Tuesday, November 01, 2005

Nursing Care Plan for the Client with Liver Disorders (Hepatitis and Liver Cirrhosis)

Nursing Assessment

1. Assess for history of hemotransfusion, previous contact with person, infected by hepatitis A, resent sexual contact with person, probably infected by hepatitis B or C .
2. Assess for history of previous liver diseases, presence of genetic and metabolic diseases, affecting liver (such as cystic fibrosis, etc.), toxic influence on liver (such as alcohol intake, etc.) , presence of long-term bile obstruction states.
3. Collect information of complaints that brought client to the hospital (jaundice, abdominal pain, nausea, vomiting, bowel disturbances, fever, appetite changes, neurological changes, changes in color of urine and stool, etc.) .
4. Obtain history of onset and progression of symptoms.
5. Perform complete physical assessment including vital signs, signs of liver damage, jaundice, bowel dysfunction, encephalopathy, ascites, etc.
6. Assess diagnostic tests and procedures for abnormal values.

Nursing Diagnosis

1. Increased risk of dehydration, electrolytes and metabolic disturbances, related to liver damage.
2. Intolerance to certain kinds of foods, related to liver damage.
3. Increased risk of secondary infections due to impaired immune state, related to liver dysfunction.
4. Increased risk of hematological complications, related to liver dysfunction.
5. Increased risk of metabolic and toxic disturbances, related to liver insufficiency.
6. Presence of risk of hemocirculatory complications and portal hypertension (ascites, esophageal varices, etc.) due to impaired liver function.
7. Changes in neurological state (encephalopathy) due to liver insufficiency.
8. Weakness and fatigue, related to diagnosis of hepatitis or liver cirrhosis, alterations in skin integrity.
9. Appetite changes and weight loss due to symptoms of the disease.
10. Anxiety related to the symptoms of disease and fear of the unknown.

Nursing Plan and Interventions


1. Prevent further infections.
2. Promote adequate nutrition and fluid intake.
3. Prevent avoidable injury, changes in electrolytes and metabolic state of the client.
4. Maintain enteric isolation precautions.
5. Prevent possible hemorrhage and neurological complications.
6. Prevent alteration in skin integrity.
7. Then surgical intervention prescribed, prevent postoperative complications.
8. Relief symptoms of liver damage, weakness and fatigue.
9. Decreased anxiety with increased knowledge of disease, it treatment, way of prevention and follow-up.


1. Assess, report , and record signs and symptoms and reactions to treatment.
2. Monitor fluids input and output closely, observe signs of dehydration, secondary infections, neurological disturbances, edemas (ascites), jaundice intensity, skin integrity daily.
3. Provide adequate diet with high proteins, carbohydrates and vitamins (carefully in client with encephalopathy).
4. Observe feces and urine for color and frequency.
5. Administer antibiotics, antiemetics, vitamins A,C, K, steroids and other medications as prescribed, monitor for side effects.
6. Monitor client’s vital signs and signs of possible dehydration closely.
7. Monitor client’s laboratory tests results (CBC, electrolytes, liver enzymes, billirubin levels, serological tests for HAV, HBV, HCV) for abnormal values.
8. Provide prescribed diet, rest and comfort measures.
9. Administer IV therapy and electrolytes replacement as prescribed.
10. Monitor for signs of possible bleeding.
11. Prepare client for paracentesis if required.
12. Provide emotional support to client and his family, explain all procedures to decrease anxiety and to obtain cooperation.
13. Instruct client regarding disease progress, diagnostic procedures, treatment and its complications, home care, daily activities, diet, restrictions and follow-up.


1. Reports increased comfort, decreased anxiety.
2. Reducing of ascites and edema.
3. Reduced weakness and fatigue in client.
4. Maintains stable vital signs, fluid and metabolic balance, nutritional state.
5. Maintain skin integrity.
6. Laboratory tests results shows no abnormalities.
7. Shows no hematological or neurological complications.
8. Demonstration of understanding of disease progress, diagnostic and treatment procedures, prevention, and need for follow-up.

This information has been published by the International Biopharmaceutical Association . Please note this information does not give any medical advice.

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