Diagnosis for Hepatocellular Carcinoma: Liver Cancer - Essay Example

Diagnosis for Hepatocellular Carcinoma Liver Cancer Diagnosis for Hepatocellular Carcinoma Liver Cancer NANDA-I Introduction Hepatocellular carcinoma (HCC) is a tumor of the liver. HCC is responsible for more than 12,000 deaths per year in the United States where it is considered that the disease is approximately 2.5 per 100,000 population. It is one among the common malignancies in adults, and is highly common in men than women (2-4:1). Across the world, an approximately over a million deaths every year (about 10% of deaths in adult range age) can be attributed to HCC (Sommers, 2010). Definition of Hepatocellular Carcinoma Hepatocellular Carcinoma is the malignant primary liver tumors which is the most common of the primary malignant liver tumors for example fibrosarcoma, malignant lymphoma, and hemangioendothelioma. Hepatocellular Carcinoma (HCC) or the primary liver cancer is one among the various types of cancer that comes from the liver cells (Brunner & Smeltzer, 2010). Hepatocellular Carcinoma ordinary and mostly occurs in patients with cirrhosis of the liver, and this 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. A major cause of the liver cancer is the infection with hepatitis B and C virus, particularly patients with antigenemia and also those having chronic hepatitis disease (Brunner & Smeltzer, 2010). With male patients having age of over 50 years who suffer from hepatitis B and C have likely to develop liver cancer. Factors that may damage the liver and result to liver cancer: Too excessive diet. Failure to eat breakfast. Too much consumption of drugs. Sleeping so much late and waking up too late. Failure to defecate in the morning. Consuming too much additives, food coloring, preservatives, and artificial sweetener. Unhealthy cooking oil. Consuming foods that are raw adds to the burden of liver. Fried vegetables are to be eaten right away, and shouldn’t be stored. Alcohol. Descent. Hepatis B, C. Pathophysiology of Hepatocellular Carcinoma Liver cancer occurs as a result of the damage to the liver parenchyma cells which are caused by the usual primary liver disease directly or indirectly as a result of the obstruction of the flow of bile or disorder of the hepatic circulation which causes liver dysfunction (DeWit, 2013). Liver parenchymal cells react to the elements of the most toxic through the means of glycogen replacement together with fatty infiltration of lipids that happens with or without necrosis or cell death. This is a situation that is often going along with the inflammatory cell infiltration and the growth of fibrotic tissue. Cell regeneration does occur if the disease course isn’t too toxic to liver cells. This result in downsizing and the subsequent fibrosis would result to liver cancer. Clinical Manifestations of Hepatocellular carcinoma The clinical manifestations of hepatocellular carcinoma in respect to signs and symptoms include: skin becomes yellow, Feeling unusually tired, Fever, Chills, Nausea, abdominal pain, body weight dropped drastically, Urine dark, loss of appetite, pain in the shoulders and back, bleeding occurred in parts of the body (Gulanick & Myers, 2011). NOC – (Nursing Outcome Classification) Nursing Care Plan  Assessment Identity Age: The HCC usually attacks adults and the elderly. Gender: Liver cancer is found to be common in men than in women. Occupation: HCC can be found in individuals with excessive activity. Medical history The main complaints: These are complaints of the patients at the current time studied. Past medical history: Patient that had once suffered from any kind of disease and how its treatment was done. History of present illness is studied. Data Focus Basic data is dependent on the cause and severity of the liver disruption or damage. Activities: Clients will experience malaise, fatigue, weakness. Circulation: Bradycardia due to heavy hyperbilirubin, jaundice in the skin, sclera, and mucous membranes. Elimination: Color dark urine (like tea), diarrhea stool color clay. Food and fluids: nausea and vomiting increased edema, Anorexia, weight loss, ascites. Neurosensori: Be sensitive to stimuli, asterixis, tend to sleep. Pain / Comfort: abdominal tenderness in the right upper