Exam 19: Nutrition and Liver Diseases

Describe why ascites, portal hypertension, and esophageal varices occur in clients with cirrhosis.

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse. The Dietary Guidelines for Americans recommend that a healthy limit of alcohol intake for Brian would be:

Describe post-transplant concerns related to medication use in a patient who has had a liver transplant.

Dietary sodium restriction is a significant part of the treatment for ascites.

Nursing Exam Review Multiple Choice A patient is admitted to the hospital with decreased albumin, elevated alkaline phosphatase, and elevated bilirubin. The nurse recognizes these clinical findings as evidence of:

The chief causes of hepatic encephalopathy in the United States are alcoholic liver disease and chronic hepatitis C infection.

Nursing Exam Review Multiple Choice A nurse is working with a patient whom she suspects is suffering from hepatic encephalopathy. What sign or symptom most likely indicates early stages of the disease?

Explain how chronic alcohol use can affect brain function.

In liver disease, blood ammonia levels rise because the liver cannot convert the ammonia to:

What signs or symptoms best describe ascites?

The blood vessels that carry nutrients from the digestive tract to the liver are called collaterals.

In many individuals, fatty liver may be associated with steatohepatitis and:

A client with cirrhosis who develops changes in personality and motor function may be exhibiting early symptoms of:

Nutritional support for hepatitis includes counseling patients to avoid:

Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse. Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss. A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis. He is 5'10" tall and currently weighs 145 pounds. What laboratory test would most likely be elevated in Mr. Jamison?

A patient with cirrhosis may present with no symptoms.

What food would most likely be suggested for a patient who is experiencing wasting and malnutrition ?

Diuretics are often prescribed to control ascites.

Brian is a 21-year-old Caucasian student who is in his last year of college. Though he is a good student, it has been Brian's practice since freshman year to binge drink on weekends, typically consuming more than a six-pack of beer on Friday and Saturday nights. Brian is 5'11" tall; has weighed about the same, 195 lbs., for the past few years; and is fairly muscular and athletic in his build. He eats most meals in the cafeteria, but despite access to homemade foods, he eats few vegetables, fruits, and whole grains, and his diet is high in fat and salt. The only snacks he consumes are from the vending machine, and he usually washes down a bag of corn chips with a soda or grabs a burger, fries, and beer when out on weekends. He doesn't take any medications and has no significant medical history. A recent physical examination in preparation for basketball season revealed no remarkable physical findings except muscle aches since restarting weight lifting and new-onset stomach pain, which the doctor assesses to be gastritis. A lipid profile found his triglycerides and VLDL cholesterol to be elevated. His blood pressure is slightly elevated. He has a family history of hypertension, stroke, and alcohol abuse. Many nutrients are adversely affected by heavy drinking. The doctor cautions Brian to take a multivitamin-mineral supplement and to be aware that heavy drinking can reduce absorption of:

The drug _____ is an alternative treatment for elevated ammonia associated with cirrhosis that works by altering bacterial populations.