Rabu, 01 Februari 2012

Nursing Care Plan for Hepatoma

Nursing Care Plan for Hepatoma
NCP for Hepatoma
Hepatoma
A hepatoma is a cancer that starts in the liver. It is the most common type of cancer originating in the liver.
Symptoms

The first signs of the disease may include :
  • Abdominal pain
  • Weight loss
  • Large mass that can be felt in the upper right section of the abdomen
People who have had cirrhosis for a long time may also experience :
  • Sudden feeling of illness
  • Fever
  • Sudden abdominal pain and shock (very low blood pressure) caused by a rupture or bleeding of the tumor
Causes and Risk Factors
Risk factors for hepatoma include :
  • Long-standing cases of cirrhosis (severe scarring of the liver)
  • Chronic infection with hepatitis B
  • Chronic infection with hepatitis C
  • Certain food fungi
Diagnosis
At first, symptoms may not offer clues that the disease is present. When the person has had cirrhosis for a long time and a tumor can be felt in the abdomen, the doctor will suspect hepatoma.
Other ways to detect the disease include :
  • Ultrasound
  • Computed tomography (CT) scans
  • Magnetic resonance imaging (MRI)scans
  • Liver biopsy. For this, a small sample of tissue is taken for examination under a microscope.
Treatment
The survival rate for people with hepatoma is poor. This is because the tumor is usually discovered at a later stage.
Treatment options include :
  • Surgery, if the tumor is small
  • Chemotherapy. This can slow the growth of the tumor but not cure the cancer.
Source : www.cedars-sinai.edu
Nursing Care Plan for Hepatoma
Nursing Assessment
On physical examination can be obtained :
  • Ascites
  • Jaundice
  • Hypoalbuminemia
  • Splenomegaly, spider nevi, palmar eritoma, edema.
In general, nursing assessment in patients with hepatoma, including :
  • Metabolic disorders
  • Bleeding
  • Ascites
  • Edema
  • Hipoproteinemia
  • Jaundice / icterus
  • Endocrine Complications
  • Activities were disrupted by treatment.
Nursing Diagnosis for Hepatoma
Based on the above assessment, the nursing diagnoses that often arises is :
  1. Malnutrition: Weight loss related to anorexia, nausea, impaired absorption, metabolism of vitamins.
  2. Ineffectiveness of breathing related to the existence of ascites and emphasis diapragma.
  3. Pain related to abdominal wall tension
  4. Lack of fluids and electrolytes related to excessive ascites, bleeding, and edema
  5. The risk of infection related to a deficiency of white blood cells
  6. The risk of skin integrity problems related to pruritus, edema, and ascites
  7. Sexual dysfunction related to hormonal dysfunction and decreased libido
  8. Anxiety related to hospitalization
  9. Lack of knowledge about the disease process and its causes
  10. Social isolation related to the risk of spreading infection.

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