00178 Risk Of Deterioration Of Liver Function

Domain 2: nutrition
Class 4: metabolism
Diagnostic Code: 00178
Nanda label: risk of deterioration of liver function
Diagnostic focus: hepatic function
Approved 2006 • Revised 2008, 2013, 2017 • Level of evidence 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « risk of impairment of liver function is defined as: susceptible to a decrease in liver function, which can compromise health.

Risk factors

  • Inappropriate use of substances
  • Substance abuse (alcohol, cocaine)
  • HIV shared infection
  • Viral infection (such as hepatitis A, Hepatitis B, Hepatitis C, Epstein-Barr)
  • Hepatotoxic medications (such as acetominophen, statins)

Associated problems

  • Coinfection of the human immunodeficiency virus (HIV)
  • Pharmacological preparations
  • Viral infection

Suggested alternative diagnostics

  • Health risk behavior, a tendency to adopt a
  • injury, risk of

NOC Results

Note : Noc does not have a result to directly measure the liver function. Two results are included that could occur in a liver failure. Other results, such as liquid overload, could be useful. The other results that are included here are related to the prevention of the decrease in liver function).

  • Blood coagulation: point to which blood is coagula within a normal time period
  • Behavior to cessation in alcohol abuse: personal actions to eliminate alcohol consumption that represents a health risk
  • Behavior to cessation in drug abuse: personal actions to eliminate drug use that represents a health risk
  • Risk control: Personal actions to prevent, eliminate or reduce the dangers modifiable for health
  • Risk detection: personal actions to identify threats to your own health
  • Gravity of the infection: severity of associated infections and symptoms
  • Answer to medication: therapeutic and adverse effects of prescribed medications

Evaluation objectives and criteria

  • The liver function is not deteriorated, as manifested by blood coagulation and the response to medication
  • It demonstrates blood coagulation, as manifested by the following indicators (specify from 1 to 5: severely diverted, substantially, moderately, slightly or without deviation from normal limits):
    • Cotulum formation
    • Part -time thromboplastin (TPT)
    • Prothrombin time (TP)
    • Hemoglobin (HGB)
    • Platelet count
  • Other examples

    The patient will be able to:

    • Refer absence of pain in the upper right quadrant
    • defecate normal feces (for example, brown, without blood or mucus)
    • Present stable vital signs
      • Without bleeding
      • Without petechiae
      • Without hematomas or ecchymosis
      • Without hematuria, hemoptysis, or hematemesis
      • Without blood in the stool
      • Without bleeding in gums

    NIC Interventions

    • Infection control: reduction of the acquisition and transmission of infectious agents
    • Teaching: Individual: Planning, application and evaluation of a teaching program designed to solve the specific needs of a patient
    • Teaching: prescribed medication: prepare a patient to correctly take the prescribed medications and monitor their effects
    • Risk identification: Analysis of possible risk factors, determination of health risks and prioritization of risk reduction strategies for a person or group
    • Medication management: Facilitate the safe and effective use of drugs with and without recipe
    • Infection prevention: Prevention and early detection of infections in a risk patient
    • Treatment of substance consumption: alcohol abstinence: patient care that suddenly suspends alcohol consumption
    • Treatment of substance consumption: drug abstinence: patient care that is detoxifying drugs
    • Treatment of substance consumption: patient care and care and family members suffering from physical and psychosocial problems related to alcohol or drug use
    • Surveillance: Collection, interpretation and synthesis of patient data, continuously and with an end, to make clinical decisions

    Nursing Activities

    • Since it is a potential diagnosis, nursing activities must focus on: (a) to modify, as far as possible, existing risk factors, and (b) evaluate the signs and symptoms of deterioration of deterioration the liver function

    Valuations

    • Monitor income and expenses
    • Monitor vital signs, pain (especially in the upper right quadrant) and mental state
    • Control the appearance of ascites, peripheral edema and jugular distension
    • Monitor electrolytes
    • Monitor the appearance of blood into the stool
    • Observe the skin and sclera to detect the appearance of jaundice

    Patient and family education

    • Inform about the disease processes that constitute a risk for the decrease in liver function

    Collaboration activities

    • Administer medications and treatments against underlying disease processes to reduce the risk of decreased liver function