c. The latent period ends with the abrupt appearance of abdominal swelling and
pain, hematemesis, and dependent edema. Skin turgor is poor, with accompanying
dryness and pruritis.
d. The condition advances to include symptoms that are a result of hepatic
insufficiency, portal HTN, and hepatic encephalopathy. Such symptoms include:
Bleeding tendencies (nosebleeds, bleeding gums, easy bruising).
Bleeding esophageal varices (2 portal HTN).
Limited thoracic expansion that interferes with gas exchanges (2
(6) Central nervous system disorders (2 hepatic encephalopathy) to include
lethargy, slurred speech, mental changes, and peripheral neuritis.
1-60. DIETARY MANAGEMENT FOR THE PATIENT WITH CIRRHOSIS
Nursing care of patients with cirrhosis requires careful assessment and
monitoring of the patient's nutritional status. The nutritional therapy ordered by the
physician must be strictly enforced in order to maintain an optimum physiologic state
that will facilitate recovery.
a. The diet should be high in calories. Total food intake should not be used to
replace energy requirements.
The patient should be kept at a level of minimum activity to conserve
Nutrient consumption is necessary for the healing process to take place.
b. The amount of protein in the diet should be limited to that which the liver is
able to handle.
The liver is the body's major organ of protein catabolism.
(2) Protein catabolism yields ammonia, which is normally converted by the
liver to the nontoxic substance called urea. (Urea is carried by the blood from the liver
to the kidneys, where it is excreted in the urine.)