Cirrhosis

Late-stage liver fibrosis with impaired hepatic function

Definition

Cirrhosis is end-stage liver disease characterized by widespread fibrosis and nodular regeneration that disrupts normal liver architecture and function. It is usually irreversible and progresses to portal hypertension, hepatic failure, and increased cancer risk.

Causes

Alcohol use disorder
Chronic viral hepatitis (B, C)
Non-alcoholic steatohepatitis (NASH)
Autoimmune hepatitis
Hemochromatosis, Wilson disease

Complications

Portal hypertension, esophageal varices, ascites, hepatic encephalopathy, hepatorenal syndrome, coagulopathy (decreased clotting factors), hypoalbuminemia, and hepatocellular carcinoma.

Nursing Interventions

Monitor mental status (asterixis, confusion = encephalopathy). Administer lactulose to reduce ammonia. Assess for bleeding (soft toothbrush, electric razor). Monitor weight, abdominal girth, I&O. Restrict sodium; protein as tolerated. Teach strict alcohol abstinence and vaccination against hepatitis A, B, influenza, pneumococcus.

NCLEX Relevance

High-yield for bleeding precautions (PT/INR elevation), ammonia/lactulose therapy, and ascites management.