The liver is the body’s second-largest organ, about the size of a football. It is located on the right side of the abdomen, just beneath the rib cage. It has various functions, including processing everything a person eats and drinks and converting them to energy and nutrients for the body to use.
The liver also helps the body fight infection and eliminate toxic substances from the blood. Damage to the liver can cause scarring, which can lead to impaired liver function, and may result in liver failure, which is a life-threatening condition.
To avoid impaired liver function, early treatment is required, allowing the liver to heal.
Signs and Symptoms of Impaired Liver Function
An impaired liver function may not exhibit any obvious signs and symptoms, but when it does, they can include the following:
- Jaundice or yellowish appearance of the skin and eyes.
- Swelling and pain in the abdomen
- Swelling of the ankles and legs
- Skin Itchiness
- Dark color of the urine
- Light pale color of feces
- Recurrent exhaustion
- Nausea and vomiting
- Appetite loss
- Tend to bruise effortlessly
Impaired Liver Function: Types of Liver Failure
Acute or chronic liver failure can occur as a result of an impaired liver function:
- Acute liver failure. It can strike without warning and may happen without causing any symptoms. Within weeks or even days, a person’s liver function may deteriorate. Acute liver failure is commonly caused by mushroom poisoning or a drug overdose.
- Chronic liver failure. It is longer to develop than acute liver failure, taking months or even years before symptoms appear. Cirrhosis, which occurs when functioning liver tissue is replaced with scar tissue, is a common cause. Cirrhosis is most commonly caused by hepatitis C infection, excessive alcohol consumption, or nonalcoholic fatty liver disease (NAFLD), according to research. The liver becomes inflamed in chronic liver failure, which leads to the generation of scar tissue throughout time. The liver tends to lose its basic scope of function as scar tissue substitutes for healthy tissue.
Related Factors to Impaired Liver Function
The following factors may increase a person’s risk of impaired liver function:
- Heavy drinking of alcohol
- Obesity
- Diabetes type 2
- Body piercings or tattoos
- Using shared needles to inject drugs
- Blood transfusion in the period when screening was not yet done
- Exposure to the blood and bodily fluids of others
- Sex without protection
- Exposure to some toxic substances
- Genetics
Causes of Impaired Liver Function
Even though some of the causes of poor liver function may be traced back to underlying medical conditions, others are more difficult to pin down. The following are some possible causes:
- Hepatitis C. If a person has hepatitis C, he or she is more likely to develop liver problems such as chronic liver failure or cirrhosis. Because symptoms are rare, this virus typically remains unnoticed; in fact, some patients suffer considerable liver damage before discovering they have hepatitis C. It is transmitted by blood, which can be transmitted through needle sharing and the use of unsterilized needles for body tattoos or piercings.
- Abuse of alcohol. The harmful consumption of alcohol is another prevalent cause of impaired liver function and eventually chronic liver failure. This is frequently the outcome of drinking heavily for at least a decade. The liver normally breaks down any alcohol consumed; however excessive drinking disables the liver’s ability to break down the alcohol quickly enough. Alcohol also contains toxic compounds that can cause liver inflammation and swelling.
- Non-alcoholic fatty liver disease (NAFLD). It is natural for the liver to have a little amount of fat, but if the fat content of the liver exceeds 5 to 10%, it is already known as steatosis or fatty liver. This can develop into Non-alcoholic fatty liver disease later on. NAFLD is a kind of liver disease that is caused by metabolic syndrome, obesity, type 2 diabetes, or genes rather than alcohol usage or misuse. While NAFLD in its early stages may not be harmful, it can eventually develop into more serious liver disorders.
- Other possible causes. Autoimmune hepatitis, bile duct diseases, cancer treatments such as chemotherapy, chronic right-sided heart failure, drug-induced liver cirrhosis, genetic variants, iron buildup in the liver and other organs, or Wilson’s disease, which causes copper buildup in the liver and other body tissues, are all possible but less common causes of impaired liver function such as chronic liver failure.
- Unidentified causes. It is also possible to acquire impaired liver function for no apparent reason.
Diagnosis of Impaired Liver Function
If a person is suffering the aforementioned signs and symptoms, he or she should get medical attention right once. The cause and extent of liver damage must be determined before treatment may begin.
- Medical History. History of alcohol abuse, genetic abnormalities, or other medical concerns is critical to disclose to the physician to further assess for impaired liver function. If drug poisoning is suspected, the doctor may prescribe medication to counteract the symptoms or halt any internal hemorrhage.
