Monitoring mental status for hepatic encephalopathy is critical in cirrhosis due to ammonia accumulation affecting brain function. Stages: 0 (normal); 1 (mild confusion, euphoria, sleep disturbance); 2 (lethargy, disorientation, asterixis); 3 (somnolent but rousable, confusion); 4 (coma). Other assessments: ascites (measure abdominal girth daily); jaundice; bleeding risk (coagulopathy, varices); nutrition; and signs of infection. Management includes: lactulose to reduce ammonia; protein restriction during encephalopathy; diuretics for ascites; avoiding sedatives; and treating precipitating factors (infection, GI bleeding, electrolyte imbalance). Nurses educate about: alcohol abstinence; medication adherence; low-sodium diet; symptom recognition; and when to seek help. Cirrhosis complications: portal hypertension, variceal bleeding, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatocellular carcinoma. Early detection of encephalopathy allows prompt treatment preventing progression to coma.

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Zambia

• Joseph Soko – 101 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies