Patient Profile M.B. is a 55-yr-old Native American man admitted… Patient ProfileM.B. is

Patient Profile M.B. is a 55-yr-old Native American man admitted… Patient ProfileM.B. is a 55-yr-old Native American man admitted with a diagnosis of cirrhosis of the liver. He has been vomiting for 2 days and noticed blood in the toilet when he vomits. Subjective Data•Has had cirrhosis for 12 yr•Acknowledges that he had been drinking heavily for 20 yr but has been sober for the past 2 yr•Complains of anorexia, nausea, and abdominal discomfort Objective DataPhysical Examination•Thin and malnourished•Has moderate ascites•Has jaundice of sclera and skin•Has 4+ pitting edema of the lower extremities•Liver and spleen are palpableLaboratory Values•Total bilirubin: 15 mg/dL (257 mmol/L)•AST: 190 U/L (3.2 µkat/L)•ALT: 210 U/L (3.5 µkat/L) Discussion Questions1.What are the possible causes of cirrhosis? What type of cirrhosis does M.B. probably 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.5. If M.B. begins to manifest signs and symptoms of hepatic encephalopathy, what would you monitor? What measures should be instituted to control or decrease encephalopathy?6.What are the possible causes of his gastrointestinal bleeding?7. Based on the assessment data, what are the priority nursing diagnoses? Are there any collaborative problems8. What are the priority nursing interventions for the patient at this stage of his illness?9.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 question? 10. The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse’s response is based on the knowledge thata. a lack of clotting factors promotes the collection of blood in the abdominal cavity.b.portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space.c.decreased peristalsis in the GI tract contributes to gas formation and distention of the bowel.d.bile salts in the blood irritate the peritoneal membranes, causing edema and pocketing of fluid. Health Science Science Nursing NURS 206 Share QuestionEmailCopy link Comments (0)

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