Cirrhosis

Nursing School Week by Week

Let's talk about Cirrhosis! Learn about the signs and symptoms, the complications, and what you, as the nurse, can do about it.
Over 44,000 people die every year from cirrhosis, so it’s the 9th leading cause of death in the US. Cirrhosis is an incurable form of liver disease that happens slowly due to inflammation and scarring of the liver tissue. When you think of cirrhosis, think of scarring, or “Scarosis”. The main cause is chronic hepatitis C. The other two causes are: drinking too much alcohol, and nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease is when too much fat gets stored in the liver cells, and this can be from obesity or diabetes.

So the liver cells get damaged, they try to fix themselves, but just wind up making scar tissue instead. So instead of having a nice, smooth liver, you’ve got a lumpy mess of a liver with constrictive bands that cut off the flow of blood and bile. Remember bile is made in the liver, and then has to go to the gallbladder to be stored.

So why do we care so much about the liver? What does it do for us?

Our liver detoxifies alcohol and drugs. It breaks down proteins and carbs, and steroid hormones. It makes blood clotting factors, so if your liver isn’t working, you’re gonna have a decrease in every coagulation factor, except factor 8. The liver makes blood proteins, like Albumin, and if you remember, Albumin is the main protein in your blood, and the main thing regulating your oncotic pressure, or the thing that’s keeping your fluids in your blood vessels, and not seeping out into the tissue. So when the liver isn’t making enough Albumin, we’re gonna see edema and ascites. Ascites is when too much fluid builds up in the peritoneal cavity, causing a big swollen belly.

A normal liver will store glucose as glycogen for later use, but with an impaired liver, we could see hypoglycemia or hyperglycemia cause the body’s having a hard time regulating the glucose levels. The liver makes bile, and bile absorbs fat and gets rid of bilirubin. Bilirubin is a yellow pigment that’s a byproduct of your old red blood cells getting broken down. A healthy liver will take that bilirubin and put it in your poop with bile to get rid of it. This is what makes your poop brown. So without that bile, your poop is gonna be pale and clay-colored, because you’re not getting rid of the bilirubin pigment, and that bilirubin is gonna keep building up building up and make your skin and the whites of your eyes yellow.