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

Ineffective Breathing Pattern

Nursing Diagnosis

Risk factors may include

  • Intra-abdominal fluid collection (ascites)
  • Decreased lung expansion, accumulated secretions
  • Decreased energy, fatigue

Desired Outcomes

ADVERTISEMENTS
  • Maintain effective respiratory pattern; be free of dyspnea and cyanosis, with ABGs and vital capacity within acceptable range.
Nursing InterventionsRationale
Monitor respiratory rate, depth, and effort.Rapid shallow respiration or presence of dyspnea may appear because of hypoxia and/or fluid accumulation in the abdomen.
Auscultate breath sounds, noting crackles, wheezes, rhonchi.May indicate developing complications. Presence of adventitious breath sounds may reflect accumulation of fluids or secretions. Absent or diminished sounds suggests atelectasis.
Investigate changes in level of consciousness.Changes in mentation may reflect hypoxemia and respiratory failure, which often accompany hepatic coma.
Keep head of bed elevated. Position on sides.Facilitates breathing by reducing pressure on the diaphragm, and minimizes risk of aspiration of secretions.
Encourage frequent repositioning and deep-breathing exercises and coughing exercises.Aids in lung expansion and mobilizing secretions.
Monitor temperature. Note presence of chills, increased coughing, changes in color and character of sputum.Indicative of onset of infection, especially pneumonia.
Monitor serial ABGs, pulse oximetry, vital capacity measurements, chest x-rays.Reveals changes in respiratory status, developing pulmonary complications.
Provide supplemental O2 as indicated.To treat or prevent hypoxia and if respirations and oxygenation is inadequate, mechanical ventilation may be required.
Demonstrate and assist with respiratory adjuncts: incentive spirometer.Reduces incidence of atelectasis, enhances mobilization of secretions.
Prepare for/assist with acute care procedures:
  • Paracentesis
Occasionally done to remove ascites fluid to relieve abdominal pressure when respiratory embarrassment is not corrected by other measures.
Surgical implant of a catheter to return accumulated fluid in the abdominal cavity to systemic circulation via the vena cava; provides long-term relief of ascites and improvement in respiratory function.
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

  • >