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CANCER OF THE LIVERPresented by: Nurse Paolo Rafael D.

Esguerra !"RN

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HEPATOC#TE

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HEPATIC $LOOD "!PPL#

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HEPATIC $LOOD "!PPL#

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HEPATIC $LOOD "!PPL#

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CLA""IFICATION OF PRI%AR#

LIVER CANCER

Origin Benign Malignant

He&ato'yte Adeno(a He&ato'ellularCar')no(a

$)le Du't C*olang)o(a Car')no(a

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$ENI+N LIVER T!%OR"

, He&at)' adeno(as are ben)gntu(or of t*e l)-er.

, %ost 'o((only seen )n

o(en )n t*e)r /01s and 201s., Nearly 304 of 'ases

asso')ated )t* oral'ontra'e&t)-e use.

, A ben)gn (ay ru&ture )t*'onse5uent *e(orr*age.

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PRI%AR# LIVER T!%OR"

, H)g*ly asso')ated )t* C*ron)'l)-er d)sease H$V HCV andl)-er ')rr*os)s

, He&ato'ellular'ar')no(a6HCC7 )s t*e (ost'o((on ty&e of &r)(ary l)-ertu(or

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LIVER %ETA"TA"E"

, 804 of all ad-an'ed 'an'er'ases (etastas)9ed to t*e l)-er6$a'on and D) $)s'egl)e 0007

, %al)gnant tu(ors rea'* t*el)-er t*roug* t*e &ortalsyste(6Ad-an'ed ColonCan'er7 ly(&*at)'

'*annels6$reast Can'er LungCan'er7 or by d)re't e;tens)onof an abdo()nal tu(or

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RI"< FACTOR"

, Pre-)ous H$V or HV$ )nfe't)on

, L)-er C)rr*os)s

, C)garette "(o=)ng

, E;&osure or Ingest)on ofAlfatoxins

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RI"< FACTOR"

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THE DEFECT

, +ene &8/

A tu(or>su&&ressor generes&ons)ble for (on)tor)ng

t*e *ealt* of t*e 'ell and)ntegr)ty of t*e 'ellular DNA

Controls 'ellular re&l)'at)onby 'aus)ng t*e 'ell to &ause

)nde?n)tely unt)l errors are'orre'ted or to undergoa&o&tos)s

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DIA+NO"TIC E@A%"

, "erolog)'al E;a(s

In'reased $)l)rub)n Al=al)ne&*os&*atase "+PT "+OT LDH

C$C 6leu=o'ytos)seryt*ro'ytos)s7

Hy&er'al'e()a Hy&ogly'e()aHy&o'*olesterole()a

In'reased seru( Al&*a>feto&rote)n 6AFP7 and'ar')noe(bryon)' ant)gen 6CEA7

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DIA+NO"TIC E@A%"

X-ray Ultrasound

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DIA+NO"TIC E@A%"

MRI CT Scan

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LIVER $IOP"#

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N!R"IN+ %ANA+E%ENT

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A""E""%ENT

,VERA$IATION" OFBEA

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N!R"IN+ DIA+NO"I"

ACTIVIT#

INTOLERANCERELATED TO FATI+!E

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PLANNIN+

,PATIENT REPORT"DECREA"E IN

FATI+!E ANDE@HI$IT" INCREA"EDA$ILIT# TO

PARTICIPATE INACTIVITIE"

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INTERVENTION

, Assess le-el of a't)-)ty anddegree of fat)gue *en&erfor()ng rout)ne ADLs

, Pro-)de ass)stan'e )n&erfor()ng ADLs

, Pro-)de an a't)-)ty s'*edule)t* &ro&er rest &er)ods

t*roug*out t*e day, En'ourage to ad*ere to a *)g*

'arbo*ydrate *)g* &rote)n d)et

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EVAL!ATION

, E;*)b)ts )n'reased )nterest)n a't)-)t)es

, A't)-ely &art)')&ates )na't)-)t)es and gradually)n'rease e;er')se )t*)n&*ys)'al l)()ts

, Re&orts )n'rease )nstrengt* and ell>be)ng

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A""E""%ENT

,$%I .8

,CACHE@IA

,BEI+HT LO"",ANORE@IA

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N!R"IN+ DIA+NO"I"

I%$ALANCED

N!TRITION:LE"" THAN$OD# RE!IR%ENT"

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PLANNIN+

,%a)nta)n &os)t)-en)trogen balan'e

and &re-ent furt*erloss of (us'le (ass

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INTERVENTION

, Assess d)etary )nta=e andnutr)t)onal status

, Pro-)de d)et *)g* )n CHO and CHON'ons)stent )t* l)-er fun't)on

, Ass)st &at)ent )n )dent)fy)ng foodslo )n Na

, Ele-ate *ead of bed dur)ng (eals

, Pro-)de oral *yg)ene before (eals, OGer s(all fre5uent (eals 6at

least s(all (eals7

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EVAL!ATION

, E;*)b)ts )(&ro-ed nutr)t)onalstatus 6)n'reased e)g*t)t*out u)d retent)on7

, Re&orts )n'reased )na&&et)te

, Re&orts nor(al

gastro)ntest)nal fun't)on)t* regular boel fun't)on

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A""E""%ENT

, Pat)ent 'o(&la)nts of R!abdo()nal &a)n andJord)s'o(fort

, 6K7 Fa')al gr)(a'e andguard)ng be*a-)or

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N!R"IN+ DIA+NO"I"

AC!TE PAIN RELATED

TO CONTIN!O!"LIVER T!%OR

+ROBTH

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PLANNIN+

,To alle-)ate &a)n and&ro(ote 'o(fort

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INTERVENTION

, %a)nta)n bed rest *en t*e&at)ent e;&er)en'e abdo()nald)s'o(fort

,Tea'* non>&*ar(a'olog)'te'*n)5ues to alle-)ate &a)n6rela;at)on te'*n)5ues gu)ded)(agery (assage7

, Pro-)de o&t)(al &a)n rel)eft*roug* ad()n)strat)on of &a)n(ed)'at)ons as )nd)'ated

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EVAL!ATION

, Pat)ent -erbal)9es rel)ef of&a)n or d)s'o(fort

, In'reased ab)l)ty to

&erfor( ADLs