Report Sample on Cirrhosis: The Last Stage of Liver Fibrosis

Introduction

The pathophysiology involves the study of biological and physical abnormalities that happen to occur in a human body due to a disease. It forms the basis upon which a physician manages to undertake diagnostic tests, treat illnesses, manage health care and medication, and ensure that there is disease prevention. Cirrhosis is the last stage of liver fibrosis, and it is triggered by various forms of liver conditions and diseases like chronic alcoholism and hepatitis. When the liver is infected by any issue that may range from alcoholism or disease, it works on repairing itself, and this causes scar tissues. The progression of the cirrhosis condition leads to more scar tissues, and this leads to liver failure, for it is unable to undertake its duties. The advanced condition is life-threatening, and the situation cannot be undone. However, early diagnosis and treatment can help to prevent serious damage. The chronic liver condition happens when the problem persists for more than six months, and it happens when there is a permanent structural changes. Alcohol-related liver disease (ARLD) happens to an individual that has years of excessive drinking leading to a swollen and inflamed liver (Böttcher & Pinzani, 2017). The cirrhosis is a severe situation when the progress cannot be undone, and some of the symptoms that appear when an individual is suffering from the problem include jaundice, lightening or darkening of the skin, appetite loss, and anemia.

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Explain Each of Murray Symptoms

The symptoms that Murray is portraying is an indication of great underlying problems that are associated with liver cirrhosis.

Thin, malnourished with moderate ascites: Murray is experiencing cases of accumulation of fluids in the cavity that is leading to abdominal swelling. The fluid accumulate between two membrane layers, and its retention causes internal organs’ pressure. Alcohol triggers the occurrence of the liver disease that leads to occurrence of ascites. Therefore, there is a high correlation between the ascites and the consumption of alcohol by the patients that is leading to the occurrence of liver disease.

Jaundice of sclera and skin: The red blood cells are moved to the liver where they are supposed to be broken down, leading to the formation of bilirubin, which is a yellow pigment. When the Murray’s liver is unable to engage in the metabolization of bilirubin in the right way, the jaundice condition is formed, and this mostly happens when the liver is damaged. Murray is experiencing the jaundice condition, and this shows that the liver is severely damaged, and this is from years of alcohol consumption and smoking.

4+ pitting oedema of the lower extremities: Edema happens in the Murray body when there is excess fluid and when the liver functions are adversely affected. The swelling makes the skin feel tight, and this happens when the liver is not managing to remove excess water and unwanted substances in the body. Murray’s excessive alcohol amount is toxic to the human body, and since the toxicity is removed by the liver, when it is not working, the level of toxicity will rise in the body.

Liver and spleen palpable: The swelling of the liver and spleen beyond the normal size is not a healthy situation for Murray, and the spleen becomes dysfunctional when the liver is not working in the right way. The enlargement of these organs leads to abdominal pains. It can be noted that Murray has consumed a lot of alcohol over the years, and this has led to liver damage.

Further Assessment

Some of the additional tests that may be conducted regarding the cirrhosis of the liver include the laboratory tests. A physician may order a blood test that will help in checking whether there is the malfunctioning of the liver, which can be triggered by the excess level of bilirubin. Additionally, it is essential to test for enzymes that will help in determining if the liver is damaged. The functioning of the kidney is determined by blood for creatinine. The tests will also screen for hepatitis viruses and the clotting ability of the blood by relying on the international normalized ratio (INR). When relying on the blood test results, it is possible for a physician to diagnose the issue that is triggering the occurrence of cirrhosis. The further assessment process may incorporate the use of the imaging tests that makes use of magnetic resonance elastography (MRE), which manages to detect cases of liver stiffening and hardening. The other tests that can be utilized for further assessment processes include magnetic resonance imaging, ultrasound, and computed tomography. The biopsy can be used in the determination of the severity of the liver damage.

What Follow-Up Care

The follow-up care process is essential for the safety Murray and the healing process. Murray needs to make and attend all the appointments. When at home, Murray should ensure that he is calling the nurses whenever there is any arising problem. Additionally, it is also essential to know all the test results, and the medicine that Murray is taking, for this will provide an individual with a chance to have a better understanding of the treatment processes they are getting. Taking alcohol for so many years will require a detailed treatment process for Murray to realize the desired results. Murray has a significant role to play towards ensuring that the treatment process becomes a success. It is essential to ensure that Murray continues to avoid alcohol and ensure that safety with medications is observed. Whenever there is a problem with the medicines, Murray should inform a physician to ensure that the issue is rectified correctly. There are instances that the drugs that Murray is taking may fail to deliver the desired results, and in such an instance, the patient will have to seek another drug. Part of the follow-up program will include Murray talking to the nurse on matters regarding over the counter drugs. Murray should not take drugs bought over the country without a doctor’s prescription.

