Xavier University Ateneo de Cagayan

College of Nursing
S.Y. 2016 2017

A Concept Map of Hepatic Cirrhosis

Submitted to:
Maam Jesseca Monsanto, RN MAN
Clinical Instructor

Submitted by:

Marvin John A. Labiano

Michael Divine T. Gemeniano

BSN 3 NB
September 16, 2016

A. Describe briefly the disease condition

Cirrhosis is defined histologically as a diffuse hepatic process characterized

by fibrosis and the conversion of normal liver architecture into structurally abnormal
nodules. The progression of liver injury to cirrhosis may occur over weeks to years.
Indeed, patients with hepatitis C may have chronic hepatitis for as long as 40 years
before progressing to cirrhosis.

B. Determine the predisposing and precipitating factors and discuss.

Predisposing factors include viral hepatitis (eg, hepatitis C), Fulminant hepatic
failure (FHF) and the precipitating factors include alcoholic liver disease
D. Identify the different clinical manifestations as the disease condition progresses.
Valve stenosis ranges from mild to severe. Valve stenosis signs and symptoms
generally develop when narrowing of the valve is severe and can include:

Chest pain (angina) or tightness

Feeling faint or fainting with exertion

Shortness of breath, especially with exertion

Fatigue, especially during times of increased activity

Heart palpitations sensations of a rapid, fluttering heartbeat

Heart murmur

Valvular heart disease may cause the following symptoms:

Dizziness
Chest pain
Breathing difficulties
Palpitations
Edema (swelling) of the feet, ankles, or abdomen
Rapid weight gain due to fluid retention

The heart-weakening effects of heart valve stenosis may lead to heart failure. Heart
failure signs and symptoms include fatigue, shortness of breath, and swollen ankles
and feet.
Heart valve stenosis often doesn't produce warning signs or symptoms right away,
making it difficult to detect at first. You also may not recognize that you're
experiencing symptoms. The condition is often discovered during a routine physical
when your doctor hears an abnormal heart sound (heart murmur). This murmur may
occur long before other signs and symptoms develop.
Heart valve stenosis usually affects adults but can occur in children. Infants and
children with the condition may experience symptoms similar to those of adults. If
you or your child experiences such signs or symptoms, see a doctor especially if you
or your child has a known heart problem.
E. What are the diagnostic studies and its relevance to the disease condition?
If your doctor suspects that you or your child may have a deformed or
narrowed heart valve, you may need to undergo several tests to confirm the
diagnosis and gauge the severity of the problem. You may be referred to a doctor
trained in heart conditions (cardiologist) for tests such as:

Echocardiogram. This test uses sound waves to produce an image of your

heart. This is the primary test your doctor may use to diagnose your condition
if he or she suspects you have a heart valve condition.

Electrocardiogram (ECG). In this test, patches with wires (electrodes) are

attached to your skin to measure the electrical impulses given off by your
heart. Impulses are recorded as waves displayed on a monitor or printed on
paper. An ECG can provide clues about whether the left ventricle is thickened
or enlarged, a problem which can occur with aortic valve stenosis.

X-ray. An X-ray image of your chest allows your doctor to check the size and
shape of your heart to determine whether the left ventricle is enlarged a
possible indicator of aortic valve stenosis. A chest X-ray can also reveal
calcium deposits on the aortic valve. In addition, a chest X-ray helps your
doctor check the condition of your lungs. Aortic valve stenosis may lead to
blood and fluid backing up in your lungs, which causes congestion that may
be visible on an X-ray.

Magnetic resonance imaging (MRI). An MRI uses powerful magnets and

radio waves to create detailed images of your heart and heart valves. Doctors
may inject a dye into your blood vessels to highlight the heart and blood
vessels in images (magnetic resonance angiography).

F. What are the medical/surgical treatment management and discuss briefly.

Medications sometimes can ease symptoms of heart valve stenosis. However,
the only way to eliminate aortic valve stenosis is surgery to repair or replace the
valve and open up the passageway. In general, surgery is necessary when
narrowing becomes severe and symptoms develop.
No medications can reverse heart valve stenosis. However, your doctor may
prescribe certain medications to help your symptoms, such as ones to reduce fluid
accumulation, to slow your heart rate or to control heart rhythm disturbances
associated with heart valve stenosis. You may need valve repair or replacement to
treat aortic valve stenosis. Although less invasive approaches are possible in some
cases, surgery is the primary treatment for this condition. Therapies to repair or
replace the aortic valve include:

Balloon valvotomy/ Valvuloplasty - a catheter procedure that stretches the

valve open.

Commissurotomy - an open-heart surgery to remove calcium deposits and

other scar tissue from the valve.

Reshaping - is done when the surgeon cuts out a section of a leaflet. Once
the leaflet is sewn back together, the valve can close properly.

Decalcification removes calcium buildup from the leaflets. Once the calcium
is removed, the leaflets can close properly.

Repair - of structural support replaces or shortens the cords that give the
valves support (these cords are called the chordae tendineae and the papillary
muscles). When the cords are the right length, the valve can close properly.

Patching - covers holes or tears in the leaflets with a tissue patch.

G. Determine the nursing diagnosis based on the clinical manifestations

Decreased cardiac output related to aortic valve stenosis.

Difficulty of breathing related to low insufficient oxygen supply to the

body
Ineffective Airway Clearance related to low oxygen output in the body

BIBLIOGRAPHY

http://www.texasheart.org/HIC/Topics/Proced/vsurg.cfm
http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblem
sandDisease/Problem-Heart-Valve-

Stenosis_UCM_450369_Article.jsp#.V4yS74R97IV
http://www.mayoclinic.org/diseases-conditions/aortic-

stenosis/basics/symptoms/con-20026329
http://www.mayoclinic.org/diseases-conditions/aortic-

stenosis/basics/tests-diagnosis/con-20026329
http://www.mayoclinic.org/diseases-conditions/aorticstenosis/basics/treatment/con-20026329