- Blood tests. Several blood screening tests can be performed to detect any abnormalities in the blood, including abnormalities that could indicate decreased liver function depending on the cause. Other blood tests might be performed to check for particular liver problems or hereditary disorders.
- Imaging tests. Liver damage can be detected by an ultrasound, computerized tomography (CT) scan, or Magnetic Resonance Imaging (MRI).
- Liver Biopsy. The removal of a tissue sample from the liver may aid in the diagnosis of impaired liver function as well as the detection of indicators or the extent of liver damage. A liver biopsy is often performed with a long needle introduced through the skin to extract a tissue sample for testing to be sent to the laboratory for examination.
Treatment for Impaired Liver Function
Treatment is determined by the severity of the impaired liver function. If only a portion of the liver is affected, the doctor may give medications or recommend surgery to remove the infected portion. Although a healthy liver can regenerate on its own if it is damaged, a liver transplant may be required if the damage is too severe, as is sometimes the case with fast-acting acute liver failure.
Prevention of Impaired Liver Function
The most prevalent causes of impaired liver function can be avoided if the underlying reasons are addressed. To assist minimize the condition, the doctor may suggest the following steps.
- Moderately consume alcohol. Moderate alcohol consumption for healthy people is defined as one drink per day for women and two drinks per day for men. More than seven drinks in a week for women and more than 14 drinks weekly for males is considered too much drinking.
- Avoid taking chances. Use a condom during sex and choose a business that is clean and safe when getting tattoos or body piercings. If using intravenous drugs, seek medical care and do not share needles.
- Get vaccinated. If an individual is at a greater risk of acquiring hepatitis or has already been infected with any type of hepatitis virus, the hepatitis A and B vaccines should be considered.
- Use drugs with caution. Take prescription and over-the-counter medications only as directed and in the authorized dosages. Alcohol and medications should not be mixed while mixing herbal supplements with prescription or non-prescription medicines should also be discussed with the doctor first.
- Keep away from other people’s blood and bodily fluids. Accidental needle jabs or inadequate removal of blood or other fluids can transmit hepatitis infections.
- Maintain food safety. Before eating or preparing food, remind the patient to always wash hands thoroughly. When visiting a developing country, drink bottled water, wash hands, and brush teeth properly.
- Exercise caution when using aerosol sprays. When spraying insecticides, fungicides, paint, or other harmful chemicals, make sure to apply them in a well-ventilated location, wear a mask, and follow the manufacturer’s directions at all times.
- Shield the skin. Wear gloves, long sleeves, a hat, and a mask when handling insecticides and other harmful chemicals to prevent chemicals from being absorbed through the skin.
- Keep overall weight in check. Obesity can also be associated with non-alcoholic fatty liver disease.
Impaired Liver Function Nursing Diagnosis
Nursing Care Plan for Impaired Liver Function 1
Viral Hepatitis
Nursing Diagnosis: Impaired Liver Function related to unsafe practices and exposure to infected person secondary to viral hepatitis as evidenced by abnormal liver function tests, yellowish appearance of the skin, and presence of hepatitis virus or antibodies in the blood.
Desired Outcomes:
- The patient will display no indications of viral hepatitis, as demonstrated by normal liver function tests and the disappearance of jaundice.
- The patient will display actions or lifestyle adjustments to mitigate the symptoms of the disease.
| Nursing Interventions for Impaired Liver Function | Rationale |
| Verify whether the condition is present and whether the liver problem is acute or chronic. | The extent and etiology of the disease can have an impact on the nursing interventions to be considered. |
| Examine the prescriptions for hepatotoxic or over-the-counter medications. | Changes in the regular prescription regimen and patient education about the toxic effects of OTC medications on the liver may be required for drugs known to possibly cause liver damage. |
| Determine whether the patient has a high-risk occupation, such as dealing with blood, blood-contaminated body fluids, other body fluids, or sharps or needles. | Knowing the nature of the patient’s work helps in determining the cause of the disease or occupational risk of viral hepatitis exposure. |
| Examine the patient for signs of exposure to contaminated food or untreated drinking water, as well as evidence of inadequate sanitation standards if the source of the liver problem is identified. | This evaluation aids in determining the source of infection as well as the risk of infection from enteric viruses. |
| Study the patient’s laboratory test results, such as hepatitis virus titers, liver function tests, and other diagnostic examinations. | Laboratory testing determines the cause of hepatitis, impacts treatment options, and tracks treatment response. |
| Assist with the therapy of the underlying problem. | Promotes organ function and reduces the risk of liver damage and organ failure. The goals of treatment for chronic hepatitis infections are to reduce liver inflammation and fibrosis while also preventing progression to cirrhosis and its repercussions. |
| Administer medications as directed by the attending physician. | The type of infection determines which drug or combination of medications is administered to prevent viral reproduction. |
Nursing Care Plan for Impaired Liver Function 2
Nursing Diagnosis: Impaired Liver Function related to liver cirrhosis secondary to alcohol abuse as evidenced by abnormal liver function and imaging tests, presence of jaundice, weight loss, easy fatigability, and swollen legs and feet.
