NURS 530 MDC Hepatic Encephalopathy in Psychiatric Units Discussion

Peer Response :Answer the questions below about one of your classmate’s presentations.

• How does this topic relate to something you might see in clinical practice?
• How does this topic relate to your presentation
• Which ideas make the most sense and why?
• How does this topic relate to current events?
• What might make this problem more treatable? 

Use at least one scholarly source besides your textbook to connect your response to national guidelines and evidence-based research to support your ideas. 

Logan Berrian

• How does this topic relate to something you might see in clinical practice?
• Which ideas make the most sense and why?
• How does this topic to current events?
• What might make this problem more treatable? 

My topic is hepatic encephalopathy(HE) aka portal systemic encephalopathy(PSE). I have worked with many patients over the years with HE, mainly bc in moderate to severe psych, there is a high cross over rate of cooccurring disorders, of both intervenous drug use(IVDU) and alcoholism. IVDU and ETOH dependence can both lead to cirrhosis, IVDU via contracting Hep b or more often, C, and ETOH dependence from the gradual destruction of the liver from ETOH misuse. 

I did not know about the diagnostic algorithm for HE. “A survey among general practitioners in Germany reveals that diagnostic algorithms can help in decision-making, particularly in complex or rare clinical pictures, and for consistent monitoring”(Jansky, 2022). It makes a lot of sense: Assess for psych/neuro hx, assess for liver dz hx, then assess differential dx, and if the patient looks to be positive for HE, then assess LOC using West Haven Criteria. 

It relates to current events bc “More than 100 million people in the U.S. have some form of liver disease”(Rivera, 2023). It’s a widespread problem, especially when the disease advances to cirrhosis. The more we can learn about HE/PSE the better equipped we will be to identify it in the field and to educate patients in prevention and health promotion measures.

It could be more treatable by the underlying causes having earlier detection and treatment. By the time you are treating HE in the patient, it is usually the end stage of that person’s life. 

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