Eugene Harris. 65 year old male presenting with liver cirrhosis.

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Eugene Harris. 65 year old male presenting with liver cirrhosis. by Mind Map: Eugene Harris. 65 year old male presenting with liver cirrhosis.

1. Experience of illness

1.1. chronic liver disease

1.1.1. signs and symptoms disturbance of ADLs

1.1.2. impact on individuals and loved ones

1.1.3. complications can cause blood flow problems blood may need to find different routes and these can rupture as a result of pressure potential to lead to liver failure or death

1.1.4. bleeding and hemorrhage, fluid volume excess, hepatic encephalopathy

1.2. circumstances prior to diagnosis

1.2.1. alcoholic

1.2.2. depression disturbance of ADLs

1.3. mental status

1.4. resiliency

1.4.1. role of family

1.4.2. self actualization

2. Interpreting- Get a history of precipitating factors

3. Noticing- Note abdominal distension and bloating, GI bleeding, bruising and weight changes

4. Responding- medications, diet, helping maintain healthy weight, educate on reducing risk of hepatitis and drinking alcohol, assess psychological status

5. Nutrition

5.1. alcohol consumption

5.1.1. chronic gastritis

5.2. iron buildup

5.3. loss of appetite

5.3.1. malnutrition

5.3.2. weight loss

5.3.3. poor nutrition impaired skin integrity

5.4. nausea

5.5. factors effecting intake and output

5.5.1. nausea

5.5.2. decreased GI motility

5.5.3. finanance

5.5.4. age

6. Noticing-dietary intake, skin integrity, change in weight, edema, jaundice

7. Interpreting- poor nutritional intake,

8. Responding- refer client to dietitian, focus on dietary intake, discuss balance diet, nutritional supplements, high protein diet, small frequent meals

9. Experience of pain

9.1. signs and symptoms

9.1.1. abdominal discomfort

9.1.2. itchy skin

9.1.3. nausea

9.2. complications

9.2.1. edema in peripheries and abdomen

9.2.2. infection

9.3. emotional and psychological pain

9.3.1. past experiences

9.4. pain management

9.4.1. severity

9.5. chronic

9.5.1. severity

9.6. factors influencing

9.6.1. perception

9.6.2. gender

9.6.3. knowledge, attitudes, beliefs

9.7. response to medications

10. Noticing- pain discomfort and affects of disease on patient,

11. Interpreting- client is in pain, what is causing patient distress, mood, is the pain effecting every day life, severity of the pain

12. Responding- medications and patient teaching on them, reduce risk of injury, monitor and manage for complications, check stools for blood, emotional support

13. Mobility

13.1. activity intolerance

13.1.1. fatigue

13.1.2. muscle wasting

13.1.3. discomfort

13.2. rest required

13.3. complications

13.3.1. respiratory

13.3.2. circulatory -DVT

13.3.3. GI

14. Responding-getting goals such as independence in activities, decreased potential for injury, position bed for maximal respiratory efficiency, prevent circulatory and vascular disturbances, encourage gradual activity

15. Noticing-Fatigue, immobility, activity intolerance, discomfort with mobility

16. Interpreting- affect of the respiratory, circulatory, integumentary and GI systems, psychological effect

17. Quality of life

17.1. lifestyle

17.1.1. avoidance of alcohol

17.1.2. exercise

17.1.3. increased nutritional intake

17.2. relationships

17.2.1. family and friends

17.2.2. damaged relationships

17.3. healthcare visits

17.4. self worth

17.4.1. avoidance of alcohol

17.5. living with a chronic disease

18. Noticing- relationships with family, friends and coworkers, emotional status

19. Interpreting- finding meaning in life, looking to improve health status

20. Responding- providing emotional support, educating and preparing client for home care, gets self goals, refer to alcohols anonymous, provide reinforcements to patient and family, encourage rest and change in lifestyle

21. Infection and Healing

21.1. management

21.2. immunological status compromised

21.2.1. impaired skin integrity

21.3. clotting mechanisms

21.3.1. risk for injury

21.4. effects of healing

21.4.1. immune system

21.4.2. nutritional intake

21.4.3. stress and sleep

21.4.4. medications

21.4.5. age and lifestyle

22. Noticing- impaired skin integrity, WBC

23. Interpreting-infection

24. Responding-medications, lifestyle change, environment