Nursing Care Plan for Hepatocellular Carcinoma
Definition of Hepatocellular carcinoma
Hepatocellular carcinoma is a malignant primary liver tumors and the most common of the primary malignant liver tumors such as malignant lymphoma, fibrosarcoma, and hemangioendothelioma.
Hepatocellular carcinoma (HCC) or primary liver cancer is one of the types of cancer that originates in the liver cells (Misnadiarly, 2007). Hepatocellular Carcinoma ordinary and often occurs in patients with cirrhosis of the liver which is a complication of chronic viral hepatitis.
Etiology of Hepatocellular carcinoma
The cause of liver cancer in general is a viral infection of hepatitis B and C, aflatoxin B1 contamination, liver cirrhosis, parasitic infections, alcohol and heredity. (Fong, 2002).
Infection with hepatitis B and C virus is a major cause of liver cancer in the world, especially patients with antigenemia and also have chronic hepatitis disease. With male patients aged over 50 years who suffer from hepatitis B and C have the possibility of developing liver cancer. (Tsukuma et al., 1993; Mor et al., 1998).
Factors that can damage the liver and cause liver cancer:
- Sleeping too late and waking up too late.
- Do not defecate in the morning.
- A diet that is too excessive.
- Do not eat breakfast.
- Too much consumption of drugs.
- Consuming too much preservatives, additives, food coloring, and artificial sweetener.
- Unhealthy cooking oil. As much as possible reduce cooking oil use when frying food. Do not consume fried foods when you are tired, except if the body is fit.
- Consuming raw food (very mature) also adds to the burden of liver. Fried vegetables should be eaten right away, not stored.
- Alcohol.
- Descent.
- Hepatis B, C.
Pathophysiology of Hepatocellular carcinoma
Liver cancer occurs due to damage to the liver parenchyma cells that are directly caused by the usual primary liver disease or indirectly by the obstruction of bile flow or hepatic circulation disorder that causes liver dysfunction. Liver parenchymal cells will react to the elements of the most toxic through glycogen replacement with fatty infiltration of lipids that occurs with or without necrosis or cell death. This situation is often accompanied by inflammatory cell infiltration and growth of fibrotic tissue. Cell regeneration can occur if the disease course is not too toxic to liver cells. Resulting in downsizing and subsequent fibrosis would be liver cancer.
Clinical Manifestations of Hepatocellular carcinoma
Clinical manifestations of hepatocellular carcinoma in the form of signs and symptoms include: skin becomes yellow, Fever, Chills, Feeling unusually tired, Nausea, abdominal pain, loss of appetite, body weight dropped drastically, pain in the back and shoulders, Urine dark, bleeding occurred in parts of the body.
Nursing Care Plan
Assessment
Identity
- Age: Usually attacking adults and the elderly.
- Gender: Liver cancer is common in men than in women.
- Occupation: Can be found in people with excessive activity.
Medical history
- The main complaints: Complaints of patients at the time studied.
- Past medical history: Patient had once suffered from any disease and how treatment.
- History of present illness.
Data Focus
Basic data depends on the cause and severity of the liver damage or disruption by Doengoes, 1999 are:
- Activities: Clients will experience fatigue, weakness, malaise.
- Circulation: Bradycardia due to heavy hyperbilirubin, jaundice in the sclera, skin and mucous membranes.
- Elimination: Color dark urine (like tea), diarrhea stool color clay.
- Food and fluids: Anorexia, weight loss, nausea and vomiting, increased edema, ascites.
- Neurosensori: Be sensitive to stimuli, tend to sleep, asterixis.
- Pain / Comfort: abdominal cramping, abdominal tenderness in the right upper quadrant, myalgia, headache, itching.
- Security: Urticaria, fever, erythema, splenomegaly, enlargement of the cervical nodes posteior.
- Sexuality: Homosexual behavior is active or bisexual women may increase the risk factor.
Physical examination
According Doengoes 1999 physical examination in patients with liver cancer are:
- Vital signs: increased blood pressure, pulse brakikardial, increased temperature, increased respiration.
- Eyes: sclera jaundice.
- Mouth: Dry mucosa, lips pale.
- Abdomen: There is tenderness in the right upper quadrant, liver enlargement, ascites, palpable irregular surfaces.
- Skin: Itching (pruritus).
- Extremities: Experiencing weakness, increased edema.
Nursing Diagnosis for Hepatocellular Carcinoma
1. Ineffective breathing pattern related to a decrease in lung expansion (emphasis ascites and diaphragm).
2. Pain (acute / chronic) related to a buildup of fluid in the abdominal cavity (ascites).
3. Imbalanced Nutrition: less than body requirements related to inadequate nutritional intake, abdominal distention, feeling sick to the stomach and anorexia
4. Anxiety related to enlargement of the abdomen.
5. Activity intolerance related to fatigue, lethargy and malaise (not feeling well).
