nurse's notes

HEPATIC COMA -

• one of the most serious complication of liver disease
• manifestation of liver failure due to failure of liver cells to detoxify ammonia

Early Signs and Symptoms:

• slightly confused
• far away look in his eyes
• drowsy during the day
• wander at night
• disoriented with time and date
• if progresses - lapses with frank coma

Complication:

• gastrointestinal bleeding
• enteric infection
• fluid and electrolyte imbalance
• hyponatremia - sodium deficit
• hypokalemia- potassium deficit

NURSING CARE:

• close observation of neurologic status and record
  
• accurate record of fluid intake and output
• monitor and record vital signs and blood pressure
• symptoms of pulmonary infection to be reported

Treatment as per doctor's order:

• protein intake reduced or eliminated
• antibiotic
  
• sedatives
• analgesics

Reference: medal nursing book and my nursing notes