Desired Outcome: The patient will demonstrate activities or lifestyle modifications to stop the progression of the disease.
| Nursing Interventions for Impaired Liver Function | Rationale |
| Monitor vital signs, particularly the respiratory status of the patient | Impaired gas exchange and compromised respiratory ability may arise, therefore the nurse must assess the patient for decreased or labored breathing to avoid more serious complications. |
| Encourage rest to save the energy of the patient. | Patients with impaired liver function may become quickly exhausted. To save energy for nourishment and self-care, promote rest intervals and clustered care. |
| Administer drugs such as diuretics, lactulose, analgesics, vitamin K, or blood products as directed by the attending physician. | Diuretics are commonly used to treat fluid retention and edema for patients with liver problems. Lactulose is a man-made sugar that is used to lower blood ammonia levels and avoid hepatic encephalopathy, whereas analgesics are used to relieve pain. When there is a lot of bleeding and complications, blood products may be administered, and Vitamin K helps to improve clotting and prevent bleeding issues. |
| Encourage lifestyle improvements by providing appropriate nutrition and awareness. Promote and advise patients to adopt a low-sodium, low-fat diet, avoid alcohol, and seek alcohol dependency treatment. | Malnutrition is a common consequence of liver illness that can go undiagnosed due to edema-induced weight gain, while overuse of alcohol is the common cause of liver cirrhosis. |
| Daily weighing, screening for the presence of jugular vein distention (JVD), and monitoring the patient’s fluid and electrolyte balance. | Kidney function may be affected by liver damage. Few of the signs of kidney problems include ascites, dependent edema, and electrolyte imbalances. Vascular congestion may be indicated by increased weight and blood pressure, therefore, a decrease in weight and blood pressure may indicate that treatments are working. |
| Begin bleeding precautions according to facility practice, such as not using straight razors, brushing with a soft toothbrush, and maintaining good oral hygiene. | When the liver is injured, coagulation elements like prothrombin and fibrinogen are compromised. The damage could also change the way these substances are produced, increasing the risk of bleeding. |
Nursing Care Plan for Impaired Liver Function 3
Acute Liver Failure
Nursing Diagnosis: Impaired Liiver Function related to illicit drug use and overdose secondary to acute liver failure as evidenced by the presence of jaundice, decreased appetite, easy fatigability, flapping tremor, and peripheral edema.
Desired Outcome: The patient will display behavior to help support body functions, manage signs and symptoms, and prevent worsening and possible complications.