quadrant, abdominal cramping, myalgia, headache, itching. Security: Urticaria, splenomegaly, fever, erythema, enlargement of the cervical nodes posteior. Sexuality: Homosexual behavior is active or bisexual women can increase the risk factor. Physical examination The physical examination in patients having liver cancer are: Vital signs: pulse brakikardial, increased blood pressure, increased respiration, increased temperature. Eyes: sclera jaundice. Mouth: Lips pale, dry mucosa. Abdomen: There is tenderness along the right upper quadrant, ascites, liver enlargement, palpable irregular surfaces. Skin: Itching (pruritus). Extremities: Increased edema, experiencing weakness. Nursing Diagnosis for Hepatocellular Carcinoma 1. Ineffectiveness in the pattern of breathing related to a decrease in lung expansion (emphasis ascites and diaphragm). 2. Pain (acute / chronic) that is related to a buildup of the fluid in the abdominal cavity (ascites) (Jarvis & Jarvis, 2012). 3. Imbalanced Nutrition: a smaller amount than body requirements that is related to inadequate nutritional intake, distention of the abdominal, feeling sick to the stomach and anorexia. 4. Anxiety as a result of enlargement of the abdomen. 5. Activity intolerance related to lethargy, fatigue, and malaise (not feeling well). HCC medical therapy Nonsurgical therapies Patients who are not candidates for liver resection or transplantation, tumor ablation can be provide to extend life and to possibly downstage the tumor to enable resection and transplantation (McMasters & Vauthey, 2011). As an alternative, the patients with advanced disease can benefit from the interventions of palliative care rather than ineffective therapies. The most usually offered therapy is transcatheter arterial chemoembolization (TACE). The TACE is offered by an interventional radiologist who in a selective manner cannulates the feeding artery into the tumor and then delivers high local dozens of chemotherapy. NIC- (Nursing Interventions Classification) Surgical interventions for liver cancer In the determination of treatment of HCC, an evaluation of lesion imaging and lab results, liver function, patient’s age and overall health is done to recommend the most appropriate treatment options. This is due to the fact that choosing a treatment plan is a very important decision and thus all the options are reviewed for the best of all option to be selected (Qiao et al., 2012) Systematic chemotherapy Systematic chemotherapy uses mixture of anti-cancer drugs being injected into the vein or taken by mouth (Reau & Poordad, 2012). Normally, this option is reserved for the patients with metastatic diseases or those patients are not candidates for other procedures. Conclusion A good of patients with hepatocellular carcinoma present themselves so late for any effective treatment (Sommers, 2010). Screening for hepatocellular carcinoma improves the outcomes by detecting small tumors. To make a key impact on the mortality of hepatocellular carcinoma across the world, a cheap, yet sensitive tool for diagnosis, alongside an equally effective treatment, must be made available (Reuben, 2011). References Brunner, L. S., & Smeltzer, S. C. O. C. (2010). Brunner & Suddarths textbook of medical surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. DeWit, S. C. (2015). Saunders student nurse planner 2014-2015: A guide to success in nursing school. Gulanick, M., & Myers, J. L. (2011). Nursing care plans: Diagnoses, interventions, and outcomes. St. Louis, Mo: Elsevier Mosby. Jarvis, C., & Jarvis, C. (2012). Student laboratory manual, Physical examination & health assessment. St. Louis, Mo: Elsevier Saunders. McMasters, K. M., & Vauthey, J.-N. (2011). Hepatocellular carcinoma: Targeted therapy and multidisciplinary care. Totowa, N.J: Humana. Qiao, L., Li, Y., & Yan, X. (2012). Molecular Aspects of Hepatocellular Carcinoma. Sharjah: Bentham Science Publishers. Sommers, M. S. (2010). Diseases and Disorders: A Nursing Therapeutics Manual. Philadelphia: F.A. Davis Co. Reau, N., & Poordad, F. (2012). Primary liver cancer: Surveillance, diagnosis and treatment. New York: Humana Press. Reuben, A. (2011). Diagnosis and therapy of hepatocellular carcinoma: Status quo and a glimpse at the future. Philadelphia, Pa: Elsevier/Saunders Read More