Years Male Diagnosed Question & Answer Guide (With Explanation)
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Original Question
46 years male diagnosed with cirrhosis of liver,heavily drank for 20 years but sober for past 2 years, smoking 2 packs for last 20 years ,thin and malnourished, moderate ascites jaundice of sclera and skin,Complaint of nausea, anorexia, and abdominal discomfort and 4 + pitting edema of lower extremities, liver and spleen are palpable VS q4h, i&o, neuro checks q4h, weight daily, bed rest with bathroom privileges. Diet: increased CHO, 30 g protein, 2 g Sodium Saline lock in situ,laboratory results today are: PT 40 sec, Serum ammonia 70 mcg/dL, Hgb 10.6 g/dL, Hct 30% ,WBC 3500/mm3, Platelets 100, 000/mm3, AST 100 U/L, ALT 500 U/L,Medication Amphogel 30 mL po qid, Furosemide 40 mg IV qAM, Aldactone 50 mg po bid Abdominal paracentesis done removes 2.5 L of fluid. VS during the procedure were P 90, R 32, BP 136/86. Post procedure you ass: VS: P 94, R 24, BP 136/86, pain level 1, Dressing at the abdominal puncture site is clean, lying in a semi-Fowler position, alert and oriented, although slow to respond please make a ISBAR for above case scenario
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