| Nursing Interventions for Impaired Liver Function | Rationale |
| Continuously monitor the patient’s state of consciousness, blood pressure, volume status, blood and coagulation tests, and signs and symptoms. | Keeping track of the patient’s vital signs, laboratory tests, and other indicators can greatly help in determining the effects of the treatment regimen. |
| Maintain a 30-degree elevation in the patient’s bed while maintaining the head in its neutral position. | Acute liver failure patients may experience cerebral edema and elevated intracranial pressure. To minimize the further increase in intracranial pressure, these patients should have their heads elevated and in a neutral position. |
| Reduce stimulation and promote a calm and relaxing atmosphere with restricted stimulus. | Patients with acute liver failure get easily tired, and providing a relaxing atmosphere can promote rest periods and less stress for the patients. |
| Be on the lookout for elevated respiratory rates and hypoxia – address these problems as directed by the attending physician. | To avoid further serious complications of liver failure, the nurse must examine the patient for reduced or labored breathing to address compromised respiratory function immediately. |
| Use a fan, a cooling blanket, or both to combat the fever and regulate the body temperature. | Fever can develop as acute liver failure worsens. To avoid further major health complications, body temperature must be controlled. |
| Check for signs and symptoms of infection and possibly sepsis. Administer antibiotics as prescribed. | Because sepsis-related liver failure has a high mortality rate, the nurse must constantly monitor the patient for early indications and correctly provide drugs prescribed by the attending physician. |
| Keep a close eye on the glucose levels to avoid hypoglycemia or hyperglycemia. | Damaged livers might not respond to insulin, preventing glucose from entering cells and causing blood sugar levels to rise (hyperglycemia). Damaged livers may also be unable to mobilize glucose from the body’s storage, resulting in low blood sugar (hypoglycemia). |
| Provide dietary assistance as needed. | Low blood count, neurological difficulties, and nutritional problems caused by the liver disease can all be addressed by eating a healthy diet and taking vitamins and medications recommended by the doctor. |
Nursing Care Plan for Impaired Liver Function 4
Chronic Liver Disease
Nursing Diagnosis: Impaired Liver Function related to compromised regulatory mechanism secondary to chronic liver disease as evidenced by extreme exhaustion, bipedal edema, abdominal distention, presence of jaundice, and pruritus.
Desired Outcome: The patient will identify individual risk factors and exhibit behaviors and lifestyle changes to prevent disease progression and more serious health complications.
| Nursing Interventions for Impaired Liver Function | Rationale |
| Discuss the patient’s health situation and inform him or her of the causes, risk factors, and therapeutic approaches for chronic liver disease. | Compliance with the treatment plan will be improved and suitable behaviors will be developed if the patient is well-informed about the disease and other critical details. |
| Examine the skin’s surface and pressure points, then lightly massage any bony prominences or stressed areas. | Edema caused by chronic liver disease predisposes the skin to breakdown and the development of pressure ulcers; regular checks and gentle massage can help prevent them. |
| Help with regular repositioning when in bed or chair, and encourage active-passive ROM exercises as necessary. | While suitable exercises increase and preserve mobility, repositioning relieves pressure on edematous tissues and improves circulation. |
| Keep the linens dry and clean at all times. | Moisture exacerbates skin itchiness and increases the likelihood of skin breakdown. |
| Stress the need for proper nutrition and advise against high-protein and salty foods. As needed, provide written dietary guidelines. | Maintaining a healthy diet and avoiding meals rich in sodium and protein can alleviate the symptoms and stop ammonia buildup as well as further liver damage. |
| If possible, play quiet music and keep a peaceful and relaxing environment at all times. | A suitable environment decreases sensory stimulation and promotes restful sleep by shutting out other environmental sounds. |
Nursing Care Plan for Impaired Liver Function 5
Alcoholic Liver Disease
Nursing Diagnosis: Impaired Liver Function related to overconsumption of alcohol secondary to alcoholic liver disease as evidenced by restlessness, abdominal distention, yellowish skin appearance, and body malaise.
Desired Outcome: The patient will verbalize understanding of the causative factors of the liver condition and develop ways to modify inappropriate behaviors.
| Nursing Interventions for Impaired Liver Function | Rationale |
| Explain the relationship between the causes and nature of the alcoholic liver disease and the patient’s health situation. | If the patient is well-informed on the disease and other important aspects, compliance with the treatment plan will improve, and appropriate behaviors will emerge. |
| Observe variations in the level of consciousness and keep track of the breathing rate, rhythm, and depth. | In alcoholic liver disease, a change in the level of consciousness suggests the development of complications and an increased risk of infection, whereas quick and shallow breathing may indicate a lack of oxygen due to fluid accumulation in the abdomen. |
| Promote and help the patient to make lifestyle changes, and administer treatment in a positive, nonjudgmental manner. | Being disapproving of a healthcare provider may have an impact on the patient’s care. The nurse must make every effort to ensure that the patient feels empowered to maintain proper behaviors and follow the treatment plan. |
| Assess the patient’s current activity tolerance, alter activities, and lessen the severity of tasks that need extra effort and energy. | Tolerance testing establishes a cooperative baseline, prevents overexertion, improves activity tolerance, and reduces energy waste. |
| Provide the patient with information that demonstrates their improvement. | Positive evidence enhances and boosts the patient’s motivation to make positive changes and maintain his healthy lifestyle and behaviors. |
Nursing References
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
