HomeNursingNandaNursing Care Plan Risk For Impaired Liver Function

Nursing Care Plan Risk For Impaired Liver Function

image 300x225 Nursing Care Plan Risk  For  Impaired  Liver  FunctionNursing Care Plan Risk  For  Impaired  Liver  Function Definition:At risk for liver dysfunction Vitamin D helps in the calcification of bone. It is made by the action of sunlight in the skin; sunlight exposure and adequate dietary intake of vitamin D are needed to sustain adequate levels of active vitamin D in the blood. Vitamin D deficiency can occur in both children and adults. In the metabolism of vitamin D, the liver’s role is to convert vitamin D to hydroxyvitamin D. When the liver is impaired by disease, vitamin D metabolism is affected as well.Nursing Care Plan Risk  For  Impaired  Liver  Function

Risk Factors

  • Hepatotoxic medications (e.g.,
  • Viral infection (e.g., hepatitis acetaminophen, statins)

A, B, or C, Epstein-Barr

  • HIV coinfection
  • Chronic biliary obstruction
  • Substance abuse (e.g., alcohol, and infection cocaine)
  • Nutritional deficiencies

Assessment Focus

  • Risk management
  • Pharmacological function
  • Fluids/electrolytes

Expected Outcomes The patient will

  • State effects of environmental and ingested chemicals and substances on their health and liver function.
  • Work with industry managers and with public health officials to lower or eliminate the presence of environmental chemicals and  substances in their work or living environment.
  • Have liver function indicators within normal limits.
  • Modify lifestyle and risk behaviors to avoid behaviors leading to hepatic dysfunction and inflammation.
  • Maintain long-term follow-up for chronic illness with healthcare provider.
  • Manage concurrent disease processes that impact hepatic function.
  • Optimize nutritional intake for needs.
  • Acknowledge the impact of medications on hepatic function.
  • Observe measures to avoid the spread of infection to self and to others.

Suggested Noc Outcomes

Health-Promoting Behavior; Risk Control—Alcohol; Risk Control— Drug Use; Safe Home Environment; Substance Addiction Consequences

Interventions And Rationales

Determine: Assist patient and family to assess workplace and home environments for potential hepatotoxic substances to increase patient’s awareness of hazards in the environment and to lower potential for hepatic injury. Monitor for clinical manifestations of hepatic inflammation and dysfunction to notify physician in order to initiate treatment if liver function is compromised. Clinical manifestations may include fatigue, depression or mood changes, anorexia, RUQ tenderness, pruritis, jaundice, bruising, or nontraumatic bleeding. 221
Monitor customary clinical laboratory tests to alert the healthcare provider of the status of the immune/inflammatory response, the degree of hepatic metabolic dysfunction, and the impact of concur- rent disorders on liver function. Clinical laboratory tests include complete blood cell (CBC) count:   lower red blood cell count, elevated WBC (increased immunocyte and inflammatory responses); basic metabolic panel—altered electrolyte balance, elevated glucose, elevated blood urea nitrogen and creatinine level, elevated HbA1c; hepatic plasma markers: elevated liver enzymes (alanine aminotrans- ferase, aspartate aminotransferase, and  -glutamyltranspeptidase); positive immunoassays for pathogen and viral antigens; elevated ammonia; elevated bilirubin; low coagulation factors; low total protein/albumin; elevated lipid panel. Perform: Carry out postprocedure measures, as ordered, to identify and/or minimize complications. Inform: Teach patient about the following: perform hand hygiene before and after personal hygiene and care; cover draining and non healing wounds; report to care provider; inform others of infectious condition so that each observes barrier precautions; adhere to prescribed plan of care and treatment with immune system modifiers (antibiotics, antivirals, interferon, others); maintain a balanced nutri- tional diet intake. These measures minimize patient’s risk for self- infection and spread of infection and allow the patient to help modify lifestyle to maintain optimum health level for self and for others. Along with healthcare team, prepare the patient for and later evaluate the results of liver biopsy and provide explanation to patient and family. The patient and family need understanding of purpose for and implications of results obtained from a liver biopsy. This support and education helps the patient understand rationale for plan of treatment and genetic counseling for genetically linked hepatic disorders. Attend: Provide a nonjudgmental attitude toward patient’s lifestyle choices to promote feelings of self-worth. Manage: Refer patient to counseling and therapy to address lifestyle choices and risk behaviors. Modification of behaviors will provide risk avoidance for drug and alcohol abuse and exposure to body- substance pathogen infection.

Suggested Nic Interventions

Behavioral Modification; Environment Risk Protection; Infection Protection; Risk Identification; Risk Identification—Genetic; Self- Modification Assistance; Sports Injury Prevention; Surveillance

Reference

McCance, K. L., & Huether, S. E. (2006). Pathophysiology: The biologic basis for disease in adults and children (5th ed., pp. 1413–1428). St. Louis, MO: Elsevier-Mosby.