(^292) Medical-Surgical Nursing Demystified
- Spider veins—spider angiomas or telangiectasias on cheeks, nose, shoulders
or upper chest - Redness of palms—palmar erythema
- Glossitis due to vitamin deficiency
- Peripheral edema
- Dyspnea due to pressure on diaphragm from ascites
- Encephalopathy (asterixis, tremors, delirium, drowsiness, dysarthria, coma)
INTERPRETING TEST RESULTS
- Aspartate aminotransferase (AST) elevated.
- Alanine aminotransferase (ALT) elevated.
- Lactate dehydrogenase (LDH) elevated.
- Bilirubin direct (conjugated) and indirect (unconjugated) elevated.
- Urinary bilirubin elevated.
- Fecal urobilinogen decreased with biliary tract obstruction.
- Serum protein decreased.
- Serum albumin decreased.
- Anemia with elevated MCV, MCH.
- White blood cell (WBC) count low.
- Prothrombin time is prolonged due to changes in hepatic production of clot-
ting factors. - Platelet count low (thrombocytopenia).
- Ammonia level elevated as the disease advances.
- Abdominal x-rays show hepatomegaly.
- Abdominal CT scan shows hepatomegaly, ascites.
- Ultrasound shows hepatomegaly, ascites, portal vein blood flow.
- Liver biopsy shows fibrosis and regenerative nodules.
- Esophagogastroduodenoscopy (EGD) to detect esophageal varices.
TREATMENT
- Low-sodium diet; adequate calorie intake.
- Restrict fluid intake if hyponatremic (low serum sodium) or fluid overloaded.