Cirrhosis — NCLEX Cheat Sheet
Scarred liver → portal HTNAlso known as: liver scarring · scarred liver · liver disease · end-stage liver disease · liver cirrhosis
Use this quick-reference guide to spot, treat, and prevent Cirrhosis on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
⚠️ Causes
- Alcohol, hepatitis C, NAFLD
- Fibrosis → ↓ liver function
🩺 Signs
- Jaundice, ascites, edema
- Spider angiomas, palmar erythema
- Caput medusae, varices, bruising
🧪 Labs
- ↑ bilirubin, ↑ AST/ALT, ↑ ammonia
- ↓ albumin, ↑ PT/INR, ↓ platelets
✅ Do
- Low Na, fluid restrict, diuretics
- Bleeding precautions, daily weight
- Measure abd girth, no alcohol
📚 Cirrhosis — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Portal hypertension causes ascites, esophageal varices, splenomegaly, and caput medusae (distended abdominal veins).
- Impaired bilirubin metabolism causes jaundice, dark urine, clay-colored stools, and pruritus.
- Decreased synthesis of clotting factors and low platelets produce bleeding tendency and easy bruising.
- Low albumin reduces oncotic pressure, worsening ascites and peripheral edema.
- Failure to detoxify ammonia leads to hepatic encephalopathy and confusion.
- Hyperestrogenism from poor hormone breakdown causes spider angiomas, palmar erythema, and gynecomastia.
Nursing priorities
What to do, in order- Monitor for and manage bleeding; implement bleeding precautions due to clotting deficits.
- Measure abdominal girth and daily weight to track ascites and fluid status.
- Administer diuretics (spironolactone) and restrict sodium and fluids as ordered.
- Assess neurologic status for encephalopathy and give lactulose to lower ammonia.
- Provide skin care and antipruritics for jaundice-related itching to prevent breakdown.
Red flags — report now
Escalate immediately- Hematemesis or melena suggests variceal bleeding and is a life-threatening emergency.
- Worsening confusion, asterixis, or rising ammonia signals advancing hepatic encephalopathy.
- Rapidly increasing abdominal girth with respiratory distress may require paracentesis.
Labs & values
Numbers to know- Albumin: 3.5-5 g/dL (decreased)
- Total bilirubin: 0.3-1.0 mg/dL (elevated)
- Ammonia: 15-45 mcg/dL (elevated); PT/INR prolonged
Patient teaching
What patients must know- Abstain completely from alcohol and avoid hepatotoxic drugs including acetaminophen excess.
- Follow a low-sodium diet and weigh daily, reporting rapid weight gain.
- Report increasing confusion, bleeding, or worsening abdominal swelling to the provider.
❓ Cirrhosis: NCLEX FAQs
What are the priority nursing interventions for Cirrhosis?
Monitor for and manage bleeding; implement bleeding precautions due to clotting deficits. Measure abdominal girth and daily weight to track ascites and fluid status. Administer diuretics (spironolactone) and restrict sodium and fluids as ordered. Assess neurologic status for encephalopathy and give lactulose to lower ammonia.
What are the warning signs of Cirrhosis a nurse must report?
Hematemesis or melena suggests variceal bleeding and is a life-threatening emergency. Worsening confusion, asterixis, or rising ammonia signals advancing hepatic encephalopathy. Rapidly increasing abdominal girth with respiratory distress may require paracentesis.
What do I need to know about Cirrhosis for the NCLEX?
Portal hypertension causes ascites, esophageal varices, splenomegaly, and caput medusae (distended abdominal veins). Impaired bilirubin metabolism causes jaundice, dark urine, clay-colored stools, and pruritus. Decreased synthesis of clotting factors and low platelets produce bleeding tendency and easy bruising. Low albumin reduces oncotic pressure, worsening ascites and peripheral edema.
What patient teaching is important for Cirrhosis?
Abstain completely from alcohol and avoid hepatotoxic drugs including acetaminophen excess. Follow a low-sodium diet and weigh daily, reporting rapid weight gain. Report increasing confusion, bleeding, or worsening abdominal swelling to the provider.
Quick Tip
Portal hypertension causes ascites, esophageal varices, splenomegaly, and caput medusae (distended abdominal veins).
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