Cirrhosis Case Study

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- Obvious ascites with 3+ peripheral edema
- Breath sounds clear but diminished all lobes; 32 and shallow
- Admitting labs: H&H, Na+, and BUN all elevated; total protein 5.0, albumin 2.8 (low)
- Urine voided shortly after admission: 80 mL, very concentrated, specific gravity 1.048
The hepatic artery receives twenty-five percent of the oxygenated blood from cardiac output to stimulate liver function. The function of the liver is to metabolize the blood supply nutrients from the digestive track allowing secretion of electrolytes, lipids, and cholesterol from the hepatic vein into the inferior vena cava. The liver also synthesizes cholesterol to form bile acids necessary for digesting and absorbing fat. Autoimmune disorders, alcoholism,
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Normal potassium level range from 3.5-5.0 mEq/L. Causes include decreased potassium intake, reparatory alkalosis, increased aldosterone secretion and increased renal excretion. Without proper nutrition, bananas, broccoli, nuts and meat, the cells do not gain enough dietary potassium through the gastrointestinal track. Due to dyspnea from ascites, blowing off increased amounts of C02, a patient could experience respiratory alkalosis moving hydrogen out of the cell and moving potassium in to maintain balance. Likewise, increased secretions of aldosterone and ADH from loss of blood volume, a result of cirrhosis, causes potassium loss through renal excretions. (Ignatavicius & Workman,…show more content…
Cardiac and neuromuscular tissues decrease in excitability causing skeletal muscle weakness, cardiac dysrhythmias and smooth muscle atony. Respiratory skeletal muscles weaken causing shallow respirations. Weakness and pain of lower extremities triggered by muscle cramps due to decreased potassium. Flaccid muscles along with hyporeflexia of the deep tendon reflex has been noted. Decreased potassium in the brain alters mental status, contributing to irritability or anxiety. Prolonged hypokalemia can result in confusion or coma. Without potassium, repolarization of action potentials is behind creating irregular heartbeats called dysrhythmias. Pulse rates are high but thread and weak requiring extremely light palpation as it is easily obstructed. ECG can show a change in potassium imbalance. Orthostatic hypertension occurs with hyperkalemia meaning diastolic and systolic arterial blood pressure decrease when a patient stands. Hypokalemia will cause increased sensitivity to cardiac glycosides. Due to complications of smooth muscle contractions patient will present with hypoactive bowel sounds due to decreased peristalsis. (Ignatavicius & Workman,
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