirrhosis includes promoting rest, providing adequate nutrition, skin care, reducing risk for injury, and monitoring and managing complications.

Here are eight (8) nursing care plans (NCP) and nursing diagnosis for patients with liver cirrhosis:

ADVERTISEMENTS
  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Excess Fluid Volume
  3. Risk for Impaired Skin Integrity
  4. Ineffective Breathing Pattern
  5. Risk for Injury
  6. Risk for Acute Confusion
  7. Disturbed Body Image
  8. Deficient Knowledge
  9. Other Possible Nursing Care Plans
ADVERTISEMENTS

Risk for Impaired Skin Integrity

Nursing Diagnosis

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

ADVERTISEMENTS
  • Maintain skin integrity.
  • Identify individual risk factors and demonstrate behaviors/techniques to prevent skin breakdown.
Nursing InterventionsRationale
Inspect pressure points and skin surfaces closely and routinely. Gently massage bony prominences or areas of continued stress. Use of emollient lotions and limiting use of soap for bathing may help.Edematous tissues are more prone to breakdown and to the formation of decubitus. Ascites may stretch the skin to the point of tearing in severe cirrhosis.
Encourage and assist patient with reposition on a regular schedule. Assist with active and passive ROM exercises as appropriate.Repositioning reduces pressure on edematous tissues to improve circulation. Exercises enhance circulation and improve and/or maintain joint mobility.
Recommend elevating lower extremities.Enhances venous return and reduces edema formation in extremities.
Keep linens dry and free of wrinkles.Moisture aggravates pruritus and increases risk of skin breakdown.
Suggest clipping fingernails short; provide mittens/gloves if indicated.Prevents patient from inadvertently injuring the skin, especially while sleeping.
Provide perineal care following urination and bowel movement.Prevents skin excoriation breakdown from bile salts.
Use alternating pressure mattress, egg-crate mattress, waterbed, sheepskins, as indicated.Reduces dermal pressure, increases circulation, and diminishes risk of tissue ischemia.
Use calamine lotion and provide baking soda baths. Administer medications (as indicated) such as cholestyramine (Questran), hydroxyzine (Atarax), diphenhydramine (Benadryl).May be soothing and can provide relief of itching associated with jaundice, bile salts in skin.
ADVERTISEMENTS

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

ADVERTISEMENTS

See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • Just a question – is this site like Wikipedia where anyone can upload information? its just i would love to be able to reference this for my assignment on adult nursing degree but i don’t know if i am allowed to cite it? please could you let me know or could you let me know where you found your orriginal sources? THanks for your help…

  • Hello! I would like too, to know if i’m allowed to cite your work in my thesis. please let me know your sources and if I can put this in my references

  • >