Case Study: In cirrhosis, fibrous scar tissue gradually replaces the healthy liver tissue which results in a loss of the

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Case Study:
In cirrhosis, fibrous scar tissue gradually replaces the healthy
liver tissue which results in a loss of the metabolic function of
the organ. The fibrous tissue forms constrictive bands that disrupt
blood and bile flow within liver lobules. Resulting in a lack of
blood flow to the liver and then resulting in a host of
manifestations. This restricted blood flow leads to portal
hypertension, increased pressure in the portal venous system. A 68
year old male is a recovering Alcoholic who has been drinking for
over 27 years. His past medical history consists of Hypertension,
Diabetes Mellitus, lipidemia, and End stage liver failure. He has
been experiencing constipation, weight loss in the past few months
and during your interactions you notices a consistent downward
muscle tremor of the hands like an involuntary jerking movement. He
was admitted to the hospital for confusion and for
malnutrition.
Physical Manifestations: ·
Ascites ·
jaundice ·
mild neurologic changes. ·
Peripheral edema ·
low WBC and platelet count. ·
Low albumin ·
Liver enzymes function studies include ALT, AST, and ALP were
all elevated ·
Bilirubin levels are usually elevated in severe cirrhosis,
including both direct (conjugated) and indirect (unconjugated)
bilirubin
Medications prescribed: ·
Spironolactone 200mg tab BID P.O QAM AT 0900hours
· Lactulose 60cc BID elixir P.O at 0900hours and 1400hours
· Ferrous Sulfate and Folic acid 300mg daily QAM at
0900hours
· Propanolol 30m daily QAM 0900hours
6. Why was liver enzymes, bilirubin, Albumin and complete blood
count ordered for this patient? What would be a normal finding for
this test? What would an abnormal finding indicate?
7. What collaborative treatment(s) would the nurse expect for
this patient if not already ordered?
8. What would be an appropriate nursing diagnosis for this
patient?
9. Provide an overview of nursing interventions you would
implement in regards to the above-mentioned nursing diagnosis. Give
your rationale for these.
10. What health teaching (medications, treatments, tests,
pharmacological and non pharmacological interventions, self
monitoring) would you provide to this patient before they are
discharged home?