Cirrhosis of the Liver. Dr Ibraheem bashayreh, RN, PhD . ANATOMY & PHYSIOLOGY. LIVER Weighing between 1,200 and 1,600 g, the liver is the largest glandular organ in the body. It is located in the right upper abdominal quadrant, under the right diaphragm.
Dr Ibraheem bashayreh, RN, PhD
Regulating blood glucose level by making glycogen, which is stored in hepatocytes.
Synthesizing blood glucose from amino acids of lactate through gluconeogenesis.
Convertingammonia produced from gluconeogenetic by-products and bacteria to urea
Synthesizing plasma proteins such as albumin, globulins, clotting factors, and lipoproteins.
Breaking down fatty acids into ketone bodies
Storing vitamins and trace metals
Affecting drug metabolism and detoxification
- Intraperitoneal accumulation of watery fluid containing small amounts of protein
Draining bile from hepatocytes to the gallbladder by way of biliary tree
Storing bile in the gallbladder and releasing it to the duodenum, which is mediated by the hormone cholecystokinin-pancreozymin.
Located below the liver
Supersaturated bile, Biliary stasis
Blockage of Gallbladder
Inflammation, Mucosal Damage and WBC infiltration
– inflammation of gallbladder with gallstone formation.
Signs and Symptoms:
Severe Right abdominal pain radiating to the back
Tea colored urine
US detects the presence of gallstone
Serum alkaline phosphatase – 50-120 u/L
Endoscopic retrograde cholangiopancreatography (ERCP) -
Administer Rx Medications
Diet – increase CHO, moderate CHON, decrease fats
Meticulous skin care
Instruct patient to AVOID HIGH- fat diet and GAS-forming foods
Assist in surgical and non-surgical measures
ESWL – non-invasive fragmentation of stones by using repeated shockwaves directed at the gallstones in the gallbladder or common bile duct.
Post-operative nursing interventions
1. Monitor for surgical complications
2. Post-operative position after recovery from anesthesia- LOW FOWLER’s
3. Encourage early ambulation
4. Administer medication before coughing and deep breathing exercises
5. Advise client to splint the abdomen to prevent discomfort during coughing
6. Administer analgesics, antiemetics, antacids
7. Care of the biliary drainageor T-tube drainage
8. Fat restriction is only limited to 4-6 weeks. Normal diet is resumed