A nurse is working on the medical-surgical unit of the hospital and is starting her shift for the day. One of her patien...
A nurse is working on the medical-surgical unit of the hospital and is starting her shift for the day. One of her patient’s, Mr. W, is in the hospital for exacerbation of symptoms related to cirrhosis. Mr. W is a 55-year-old patient who has a history of alcohol use disorder, having abused alcohol for 33 years; he also suffers from atrial fibrillation and gastroesophageal reflux disease, and he is a smoker. He was admitted to the hospital last evening for abdominal pain. Upon assessment, the nurse notes that Mr. W has pale skin with a slightly yellowish hue; his abdomen is full and rounded and he has 3+ pitting edema in the ankles bilaterally. He complains that his skin feels itchy and he is very tired. He rates his abdominal pain as a “6” on a scale of 1 to 10.
-
Mr. W’s condition is caused by his history of alcohol abuse. Explain how chronic alcohol abuse causes cirrhosis of the liver.
-
List other potential causes of cirrhosis that are unrelated to alcohol intake.
-
What type of diagnostic tests would Mr. W have had that would have confirmed his diagnosis of cirrhosis?
-
What activities or lifestyle factors would most likely worsen Mr. W’s condition?
Mr. W undergoes an ultrasound, which confirms that he has abdominal ascites. The nurse sets up and prepares to assist the physician with paracentesis to remove the excess fluid from Mr. W’s abdomen.
-
Describe the process of performing a paracentesis to control ascites.
-
What is the nurse’s role while assisting with this procedure?
-
What signs or symptoms from Mr. W would indicate complications as a result of the paracentesis?
Mr. W. tolerates the paracentesis well and the nurse administers midazolam for sedation. The physician has ordered that Mr. W rest and he is placed on NPO status with an order for TPN to support his nutritional intake. He is to receive a dose of spironolactone and to have a metabolic panel to check his electrolyte levels.
-
What electrolyte imbalances would the nurse most likely expect to see with Mr. W’s condition?
-
Explain why Mr. W has been placed NPO and he is receiving parenteral nutrition.
-
What types of complications would the nurse need to monitor for while Mr. W receives TPN?
-
The nurse has given Mr. W a nursing diagnosis of Fluid Volume Excess related to his ascites and peripheral edema. What interventions would be most appropriate with this nursing diagnosis?
-
List 2 other potential nursing diagnoses that would be appropriate for Mr. W. with 2 corresponding nursing interventions for each diagnosis
Homework Answers
Causes of liver cirrhosis
- Cryptogenic causes
- Non alcoholic fatty liver disease
- Hepatitis
- Biliary cirrhosis
- Genetic disorders
- Autoimmune hepatitis
Diagnostic tests for cirrhosis
- Liver function test
- Liver biopsy
- Hepatoscopy
- Transient elastography
- Ultrasound or CT / MRI of liver
Alcohol intake is worsened Mr.w's condition
Paracentesis
Introducing a catheter inside the abdomen to drain fluid.
Complication of paracentesis
- Persistent fluid leak
- Hypotension
- Hypovolemic
- Localised infections
- Injury
- Hyponatremia is major symptom, sodium loss causes electrolyte imbalance
Add Answer to:
A nurse is working on the medical-surgical unit of the hospital and is starting her shift for the day. One of her patien...
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal...
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal pain and general weakness. He reports that he drinks “one bottle of scotch whisky every week for the past one year, and one to two cans of beer during the weekends.” For the past three months, his condition has started to deteriorate. His wife claims that “he has not been eating well for the past three months”. Mr. McClaren reports he has passed dark...
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal...
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal pain and general weakness. He reports that he drinks “one bottle of scotch whisky every week for the past one year, and one to two cans of beer during the weekends.” For the past three months, his condition has started to deteriorate. His wife claims that “he has not been eating well for the past three months”. Mr. McClaren reports he has passed dark...
Cirrhosis Systems reviewed in Cirrhosis Case Study Up Respiratory system A Cardiovascular system C Hematologic and...
Cirrhosis Systems reviewed in Cirrhosis Case Study Up Respiratory system A Cardiovascular system C Hematologic and Lymphatic system Gastrointestinal system T Urinary system Musculoskeletal system C Neurological system M Endocrine system M Integumentary system • E= Everybody A = Alli T= Tijuan .C= Cletha •M=Mackenzie Case Ben Whitehorse, a 60 year old male of Native American descent, is admitted to the hospital with hematemesis. He has a history of alcohol abuse. Ben's wife and two daughters accompany him. Ben is...
Lenny Levitt, a 49-year-old carpenter, has just been diagnosed with cirrhosis, which is a consequence of...
Lenny Levitt, a 49-year-old carpenter, has just been diagnosed with cirrhosis, which is a consequence of his alcohol abuse over the past 25 years. Although he understands that he has an alcohol problem and recently entered an alcohol rehabilitation program, he is still drinking. At 5 feet 8 inches tall, Mr. Levitt, who formerly weighed 160 pounds, now weighs 130 pounds. According to family members, he is showing signs of mental deterioration, such as forgetfulness and an inability to concentrate....
Sam is a new nurse working the day shift on a busy medical-surgical unit. He asks...
Sam is a new nurse working the day shift on a busy medical-surgical unit. He asks his aide to walk the patient in Room 244 while he admits another patient. The patient in Room 244 is a postangioplasty, and it would be the first time he has ambulated since the procedure. Sam tells his aide to walk the patient only to the nurse's station and back. He also says that if the patient's heart rate rises more than 20 beats/min...
