Care Plan

Care planning is an important part of healthcare. A care plan helps your healthcare team to organize your care in a logical way. It also helps each member of your healthcare team to understand the goal of your care.

Care plans are known to be used in hospitals, but they are also used by family doctors, especially for patients with complex conditions. In this case, patients agree to a joint plan with their doctor to manage and understand their complex medical conditions.

When admitted to hospital there are several points of care that may be included in a care plan for a patient who is diagnosed with liver cirrhosis. This includes, but is not limited to:

  • Nutrition
  • Excess Fluid (ascites)
  • Skin
  • Breathing
  • Injury risk
  • Risk for Confusion (hepatic encephalopathy)

 

Nutrition

If you have been admitted to hospital a care plan may be used to address your diet, nausea/vomiting, feeling full, and bowel movements. Your healthcare team will look at your weight, your bowel movements and muscle tone. With this care plan, the goal is to improve weight and nutrition. Some interventions that may be used are: prescribing a diet with a specific caloric intake, decreasing salt intake, and taking nutritional supplements. It may also include frequent tests like weight, fluid levels, and muscle and skin measurements. There may also be other interventions involved, including meeting with a dietitian and a psychologist, or changing the number or times of day that you eat.

Excess Fluid

If you have been admitted to hospital a care plan may be used to address your ascites. Your healthcare team will look at your weight, laboratory results, abdomen,  and mental status. With this care plan, the goal is to decrease the level of fluid in your abdomen. Some interventions that may be included are: frequent weigh-ins, monitoring vital signs and abdomen size, changing diet, and prescribing medications.

Skin

If you have been admitted to hospital a care plan may be used to address the risk for skin damage due to the symptoms of liver disease (itching, swelling, etc.) or changes in blood flow from being in bed for an extended period of time. Your healthcare team will look at your skin and use certain interventions (rotating, frequent washing) to prevent skin damage. Some interventions can include: identifying points in your skin that may be more irritated, elevating parts of your body, and maintenance like nail clipping, frequent washing and lotion application to improve your skin condition.

Breathing

If you have been admitted to hospital a care plan may be used to address the risk for changes in your breathing. Your healthcare team will look at fluid collection in your belly, lung function, and energy levels. Some interventions that may be included in the plan are monitoring and listening to breathing, breathing exercises, providing excess oxygen and education.

Injury risk

If you have been admitted to hospital a care plan may be used to address your risk for injury. Your healthcare team may look at your blood content, different vitamin and mineral levels, and the likelihood that you could develop varices. Some interventions may include checking your body over for bleeding, monitoring for varices, checking vital signs, and prescribing medications.

Risk for confusion

If you have been admitted to hospital a care plan may be used to address your risk for developing hepatic encephalopathy (confusion). Your healthcare team may look at the level of fluid in your belly, your bowel movements, and your laboratory values. Some interventions may include frequent monitoring of brain function (confusion, behavioural changes, etc.), looking at medication doses, sleep schedule changes, and lifestyle changes.

 

These are a few of the care plans that may be used as part of a greater care plan for someone living with liver disease. Depending on your condition, what brings you into hospital, and your wishes, this plan may be different than yours and it may change over time.

Important Resources

References

The material on this page was developed from content by:

My Health Alberta 

Nurses Labs 

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