Room 362, a 48-year old married male, was admitted to Lynchburg General Hospital after showing symptoms of hepatic failure. He had a chief complaint of weakness and drowsiness displayed by the inability to be easily awoken by his wife, which led to his admission into the hospital. He has been diagnosed with hepatic failure demonstrated by laboratory testing and an arterial blood gas (ABG) analysis. Hepatic failure is a condition caused by a sudden or chronic illness, which results in irreversible damage to the liver ultimately inhibiting the liver’s functional abilities. Room 362’s hepatic failure was most likely a result of his alcoholic cirrhosis and hepatitis C. Room 362’s history with alcohol abuse and smoking led to his current state of…
Santi, L., Maggioli, C., Mastroroberto, M., Tufoni, M., Napoli, l., & Caraceni, P. (2012). Acute liver failure caused by…
The liver regulates circuiting lipids and it controls the total amount of cholesterol in the body, by synthesizing and releasing it into the blood or bile. The liver uses cholesterol to produce bile salts.…
For patients with a history of alcohol abuse or excess and evidence of liver disease, the CNS should order laboratory tests to exclude other etiologies and confirm the diagnosis of ALD. The CNS should discuss/recommend abstinence in patients with evidence of ALD because continued alcohol use is associated with disease progression. The CNS should be able to calculate a MELD score to ensure that referral to a transplant center is not delayed, as early treatment with abstinence has been shown to improve the outcome and histological features of hepatic injury, to reduce portal pressure and decrease progression to cirrhosis, and to improve survival at all stages in patients with ALD. There are few reliable predictors of relapse in alcoholic patients, whether or not they undergo liver transplantation. As stated throughout this paper, most transplant programs require patients with ALD to demonstrate a long-term commitment to alcohol abstinence prior to consideration for liver transplantation, typically for six months or…
Alcoholic cirrhosis is charactered by the replacement of the destroyed liver cells with the scar tissue (Farrell & Dempsey, 2009, p.1167). The increased liver scar tissue result in the failure of liver function to synthesis protein, clotting factors, the substances and manifestation of portal hypertension (Farrell & Dempsey, 2009, p.1168). In liver cirrhosis, the live tend to be large and its cells loaded with fat, that it causes the liver become firm and sharp edge noticeable on palpation (Farrell & Dempsey, 2009, p.1168). Moreover, as the rapid enlargement of the liver, the tension on the fibrous covering of the live is produced and may causes the abdominal pain (Farrell & Dempsey, 2009, p.1167). The late manifestation are due partly to chronic failure of liver function is the obstruction of the portal circulation as the blood cannot passage through the liver and back up into the spleen and Gastrointestinal (GI) tract (Farrell & Dempsey, 2009, p.1168). Therefore, the GI tract cannot function properly which result into the decreasing ability of indigestion and altered bowel function (Farrell & Dempsey, 2009, p.1168). Fluid rich in protein may be moved from the vascular system to the peritoneal cavity and…
First-line treatment for patients at risk for CAD will focus on primary prevention by lifestyle modifications (AACE, 2012). This approach will consist of a comprehensive method involving physical activity (AACE, 2012). Activity plans will be formulated with patient goals outlined like 30 minutes of moderately intense physical activity at least four to six days a week (AACE, 2012). Next, nutritional plans will be formulated into the treatment of hyperlipidemia prevention to include ways to eliminate ingestion of saturated and trans fats (AACE, 2012). Vegetables, fruits, grains, fish, and lean meats are incorporated into the diet plan to reduce caloric intake and weight reduction (AACE, 2012). Since smoking aids in plaque build-up on the coronary arteries, smoking cessation is very important to incorporate into the care plan (AACE, 2012). Once smoking has stopped evaluation in 30 days will often show increased HDL levels (AACE, 2012). Once lab results show the diagnosis of hyperlipidemia, a medication regimen along with the mentioned primary prevention methods will be initiated to reduce cardiovascular events (AACE, 2012). The AACE reports statins are the number one drug choice (AACE, 2012). The approach to lowering severe high levels of triglycerides, fibrates is the treatment option that is appropriate (AACE, 2012). Other potential options if the primary choice is not appropriate is niacins, bile acid sequestriants, and cholesterol absorption inhibitors (AACE, 2012). Niacins are used to lower triglycerides and LDLs and elevating HDLs (AACE, 2012). Giving in conjunction with Omega 3 Fish Oil is appropriate if necessary for lower triglyceride levels (AACE, 2012). Reducing LDL but only modestly increasing HDLs is the bile sequestriants action in the body, but increased triglycerides and lowering glucose have been noted therefore not the first-line treatment…
Low-density lipoproteins (LDL) are lipoproteins that transport lipids from the liver to alternative tissues like muscle and fat and they contain a large proportion of cholesterol.…
* May report: History of/recent onset of heart failure, pericarditis, rheumatic heart disease, or cancer (causing liver impairment leading to failure)…
Heart failure can lead to a buildup of fluid that puts too much pressure on the liver.…
1. Gonzalez SA, Davis GL. Clin Liver Dis. 2012;1(1):2-5. 2. Bell BP, et al. Am J Gastroenterol. 2008;103(11):2727-2736.…
Geokas, M., Lieber, C., French, S., & Halsted, C. (1981). Ethanol, the liver, and the gastrointestinal tract. Annals Of Internal Medicine, 95(2), 198-211. Retrieved from MEDLINE with Full Text database.…
This means too much drinking can cause serious liver problems especially in a young…
acetic acid by the liver (Freudenrich). A person becomes “drunk” when an excess of alcohol is…
Metabolic Syndrome is a risk factor that increases a chance of developing heart disease, diabetes, and stroke. There are five risk factors that include - Increased blood pressure (greater than 130/85), High blood sugar levels (insulin resistance), excess fat around the waist, high triglyceride levels, low levels of good cholesterol, or HDL. Having one of this risk factor will increase of you having a metabolic disorder. In addition, there two main factors of metabolic syndrome first, central obesity or excess fat around the middle and upper parts of the body. And lastly, insulin resistance, which makes it difficult for the body to use sugar. To diagnosed metabolic syndrome your doctor needs to run several test most likely is the measurement…
Being overweight or obese is nonetheless a health issue (Gibbons). The world’s oldest metabolic disorder is impacting an even younger age group than ever before. Studies reveal that obese children run a high risk of developing non-alcoholic fatty liver disease (NAFLD) which can be fatal. Researchers at the Mayo Clinic in Rochester, Minnesota identified obesity as the number one cause of Chronic Liver disease in the United States. America’s population is getting less and less healthy at younger ages, they will eventually face risks of chronic diseases. This problem is not going to be resolved by changing our way of life, America is going to end up replacing people's organs with artificial ones. Dr. Ariel Feldstein, principal investigator, quoted “As a pediatrician, I feel we are dealing with a big epidemic- NAFLD is certainly surpassing hepatitis C, in terms of potential damage to the liver.” Researchers have identified over 250 obesity-related genes (Wasowicz). Body Mass Index (BMI) is a way to determine obesity. As someone's BMI increases, so does their risk for Coronary Heart Disease (CHD). CHD can cause build up in the arteries and leads to a deficiency in oxygen-rich blood traveling to your heart. There are a great deal of health issues as a direct result of obesity. One of those issues is heart failure, where your heart cannot pump enough blood to supply for your body. High blood pressure is when the force of blood pushing on your…