The process of nursing care for patients with liver cirrhosis

Uvod: Ciroza jetre je terminalni i ireverzibilni stadij kronične jetrene bolesti, karakterizirana destrukcijom i istovremenom regeneracijom jetrenih stanica koje se mijenjaju vezivnim tkivom i dovode do poremećaja strukture jetre. Vodeći uzrok ciroze jetre jest alkoholizam, može nastati i kao posljedica virusnih B i C hepatitisa, nekih metaboličkih bolesti poput hematokromatoze, Wilsonove bolesti, izloženosti toksičnim kemikalijama i lijekovima. Klinička manifestacija bolesti ovisi o izraženosti bitnih karakteristika bolesti, te komplikacija ciroze jetre kao što su ascites, varikoziteti, portalna hipertenzija, encefalopatija i drugo. Razlikuje se neaktivna (kompenzirana) i aktiva (dekompenzirana) ciroza jetre s komplikacijama koje mogu ugroziti život bolesnika. Pacijenti oboljeli od ciroze jetre osjećaju umor, opću slabost, prisutan je gubitak apetita, jutarnja mučnina i povraćanje ( osobito kod alkoholičara), te mukli bolovi ispod desnoga rebranog luka. Kod uznapredovale bolesti javlja se opstipacija i/ili proljev, tamno obojen urin, ikterus, jak zadah iz usta tzv. foetor hepaticus, sladunjavo-fekalnog karaktera, splenomegalija, hepatosplenomegalija, zvjezdasti angiomi po koži, portalna hipertenzija, varikoziteti jednjaka, znakovi feminizacije u muškaraca, kod žena pojava maskulinizacije (poremećaj menstrualnog ciklusa, atrofija dojki i uterusa, smanjen libido, sterilitet). Cilj: Cilj rada jest prikazati proces zdravstvene njege bolesnika oboljelih od ciroze jetre te ukazati na važnu ulogu medicinske sestre u provođenju procesa zdravstvene njege, intervencije dijagnostike te planiranje dijagnostike i liječenja. Zaključak: Medicinska sestra ima značajnu ulogu u zdravstvenoj skrbi oboljelih od ciroze jetre, a ista se odnosi na prikupljanje podataka i prepoznavanje problema, određivanje sestrinskih dijagnoza i planiranje adekvatnih intervencija za svakog bolesnika individualno. Jednako tako medicinska sestra sudjeluje u edukaciji bolesnika i obitelji/značajnih osoba o samoj bolesti, prepoznavanju i suzbijanju rizičnih faktora koji doprinose pogoršanju bolesti te savjetovanje o potpunoj eliminaciji alkoholnih pića.Introduction: Cirrhosis of the liver is a terminal and irreversible stage of chronic liver disease characterized by destruction and simultaneous regeneration of liver cells that change with connective tissue and lead to liver disorders. The leading cause of liver cirrhosis is alcoholism, which can also be caused by viral B and C hepatitis, some metabolic diseases such as hematochromatosis, Wilson's disease, toxicity to chemicals and drugs. The clinical manifestation of the disease depends on the significance of the essential characteristics of the disease, and complications of liver cirrhosis such as ascites, varicositis, portal hypertension, encephalopathy and others. There is a difference between inactivated (compensated) and active (decompensated) cirrhosis of the liver are distinguished by complications that may endanger the patient's life. Patients suffering from liver cirrhosis feel tired, general weakness, loss of appetite, morning nausea and vomiting (especially alcoholics) and pain beneath the right rebalancer. In case of advanced disease there is constipation and / or diarrhea, dark colored urine, icterus, strong mouthache or. foetor hepaticus specific character, splenomegaly, hepatosplenomegaly, stem angiomas on the skin, portal hypertension, esophageal varices, signs of feminization in men or masculinization in women (menstrual cycle disorder, breast and uterine atrophy, decreased libido, sterility). Objectives: The aim of this paper is to present the health care process for patients suffering from cirrhosis of the liver and to point out the important role of nurses in the implementation of the nursing care process, nursing diagnostic interventions and planning of diagnostics and treatment. Conclusion: The nurse has a significant role in nursing care for patients with liver cirrhosis, the same as data collection and problem identification, severance diagnosis and adequate interventions for each patient individually. Equally, a nurse participates in educating patients and families / significant persons about the disease itself, recognizing and suppressing risk factors contributing to the deterioration of the disease and counseling on the complete elimination of alcoholic beverages