Hepatic failure

 Hepatic failure :-

Include - definition, causes , Pathophysiology, sign & symptoms,  diagnostic evaluation, management 

Definition:

Hepatic failure, also known as liver failure, is a severe condition where the liver's ability to function is impaired, leading to the loss of vital liver functions.

It can be acute (sudden onset) or chronic (developing over time).

Causes:

• Viral hepatitis (e.g., hepatitis A, B, C)
• Alcohol abuse
• Drug-induced liver injury
• Cirrhosis
• Autoimmune hepatitis
• Wilson's disease
• Hemochromatosis
• Non-alcoholic fatty liver disease (NAFLD)

Types:

Acute Hepatic Failure (AHF)

Chronic Hepatic Failure (CHF)

Pathophysiology:

Liver cells (hepatocytes) are damaged or destroyed, affecting various liver functions.

Inflammation and scarring can lead to reduced blood flow through the liver, causing further damage.

Impaired detoxification and metabolism of substances, leading to toxin buildup in the body.

Signs & Symptoms :

• Jaundice (yellowing of skin and eyes)
• Ascites (abdominal swelling due to fluid buildup)
• Fatigue and weakness
• Nausea and vomiting
• Mental confusion or altered consciousness
• Easy bruising and bleeding Edema (swelling) in the legs
• Abdominal pain

Diagnostic Evaluation:

• Blood tests: Liver function tests (ALT, AST, bilirubin), coagulation profile, ammonia levels.
• Imaging: Ultrasound, CT scan, or MRI to assess liver structure and any abnormalities.
• Liver biopsy: To examine liver tissue for inflammation and fibrosis.

Pharmacological Management:

Depending on the cause and severity, medications may include:

• Antivirals (for viral hepatitis)
• Corticosteroids (for autoimmune hepatitis)
• Diuretics (for fluid retention)
• Lactulose (to reduce ammonia levels)
• N-acetylcysteine (for acetaminophen overdose)

Non-Pharmacological Management:

Dietary changes: Low-sodium diet, limiting alcohol intake.

Liver transplant: In severe cases where liver function cannot be restored.

Nursing management:  

Nursing Diagnoses:

• Impaired liver function related to hepatic failure.
• Fluid volume excess related to ascites.
• Risk for bleeding related to coagulation abnormalities.

Monitoring vital signs, fluid balance, and mental status.

Administering medications as prescribed and monitoring their effects.

Providing emotional support and educating the patient about lifestyle changes.