Reference no: EM133520032
Case Study Assignment
The purpose of this assignment is to give you the opportunity to apply your knowledge to a case like one you might come across in your own nursing practice. Read the details of the case carefully. Then answer the questions about the case. You may type directly on this document and submit it when completed.
The Case
A 54-year-old mechanic was admitted to hospital because of severe epigastric pain and repeated episodes of vomiting of blood (hematemesis). His blood pressure was 90/40 and his pulse rate was 120/min. His appearance was somewhat unkept. Upon questioning his drinking habits, he reported he often went on "binges", sometimes drinking a quart of alcohol within a few days. The patient revealed that he had exhibited upper gastrointestinal bleeding on previous occasions, but never so profusely.
The patient's skin and conjunctivae were slightly yellow (jaundiced). His eyes appeared to be slightly sunken. His abdomen was enlarged and rounded, giving the appearance of being "fluid-filled" (ascites). There was protrusion and considerable downward displacement his umbilicus. Palpation of the patient's abdomen revealed his liver measured 14 cm in the midclavicular line, indicating an enlargement of the liver (hepatomegaly) and his spleen was palpable 3 cm below the left costal margin (splenomegaly).
Several bluish, dilated varicose veins radiated from his umbilicus, forming a caput medusae. During a proctoscopic examination (inspection of the rectum and anal canal with a proctoscope), internal hemorrhoids were observed. On questioning, the patient said that he sometimes saw blood in his bowel movements (feces, stools). At other times, he said his stools were black and shiny.
Diagnosis: Alcoholic cirrhosis of the liver
Pathophysiology
Case Study Assignment
Questions
1. What is cirrhosis of the liver?
2. What are the possible causes of the inflammation that leads to cirrhosis of the liver?
3. What are the symptoms of liver cirrhosis?
To understand the symptoms involved in cirrhosis of the liver, one must understand the normal anatomy and physiology of the liver.
4. What is the normal liver blood flow?
5. How is the liver related to bilirubin secretion?
6. What is the microanatomy and circulation of the liver?
7. What is the hepatic portal system?
8. What are the connections between the portal circulation and the systemic circulation?
9. What goes wrong in cirrhosis of the liver?
10. Account for this patient's vascular problems:
11. Why was this patient jaundiced?
13. How is chronic cirrhosis of the liver treated?
14. What procedures are used to treat bleeding and prevent re-bleeding?
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