A NURSE IS CARING FOR A CLIENT

A NURSE IS CARING FOR A CLIENT WHO HAS CIRRHOSIS OF THE LIVER This is the Nurses NOTE 1200: client has a history of cirrhosis of the liver for the past 5 years. client admitted to the medical surgical unit for weight gain, vomiting, and worsening ascites. client is lethargic and oriented only to self and place. client has profound abdominal distention including a protruding umbilicus and taut skin. client is jaundice throughout. the client nods ‘yes’ when asked if they are in pain but cannot give a pain level. +1 pitting edema noted in bilateral lower extremities. bilateral pedal pulses are +2. client is dyspneic, bilateral crackles auscultated in bilateral lower bases. Diagnostic results 1215: AST: 351 units/L ( 0-35 units/L ) ALT: 256 units/L (4-36 units/L ) Total bilirubin: 3.6 mg/dL ( 0.3-1.0 mg/dL ) Albumin: 1.6 g/dL ( 3.5- 5 g/dL ) Ammonia: 175 mcg/dL ( 10-80 mcg/dL ) Question complete the following sentence by using the list of options: 1) The nurse should first address the client’s ( please select one A,B or C ) and explain why A) pain B) fluid volume status C) bilirubin 2) followed by the clients ( select one A,B or C) and explain why A) cardiac status B) neurological status C) jaundice

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