A nurse is caring for a patient who has recently been diagnosed with liver disease.
Which laboratory values should the nurse anticipate the healthcare provider will order to confirm this diagnosis?
Erythrocyte sedimentation rate (ESR)
D-dimer
C-reactive protein (CRP)
Albumin .
The Correct Answer is D
Choice A rationale
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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Correct Answer is B
Explanation
Choice A rationale
While acetaminophen can be used to relieve discomfort, it should be used with caution in patients with liver disease like cirrhosis, as it can potentially cause further liver damage.
Choice B rationale
Patients with cirrhosis, especially those with ascites, are often advised to limit their sodium intake. High-sodium foods can contribute to fluid retention and worsen ascites. Therefore, avoiding high-sodium foods such as canned soups/vegetables, processed meats, and prepackaged frozen dinners is a key part of managing cirrhosis.
Choice C rationale
While maintaining adequate nutrition is important in cirrhosis, eating three large meals per day is not typically recommended. Instead, smaller, more frequent meals are often suggested.
Choice D rationale
While physical activity is generally beneficial, patients with cirrhosis and particularly those with complications such as ascites or encephalopathy may need to modify their activity levels based on their symptoms and overall health.
Correct Answer is B
Explanation
Choice A rationale
Donating blood after completing the medication regimen is not typically recommended for patients with hepatitis B. Hepatitis B is a bloodborne virus, and individuals with the virus should not donate blood.
Choice B rationale
Resting frequently throughout the day is a key part of self-management for patients with hepatitis B. Rest can help the body recover and fight off the virus.
Choice C rationale
Taking acetaminophen every 4 hours for discomfort is not typically recommended for patients with hepatitis B. Overuse of acetaminophen can lead to liver damage, which can be particularly harmful for individuals with liver diseases like hepatitis B56.
Choice D rationale
Consuming a high-protein diet is not typically recommended for patients with hepatitis B. A balanced diet is important for overall health, but there are no specific dietary recommendations for hepatitis B56.
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