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Case Study OOOO Subjective M.B., a 58-yr-old male rancher who lives in rural Wyoming, is admitted with a diagnosis of cirrhosis of the liver. He has been vomiting for 2 days and noticed blood in the toilet when he vomited. He lives 40 miles from the nearest hospital. He had one of his ranch hands drive him to the hospital. His medical history includes chronic hepatitis C, depression, and stage Il chronic kidney disease. • Has bee childre ago - Has ha - Ackno drinki been Repo naus .
Discussion Questions 1. What are possible causes of cirrhosis? What type of cirrhosis does M.B. likely have? 2. Describe the pathophysiologic changes that occur in the liver as cirrhosis develops. 3. List M.B.'s clinical manifestations of liver failure. For each manifestation, explain the pathophysiologic basis. 4. Explain the significance of the results of his laboratory values and ECG findings.
Discussion Questions 5. If M.B. begins to show signs and symptoms of hepatic encephalopathy. what would you monitor? What measures would be used to control or decrease the encephalopathy? 9. Evidence- says, "There respond to 6. What are possible causes of his GI bleeding? 10. Safety identify patients 7. Priority Decision: Based on the assessment data, what are the priority nursing diagnoses? Are there any collaborative problems? 11. De 8. Priority Decision: What are the priority nursing interventions for a patient at this stage of his illness? & low Circultiv
Discussion Questions 9. Evidence-Based Practice: M.B. discusses his prognosis with you. He says, "There is no hope. I might as well keep drinking." How would you respond to his statement? 10. Safety: Given M.B.'s bleeding history and current laboratory values, identify areas of injury risk and specify actions you will take to ensure patient safety. Giorgio 11. Develop a conceptual care map for M.B.