Decomposed Liver Disease
The liver is one of the vital organs in the body; it performs multiple functions making it a very crucial organ. Because of the nature of the activities performed by the liver, it is faced with multiple risks and complications. One of the most fatal diseases that attack the liver is Cirrhosis, which occurs in two phases (a) compensated and (b) decompesated (Bellentani 1994). In the first phase, the liver may show signs of damage, but its functioning is not affected. At this stage, the liver can “compensate” for the damage by functioning normally. In the second phase, the liver is deemed to have incurred extensive damage and it can no longer work as usual; at this point, decompensation is said to have set in (Schuppan & Afdhal 2008). According to research, it has been determined that the liver in most cases can undergone serious damage of between 80 to 90% before it becomes decompensated.
At the point when the liver is said to have been decompesated, patient can show signs of hepatic insufficiency. At this point, the liver may not be able to perform most of the functions as usual and for that reason, a patient will display signs like nausea, vomiting, lack of appetite, and sometime fatigue is also common (Grattagliano, Potincasa & Palasciano 2009).
In addition to this, a patient may show even more serious signs like alcoholic stools, abnormal bilirubin excretion, jaundice which manifest because of accumulation of bilirubin in tissues, the patient may also experience pain in the upper quadrant because the liver could be inflamed, and abnormal ammonium ion metabolism, which further does not allow the ammonium to be excreted from the body (Grattagliano, Potincasa & Palasciano 2009).
Ascites is also common; it is a condition caused by accumulation of fluid in the abdomen because of the inflammation of the liver (Kamath & Kim 2007). The accumulated fluid is extremely hard to control because as times goes, the liver continues to fail. The patient may also show signs of portal hypertension. At this stage, there is obstruction of the portal blood flow, which may cause the portal blood pressure, which could consequently cause rupture of the osophageal varices (Lauterburg 1999). This is extremely dangerous because it could also cause fatal bleeding.
Diagnostic of patient with Decompensated Liver Disease
There are many ways, methods, and tools used to diagnostic patients with decomposated liver disease. Patient exhibit hepatic deficiency, in the laboratory the doctor can carry out test such as galactose and indocyanine green, will clearly show loss of hepatocytes (Czaja & Freese 2002). Apart from this, clinicians can do various investigation including blood tests to determine if a patient is suffering from this disease. Blood tests range from FBC, urea, Clotting screen, alpa feto-protein, viral screen, and septic screen (Czaja & Freese 2002). In addition to these tests, radiology is also effective in examining a patient. A doctor can also do an ultrasound to check the condition of the liver. This allows the specialized clinician to observe any liver tumour, examine for ascites, and even observe veins and arteries that are linked to the liver.
Biopsy is conduced as a standard measurement to specify which stage of liver cirrhosis the patient could be (Foster & Reddy 2008).
Treatment and Medical Management
Just like other complications of the human body, decompensated liver can be managed and allow a patient to have a prolonged life. However, the management of this condition requires timing and discipline (for patient). Treatment of decompensated liver or cirrhosis is aimed at slowing the progression, to contain the risks, and avoid further complications, which may become more dangerous. The management focuses on the underlying causes. For any patient who is alcoholic or uses alcohol, it is highly recommended to do alcohol abstinence (Kurt 2011). This is a crucial component of the treatment plan for any patient suffering from this condition. This is because alcohol is more harmful and may present more danger to the patient.
In addition to this, it is extremely important for a patient to eat a healthy diet. This is because the diseases consume a lot of energy and therefore, a patient will do well with energy foods. The doctor may also recommend the patient to take laxatives, which is effective in minimizing constipation. Using medication such as antibiotics is effective in preventing infections (Kurt 2011). Diuretics, thiamine, steroids, laxatives, and acetylcysteine are some of the effective medications (Jain et al. 2012).
Transplant of liver can be encouraged in the worse case scenario. Over time, success of liver transplant has been improving with technological improvements. It is necessary incase of intense damage of the liver.
Nursing diagnose involves reviewing the history of alcoholic consumption as well as induced hepatitis (Heidelbaugh & Bruderly 2006). The nurse can physically assess the liver. Enlarged liver could indicate presence of cirrhosis. Regular checking of the symptoms is critical to indentify the condition of the patient.
Nursing Assessment, Plan and Intervention
It is highly recommended for the patient to be under a regular monitoring program. This is important to always know how the patient is progressing. There is a need to have proper timing and develop a plan in which a patient will be monitored efficiently. Therapy is an effective intervention strategy and nurses may provide this as an intervention strategy. In particular, therapy of ascites is extremely effective (Jain et al. 2012). This calls for compiled care plan so that the condition is contained. There is also a need for the patient to eat high protein, and quality calorie (Kamath & Kim 2007). Diet with no salt is also recommended