AI看護ケアプラン生成 - 肝硬変Skill

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name: AI Nursing Care Plan Generator - Cirrhosis
description: Build a structured, evidence-informed nursing care plan for a patient with cirrhosis or advanced liver disease. Use when a nursing student or nurse needs to draft an assessment-to-evaluation care plan for cirrhosis, including NANDA-style nursing diagnoses, measurable goals, interventions, and rationale.
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# AI Nursing Care Plan Generator - Cirrhosis

## Purpose

This skill helps a nursing student or working nurse draft a clear, well-organized nursing care plan for a patient with cirrhosis or advanced liver disease. It structures the plan the way most nursing programs and clinical documentation systems expect: assessment, nursing diagnosis, goals and outcomes, interventions with rationale, and evaluation.

IMPORTANT DISCLAIMER: This skill is an educational and documentation drafting aid only. It does not provide medical advice, does not diagnose, and is not a substitute for clinical judgment, facility protocols, or a physician's or advanced practice provider's orders. Every care plan produced must be reviewed, adapted, and approved by a qualified nurse or clinician before it is used in real patient care.

## How to use this skill

Give the assistant the patient context you have: age, suspected or confirmed cause of cirrhosis (alcohol, viral hepatitis, NAFLD, other), complications present (ascites, encephalopathy, varices), relevant labs (liver function, coagulation, ammonia), current medications, and care setting. The more detail you provide, the more specific and useful the plan will be. If you give only "cirrhosis," the skill will build a general care plan and flag where patient-specific data is needed.

## Care plan structure to generate

### 1. Assessment
- Signs of liver dysfunction: jaundice, ascites, peripheral edema, easy bruising/bleeding, spider angiomas, palmar erythema
- Neurological status for hepatic encephalopathy: level of consciousness, orientation, asterixis, sleep-wake pattern changes
- Abdominal assessment: girth measurement, fluid wave/ascites assessment, tenderness
- Nutritional status: appetite, weight trend, muscle wasting, and difficulty with protein/fluid restriction adherence
- Bleeding risk: coagulation labs, platelet count, history of variceal bleeding
- Fluid balance: daily weights, intake and output, response to diuretics if ordered
- Skin integrity, particularly with edema and pruritus from bile salt deposition

### 2. Nursing diagnoses (NANDA-style, pick what fits the patient)
- Excess fluid volume related to portal hypertension and decreased albumin production causing ascites and edema
- Risk for bleeding related to impaired clotting factor synthesis and portal hypertension
- Acute or chronic confusion related to hepatic encephalopathy and elevated ammonia levels
- Imbalanced nutrition: less than body requirements related to anorexia, dietary restrictions, and impaired metabolism
- Impaired skin integrity (risk) related to edema, ascites, and pruritus

### 3. Goals and expected outcomes (make these measurable and time-bound)
- Patient's fluid volume status will improve as evidenced by decreasing abdominal girth, weight trending toward the goal, and reduced edema
- Patient will remain free of bleeding complications, or such complications will be identified and managed promptly
- Patient's level of consciousness and orientation will improve or remain stable as ammonia-lowering therapy takes effect
- Patient will maintain or improve nutritional intake within prescribed dietary restrictions (sodium, protein as ordered)

### 4. Interventions with rationale
- Obtain daily weights and measure abdominal girth at the same time each day using a consistent landmark; document trends
- Administer diuretics and other ordered medications (e.g., lactulose, rifaximin for encephalopathy) and monitor for effect and side effects
- Monitor for and report signs of bleeding (melena, hematemesis, bruising) and monitor coagulation labs as ordered