Cirrhosis: An Analysis of Evidence-Based Practice
Characterized by progressive tissue injury and scarring, cirrhosis is among the leading causes of chronic liver failure in the United States. Recent research conducted by the National Institutes of Health indicated that the prevalence of cirrhosis, especially in clients diagnosed with Hepatitis C, has increased steadily throughout the past decade and will likely continue to increase in the future (Kanwal et al., 2011). Caused by recurrent tissue damage and inflammation, cirrhosis occurs as healthy hepatocytes (liver cells) are replaced by fibrotic and non-functional scar tissue through natural healing processes. Although liver tissue is normally very resilient, sustained injury eventually outpaces restorative capacity and a majority of functional tissue is replaced with collagenous tissue and liver failure occurs. In the United States, cirrhosis is most commonly caused by Hepatitis C, alcoholism, fatty liver disease, and biliary obstruction (Kanwal et al., 2011). Due to the increase in prevalence and the seriousness of the condition, cirrhosis represents a significant healthcare issue. The treatment and care of clients diagnosed with cirrhosis is complex. The following information addresses several of the major aspects of nursing care associated with the treatment of clients diagnosed with cirrhosis. Additionally, current studies regarding the treatment of cirrhosis will be evaluated in an effort to assess their readiness to be incorporated into current evidenced-based nursing practice.
Nutrition
Malnutrition, a common complication of advanced hepatic disease including cirrhosis, is associated with poor patient outcomes and diminished quality of life. Although nutrition therapy ...
... middle of paper ...
...tic patients with jaundice.” The authors concluded that their study demonstrated that supplemental enteral feedings provided no additional benefit to patients being treated for cirrhosis. Additionally, the authors argued that the risk of associated complications (e.g. infection, encephalopathy, bleeding) outweighed any benefit patients may receive through supplemental enteral feedings.
Implications for nursing practice are as follows. First, the study indicated that additional medical intervention is not always supportive of positive patient outcomes. Instead, it
Works Cited
Kanwal, F., Hoang, T., Kramer, J. R., Asch, S. M., Goetz, M. B., Zeringue, A., Richardson, P., & El-Serag, H. B. (2011). Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection. Gastroenterology, 140(4), 1182-1188. doi: 10.1053/j.gastro.2010.12.032.
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Often in practice, we as nurses deal with a variety of diseases and treatments and often have to react to the illness that the patient presents with upon our interaction. While this is an essential piece of our practice, we also have a duty to our patients to be proactive in preventing specific health-related consequences based on their risk factors and to promote their health and well being. Health promotion as it relates to nursing is about us empowering our patients to increase their control over their lives and well beings and includes: focusing on their health not just illness, empowering our patients, recognizing that health involves many dimensions and is also effected by factors outside of their control (Whitehead et al. 2008)..
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
Introduction The purpose of this report is to compare and contrast two different nursing research articles. The report will critique and evaluate two qualitative studies, one being an original research report and the second being a review paper. The scope of comparison and contrast will include research design, theories or conceptual models, how the research was conducted, analysis and reporting of research data, usefulness of the research, and a conclusion. Selection of Research Interest Area
Evidence –Based Practice is a process through which scientific evidence is identified, appraised, and applied in health care interventions. This practice obliges nursing experts to depend on logical research and confirmation more frequently than experience or instinct. EBP is intended to guide medicine of patients in a regulated methodology. This model joins together research, investigation and patient history to give the most exhaustive consideration conceivable. EBP got mainstream throughout the late 1970s. In any case, the thoughts behind the practice were presented much sooner than by nursing pioneer Florence Nightingale. As stated by Carole Cooper, "Nightingale evaluated nature's turf, gathered information, distinguished intercessions and observed patient results." This methodology mirrors current evidence- based practice. Utilization of EBP expanded throughout the 1970s and 1980s in light of calls for additional productivity in patient consideration. While restorative exploration discoveries were accessible, specialists and attendants were not equipped to get to or execute the new data rapidly enough. This new system joined together components of useful information and experience with clinical examination discoveries and investigation.
