Clinical meaning
Cirrhosis is the end stage of chronic liver disease characterized by progressive replacement of functional hepatocytes with fibrous scar tissue. This fibrosis disrupts normal hepatic architecture, impeding blood flow through the liver and causing portal hypertension. As portal pressure rises, blood is diverted through collateral vessels, creating esophageal varices, caput medusae, and hemorrhoids. Impaired hepatocyte function leads to decreased albumin synthesis (causing edema and ascites), decreased clotting factor production (causing bleeding), decreased bile production (causing jaundice and pruritus), and impaired ammonia detoxification (causing hepatic encephalopathy). The nurse monitors vital signs, mental status, skin integrity, and fluid balance, reporting changes to the nursing team.
Exam relevance
Risk factors: - Chronic alcohol abuse - Chronic hepatitis B or C infection - Non-alcoholic fatty liver disease (NAFLD/NASH) - Autoimmune hepatitis - Biliary obstruction - Medication-induced hepatotoxicity - Hemochromatosis