Interventions

When facilitating the follow-up programs, Murray needs to ensure that drugs, such as ibuprofen and naproxen are avoided, for they can lead to more damage to the liver. The cirrhosis ailment leads to the accumulation of more water content in the body, and in such instances, it is essential to avoid a lot of salt, snack, or fast foods, considering that extra fluids in the legs and belly can have serious effects on Murray’s body. Murray should work with a dietician to ensure that there is the consumption of the right amount of carbohydrates, proteins, and fats. The health of the liver is critical to the healing process, and according to the recommendations given by a doctor, Murray should reduce the amount of fluids consumed (Machado & Diehl, 2018).

Understanding of Community Nurses' Scope/Role

The community nurse is also likely to recommend Murray to exercise more, for this will help in keeping the body healthy and enabling effective management of the liver issue. A nurse has a duty to ensure that the patient is following the necessary treatment measures that will enable him realize optimal healing. Additionally, it is the duty of a physician to seek for effective treatment processes that will enable the patient to achieve the desired goals.

Risk Factors of Liver Cirrhosis

The cirrhosis ailment is triggered by various factors that increase the probability of contradicting the condition, and they include excessive consumption of alcohol. The alcohol elements are usually toxic to the liver, for it changes the way that the body breaks food down. In most cases, patients taking large amounts of alcohol tend to have a problem managing their diet, and this raises the probability of the problems affecting the human body. The disease does not develop in every individual that drinks, but rather among the persons that have a problem controlling the amount they are taking. The alcoholic fatty liver leads to liver inflammation later leading to cirrhosis, and it begins by taking small amounts of alcohol to the worst case. When cirrhosis appears, it is usually at the stage where it is not manageable.

Obesity, high cholesterol levels, and chronic viral hepatitis are factors that are likely to trigger the occurrence of cirrhosis disease. Non-alcoholic steatohepatitis is a condition that is caused by high-fat levels in the body. When an individual is ailing from hepatitis C, they are at high risk of getting cirrhosis, and sharing of contaminated needles should be avoided. When the blood transfusion is happening, it is essential to ensure that it is measured and the only health blood of donated. The hepatitis B virus is highly likely to affect the human body and lead to jaundice.

Lifestyle Modifications

It has been highlighted that one of the possible causes of the Murray problem is the excessive drinking of alcohol. Completely stopping the consumption process will ensure that Murray will get to manage the condition. Murray and the family taking the appropriate diet can help the liver to recover and lower the symptoms’ severity. It is essential to avoid raw seafood for they can be contaminated with hepatitis. The raw oysters can have a significant effect on liver functioning, and it is important to increase the amount of calories and protein intake. The regeneration of the liver tissues requires an improved intake of amino acids, mineral supplements, and vitamins that are obtained from fruits and vegetables though it is essential to avoid high amounts of vitamin A and D. At the condition that Murray is experiencing which is advanced, it is highly recommended to avoid any food elements with protein for this will help the patients avoid instances of ammonia production in the body (Morgan & Hinz, 2019). Considering that the liver is involved in the metabolism of the medication process, there is a possibility that the metabolism may be adversely affected, and this means that it is necessary to avoid high levels of medication for this may affect the process of treating cirrhosis. Murray and the family need to be vaccinated against hepatitis, pneumonia, and flu. Exercising will help to manage the weight condition and ensure that Murray is not overweight.

Medications Pharmokinetics Pharmodynamics

When a patient is diagnosed with cirrhosis condition, the ailment is usually at an advanced stage when there is no possibility of turning back. Therefore, what can be done is to limit the effects of the disease by taking the right medication and avoiding the risk factors. The medication given can help to prevent additional liver damages and treating the complications and symptoms. Some of the medications are alcohol-related, and they include acamprosate, naltrexone, and disulfiram. The antiviral medication and chelating agents are also essential in managing the condition. The complications are managed by relying on antibiotics that include the ofloxacin and norofloxacin. The Food and Drug Administration recommends the intake of drugs, such as disulfiram, among the patients experiencing cirrhosis. When such individuals take alcohol, they are likely to experience far worse effects and a hangover that exceeds the normal one (Mitchell et al., 2016). They might encounter cases of uneasiness, headache, confusion, nausea, and this will lead to the patients getting discouraged from taking alcohol. The medication process may include the acamprosate drug that lowers the emotional and physical distress that is associated with the effects of quitting alcohol use.

The pharmokinetics is the process that is involved with the movement of drugs in a human body, and it is based on various principles that range from absorption, metabolism, dist...