Liver Cirrhosis and Complications for the NCLEX

Pathophysiology

Chronic liver damage → scarring → impaired liver function. Causes: chronic alcohol use, hepatitis B/C, fatty liver disease.

Signs and Symptoms

• Jaundice, ascites, spider angiomas
• Caput medusae, palmar erythema
• Coagulopathy (decreased clotting factors)
• Gynecomastia, testicular atrophy (males)

Complications

Portal Hypertension → Esophageal Varices

• Risk of massive hemorrhage
• Treatment: band ligation, sclerotherapy, Blakemore-Sengstaken tube
• Avoid straining, coughing, hard/rough foods

Hepatic Encephalopathy

• Elevated ammonia → confusion, asterixis (flapping tremor), fetor hepaticus
• Treatment: lactulose (promote ammonia excretion via stool), rifaximin
• Low-protein diet during acute episodes
• Monitor neurological status

Ascites

• Fluid accumulation in peritoneal cavity
• Treatment: sodium restriction, diuretics (spironolactone), paracentesis
• Monitor abdominal girth daily, I&O, daily weights

Study more at GI Nursing deep dive and Physiological study guide.