Nsg Dx for hepatic encephalopathy

[dalegirl]

If anyone can help, I need 2 dx with related to and evidence by for a case study. This is what I have so far, if anyone can advise if it sounds okay

Patietn is an alcoholic and med dx is Hep encephalopathy

1.Fluid volume excess related to compromised regulatory mechanisms as evidenced by increased abdominal girth.

2. Altered nutrition: decreased body requirements related to

This is what I am having problem with????

His ammonia levels are high, I want to address the lactulose etc in the interventions

Can anyone help develope 2nd dx

Thanks

[Daytonite, BSN, RN]

1. Fluid volume excess related to portal hypertension, lowered plasma colloidal osmotic pressure, and sodium retention and evidenced by. . .

2. Altered nutrition: less than body requirements related to impaired protein metabolism as evidenced by azotemia

[dalegirl]

1. Fluid volume excess related to portal hypertension, lowered plasma colloidal osmotic pressure, and sodium retention and evidenced by. . .

2. Altered nutrition: less than body requirements related to impaired protein metabolism as evidenced by azotemia

Thank you, is there anything that stands out for the clinical pathway besides, nursing assessment, med assesment, dx tests, collabouration w/ nutritonist, etc

[Daytonite, BSN, RN]

is there anything that stands out for the clinical pathway besides, nursing assessment, med assesment, dx tests, collabouration w/ nutritonist, etc

This patient will need a lot of assistance if he ever ends up going to his own home. He will require a rather extensive discharge plan. His alcohol problem needs to be addressed. Social services consult is certainly appropriate.

Also, patients don't usually have just hepatic encephalopathy without also having other liver damage as well. In addition, there is often pancreatic and renal involvement of some sort.

I'm not sure what else you are looking for. As long as you are following the nursing process just remember to have addressed all your patients possible needs as would be covered in Gordon's 11 Functional Patterns, Mazlow's Heirarchy, or even the British Roper, Logan & Tierney Activities of Living and that the nurse is using all her roles to fulfill these needs.

[dalegirl]

thanks, for your help. the patient went to rehab and sucessfully completed 1 month