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Nursing Care of Crrt Hyovolemia

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Nursing Care of Crrt Hyovolemia

Page 1 of 11
This care study aims to outline the care provided to a patient during one 12hour shift. It will present the patients cause and course of ICU admission, identify problems both potential and actual, focussing particularly and two main problems. The nursing interventions preformed will be critically analysed and supported with research. Finally the care will be critically evaluated areas of possible improvement will be outlined.

Patient chosen is a 36yr old male pseudonym ‘Frank’ chosen for the purpose of confidentiality. Frank was day one post re- do orthotic liver transplantation (OLT) with roux -en-y anastomosis. He had his initial OLT for Primary sclerosing cholangitis secondary to auto-immune hepatitis preformed 5 days previously and required and urgent re-do transplant due to Hepatic vein thrombosis not responsive to conservative treatment. Prior to his re-do transplant he had required CRRT due to acute kidney injury(AKI) related to large blood loss of 2.5litre due to coagulopathy related to liver failure. He was currently receiving CRRT. Frank has a past medical history of auto immune hepatitis, Ulcerative colitis (total colectomy with ileostomy formation in 08 with recurrent adhesions, stomal varices, osteoporosis, Left bundle branch block (Asymptomatic). He is a single man with both his elderly parents NOK.He was unable to work due to long term illness and lives with his parents 10miles away from the hospital.

Autoimmune hepatitis is a chronic hepatitis characterised by auto immune features, generally including the presence of circulating autoantibodies and a high serum globulin concentration (Krawitt 2006). This results in the body initialling in error an immune response to the liver cells and causing inflammation damage and death of the liver cells. Primary sclerosing cholangitis is the inflammation, scarring and death of the bile ducts.Ulcerative colitis is one of the risk factors

Hepatic artery thrombosis occurs in estimated 2.5% of liver...