" Journal Of The American Academy Of Nurse Practitioners 24.12 (2012): 726-734. Academic Search Premier -. Web. The Web.
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite Professor, College of Nursing, The University of Texas at Tyler, Tyler, TX, and CEO, Management Solutions for Healthcare, Houston, TX; Jean Dois, RN, PhD, NEA-BC, FACHE, is the System Director for Quality and Nursing, CHRISTUS Health System, Houston, TX; and Peggy Landrum, RN, PhD, is Clinical Professor, College of Nursing, Texas Woman 's University, Houston,
Ulcerative colitis progresses from the rectum and moves proximally. Distal disease refers to inflammation that is limited to the rectum (proctitis) or rectum and sigmoid colon. Here it is referred to as proctosigmioditis. If the disease is more extensive it includes the left side of the colon and can cover the splenic flexure. This occurs in 40% of patients. Extensive colitis occurs up to the hepatic flexure. Pan colitis affects the whole of the colon and this can affect up to 20% of patients. Some patients with pan colitis have involvement of the terminal ileum, this is caused by an incompetent ileocaecal valve.
As mentioned previously we can do without food for weeks but without oxygen, we will die within a few minutes this is why nutrient imbalance is given second priotiy.Our bodies need a balanced nutritious diet to produce, substitute and repair cells and tissues; produce energy to stay warm and movement; carry out chemical processes such as the digestion of food and protect against infection and recover from sickness. (Fao, n.d.)Without balanced nutrition we won’t have the necessary energy to perform our ADLs. If we look at Mr Cooper he has a background of reflux and hypercholesterolemia. Mr Cooper has a high risk of nutrition imbalance due to inadequate nutrients due to constant vomiting up of foods, indigestion, and feeling of fullness in the upper abdomen all of which leads to loss of appetite thus loss of essential nutrients. (Nanda nursing care plan, 2012) Hypoxia also has an anorexic effect and is a key catabolic stimulus. (Mason, Parker and Lott,
A person infected with Hepatitis A will take weeks to months to recover. During recover an infected person will receive supportive care and therapy. A patient should remain on bed rest and receive well balanced nutrition. Patient should be restricted from school and or work until fever is reduced and jaundice diminishes. If patient is vomiting and or has diarrhea, they can be treated with antiemetic medications. Also, an adequate water intake is necessary. An infected person should avoid alcohol and limit consumption of drugs that are damaging to the liver, such as acetaminophen. Hospitalization is rare during the treatment of Hepatitis A. (Matheney, 2012; Gilroy,
During my career as a registered nurse I have had the privilege of caring for my patients at the bedside and meeting their needs holistically. Additionally, the safety of my patients is one of the most important aspects of my current role. The experience of advocating for my patients during my nursing career has taught me to place my patient’s health and wellbeing first. The second most important aspect of nursing that I have learned during my career is how to meet my patient’s needs as a whole, not just physically but also emotionally and psychologically applying the holistic approach to each patient. I believe that the patient’s needs
For nursing, research has played a major role in the way clinical practice is done. Research has allowed nurses to provide appropriate care to patients. It allows them to perform their job by providing them the tools and information they need in order to make the decisions on the concerns for caring the patient (Polit & Beck, 2006). Moreover, research can also take focus on the workers themselves in order to improve the practice both on a professional and personal level. An example of a study conducted by King, Vidourek, and Schweibert of University of Cincinnati created a study to determine if there is a correlation between ...
The common change is liver cell necrosis. It may be the form of an acute hepatitis or viral or alcoholic type. Alternatively there may be continuous liver cell damage as in metabolic disorders. When necrosis is massive as in severe viral or drug induced hepatitis, the areas of surviving parenchyma are assumed to undergo regeneration but fail to reproduce normal lobular or acinar architecture. The compressed necrotic zones then form the basis of the fibrous septa of the cirrhotic liver.
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
Lazo M, Hernaez R, Bonekamp S, et al. Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study. BMJ 2011;343:d6891. http://www.bmj.com/content/343/bmj.d6891