1. A patient who had a Cholecystectomy returns to the medical-surgical unit. Which of the folowing...
1. A patient who had a Cholecystectomy returns to the medical-surgical unit. Which of the folowing nursing interventions wound prevent Preumonia? SELECT ALL THAT APPLY a. Coughing deep breathing exercises b. Use of incentive spirometer c. Deep breathing exercises d. Anti-embolism stockings The client is diagnosed with ulcerative colitis. When assessing this client, which 2. sign/symptom would the nurse expect to find? a. Frequent bloody stools through the day b. Oral temperature of 103 F c. Hard, rigid abdomen. d....
You review EPIC for Mr. Smith and find that he was admitted to the hospital last...
You review EPIC for Mr. Smith and find that he was admitted to the hospital last night with the diagnosis of bleeding esophageal varices. He is 38 years old, 6’ tall, and weighs 155 lbs. He has a history of alcohol abuse and bipolar disorder. He is on bedrest with bathroom privileges, NPO, and has an IV with lactated ringers running at 125mL/hr. He is a bit confused and has been shivering. His temp is 100.6° F. He is scheduled...
Patient: Mr. Rogers. Gender: Male Age: 79 4/4/2040 Setting: Medical Surgical Unit in Hospital. Pre-existing Conditions:...
Patient: Mr. Rogers. Gender: Male Age: 79 4/4/2040 Setting: Medical Surgical Unit in Hospital. Pre-existing Conditions: Diabetic Type II, Chronic Leg Ulcers, Peripheral Vascular Disease, Stroke, and Aphasia. Mr. Rogers is 79-year old male that came into the ER with complaints of Right lower leg pain. He was found to have cellulitis of his right calf. Patient states, “I know my leg wounds have been draining a lot lately, but for the last 2 days my leg feels inflamed and...
358. The medical-surgical nursing unit is short-staffed for the shift for the shift and a registered...
358. The medical-surgical nursing unit is short-staffed for the shift for the shift and a registered nurse (RN) from the pediatrie unit has been floated to the nursing unit which client should the nurse assign to the float nurse? A. A 32 year old client newly diagnose with diabetes who needs dietary and medication teaching B. A 56 year old client newly admitted with Guillain-Barre syndrome who has severe leg weakness C. An 88 year old client with dementia who...
You are a nurse on a medical-surgical unit in a hospital caring for a 68-year-old brick mason who had surgery 2 days ago...
You are a nurse on a medical-surgical unit in a hospital caring for a 68-year-old brick mason who had surgery 2 days ago for repair both of his knees. The surgery went smoothly and you are responsible for his postoperative care. He will have limited weight-bearing on both legs until his first follow up with the physician. Physical therapy will be working with this patient. 1) What assessments do you need to do to determine the best method of transfer...
Cirrhosis Systems reviewed in Cirrhosis Case Study Up Respiratory system A Cardiovascular system C Hematologic and Lymphatic system Gastrointestinal system T Urinary system Musculoskeletal system C Neurological system M Endocrine system M Integumentary system • E= Everybody A = Alli T= Tijuan .C= Cletha •M=Mackenzie Case Ben Whitehorse, a 60 year old male of Native American descent, is admitted to the hospital with hematemesis. He has a history of alcohol abuse. Ben's wife and two daughters accompany him. Ben is...
1. A patient who had a Cholecystectomy returns to the medical-surgical unit. Which of the folowing nursing interventions wound prevent Preumonia? SELECT ALL THAT APPLY a. Coughing deep breathing exercises b. Use of incentive spirometer c. Deep breathing exercises d. Anti-embolism stockings The client is diagnosed with ulcerative colitis. When assessing this client, which 2. sign/symptom would the nurse expect to find? a. Frequent bloody stools through the day b. Oral temperature of 103 F c. Hard, rigid abdomen. d....
358. The medical-surgical nursing unit is short-staffed for the shift for the shift and a registered nurse (RN) from the pediatrie unit has been floated to the nursing unit which client should the nurse assign to the float nurse? A. A 32 year old client newly diagnose with diabetes who needs dietary and medication teaching B. A 56 year old client newly admitted with Guillain-Barre syndrome who has severe leg weakness C. An 88 year old client with dementia who...
Most questions answered within 3 hours.
-
The phylum Protista has often been referred to as a junk drawer
of classification. Explain what...
asked 23 seconds from now -
The average amount of money spent for lunch per person in the
college cafeteria is $7.09...
asked 1 minute ago -
You follow the lab procedure and at the end of Part 4C, you used
an average...
asked 20 minutes ago -
Write 250-450 words, about the following: • Analyze how a
servant leader in your organization or...
asked 24 minutes ago -
3. American and Japanese workers can each produce 4 cars a
year. An American worker can...
asked 27 minutes ago -
On October 1, 20X1, a company purchased a piece of land by
agreeing to pay the...
asked 39 minutes ago -
Jamie is doing a survey at her school about whether the students
feel the cafeteria food...
asked 44 minutes ago -
What are the roles of 3' and 5' untranslated regions in
mRNAs?
asked 45 minutes ago -
A domestic television receives antenna delivers a sky noise
power of -105 dBm to a matched...
asked 44 minutes ago -
What do you think are the chemical reactions involved in the
breathalyzer tests administered to potentially...
asked 59 minutes ago -
A random sample of 120 observations produces a mean of
38.2 from a population with a...
asked 1 hour ago -
The average area of land burned by forest fires every year in
Canada is 2.5 million...
asked 1 hour ago