Cirrhosis: NCLEX Priorities
Cirrhosis: ascites, varices, encephalopathy, lactulose, paracentesis.
Cirrhosis is end-stage liver scarring. NCLEX tests complications: ascites, varices, encephalopathy.
Causes
Alcohol, hepatitis B/C, NAFLD, autoimmune, hemochromatosis.
Ascites
Sodium restriction (<2 g/day), diuretics (spironolactone + furosemide), paracentesis for tension. Albumin replacement after large-volume paracentesis.
Varices
Esophageal varices → upper GI bleed risk. Non-selective beta-blockers (propranolol, nadolol) for prevention. Band ligation prophylactic in large varices. Active bleed: octreotide + endoscopy + antibiotics + transfusion.
Encephalopathy
Ammonia accumulation. Lactulose (titrate to 2-3 soft stools/day), traps ammonia. Rifaximin added in recurrent. Treat precipitants (infection, GI bleed, dehydration).
Hepatorenal, hepatopulmonary, SBP
Multiple end-organ complications. SBP (spontaneous bacterial peritonitis) treated with ceftriaxone + albumin.
Frequently asked
Why albumin after paracentesis?
Prevents post-paracentesis circulatory dysfunction. >5L drained: give albumin.
Lactulose taste, patient won't take?
Can give via NG or rectally if needed. Often becomes essential.
Quick check
Loading a question…
How ready are you right now?
10 real NCLEX questions, free, in your browser. See how close you are to ready and which subjects are costing you.
Try 10 questions free