Nursing care for Cirrhosis of the Liver with Esophageal variceal bleeding

Abstract

Liver cirrhosis is the late stage of liver diseases. The disease progresses due to chronic inflammation. Hepatitis progresses to early stage of cirrhosis to end-stage of cirrhosis. The causes may be from chronic hepatitis infection, fatty liver disease or autoimmune hepatitis. The anatomical feature is increased liver fibrosis results in portal vein hypertension due to decreased blood flow into the liver or a deterioration in liver function that leading to life-threatening complications, including: bleeding from esophageal varices, encephalopathy, ascites, hepatocellular carcinoma, etc. There will be destruction of hepatic architecture and leading to liver failure.

 From the case study, this patient came to the hospital with hematemesis and melena. The patient has never drank alcohol or used drugs. Initially, patient must has admitted to the hospital for checking her blood that revealed she had anemia (hemoglobin = 7.7 g/dl, hematocrit = 23.9 %). The initial management is giving blood component, replaced fluids, doing an electrocardiogram, record the amount of urine, checking hematocrit every 6 hours and consult the surgical department to do esophagogastroduodenoscopy. The esophagogastroduodenoscopy found multiple esophageal varices with probable cherry red spots. So, the diagnosis is esophageal variceal bleeding and management with esophageal variceal band ligation

 Continuous and effective management in terms of physical, mental, emotional and social aspects, this patient had improved quality of life. Then, the follow up on treatment was found she had a hepatitis C infection, therefore, it is necessary to provide medication and follow up for checking the recurrence of esophageal variceal bleeding.