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  • Assessing the situation
  • Liver cirrhosis is a disease which affects the cell and destroys the fibrosis of the hepatic tissue, it if often life threatening state. This case scenario involves patient Mrs Thumi Sara, female aged 75 years, admitted at the health care facility. Provisional assessment reveals positive tests of liver cirrhosis. Patient primary assessment indicates abdominal distension, bilateral pedal swelling, and shortness of breath and loss of appetite. The patient has previous history of OPD and diagnosed cirrhosis and consumer of alcohol.   (European Association for the Study of theLiver,2018)
  • Planning
  • The underlying medical options for the patient are undertaking various functional tests. Scheduled investigations are liver tests function,liver biochemistry, serum electrolytes and serum creatinin. Further, to support this ultrasound examination is essential to assess shape and size of the liver of the patient.
  • Implementation & Evaluation
  • Nursing and medical evaluation for the patient is essential,assessing hepatomegally states and regular laboratory data is critical. With the diseases progression, assessment of cirrhosis manifestations needs to be adhered to such as ascites formation, edema, portal hypertension and any signs of encephalopathy.  Further, urine output needs to be frequently checked.
  • The key essential implementation plan for the patient after discussion with medial team is to ensure fluid restriction of <1000ml/day, low salt diet , monitoring daily weight , advice for complete stop of alcohol, arrangement of transfusion of 2 pint whole blood and addition of 55 dextrose. The social care team are tasked with assessing the patient environmental state while the caregivers to adhere to recommended care plan discussed.  (Newsome et al., 2018)
  • European Association for the Study of the Liver. (2018). EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journalof hepatology, 69(2), 406-460.Newsome,P. N., Cramb, R., Davison, S. M., Dillon, J. F., Foulerton, M., Godfrey, E. M.,... & Mackie, A. (2018). Guidelines on the management of abnormal liverblood tests. Gut, 67(1), 6-19.
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