Case study:
Weight: 50%
Word Length: 2000 words
Case Study – Cirrhosis of the Liver
Murray Brown is a 55 year old man who manages the local hardware store in Urbenville. He lives with his wife Sharon and their three children aged, 16, 13 and 10 years. He smokes a pack of cigarettes a week which he has done since he was 16 years of age. Twelve years ago he was diagnosed with cirrhosis of the liver and has been sober for the last two years despite drinking heavily prior to this for twenty years.
Murray is admitted to hospital as an inpatient after he presented to his GP complaining of vomiting for two days and he had noticed blood in the toilet when he vomits.
Subjective data
- He has cirrhosis for twelve years
- Acknowledges he has been drinking heavily for twenty years but has been sober for the last two years
- Complains of nausea, anorexia and abdominal discomfort
Objective data – physical examination
- Thin, malnourished with moderate ascites
- Has jaundice of sclera and skin
- Has 4+ pitting oedema of the lower extremities
- Liver and spleen palpable
Laboratory values
- Total bilirubin: 257 mmol/L
- AST: 190u/L
- ALT: 201 U/L
Referencing
You must use the APA referencing system.
Must read: What Causes Cirrhosis?
Cirrhosis of the Liver Task
Address the following questions.
- Outline the pathophysiology for cirrhosis of the liver to explain each of Murray symptoms and what further assessment would you do?
- What follow-up care and interventions would the community nurse provide to Murray?
- Identify the risk factors of liver cirrhosis and discuss what lifestyle modifications would be included in providing education to Murray and his family?
- Based on the long term complications of liver cirrhosis what medications do you anticipate Murray would be prescribed and discuss the pharmokinetics & pharmodynamics, of those you identified?
Also read: The Pathophysiology of Disorders Academic Help
Follow the Assessment Rubrics Please :
| CRITERIA | EXCELLENT 3 marks | SATISFACTORY 2 marks | POOR 1 Mark | Total |
| Q1. Outline the pathophysiology for cirrhosis of the liver | Comprehensive discussion outlining the pathophysiology | Moderate discussion outlining the pathophysiology | Scant or absence of discussion outlining the pathophysiology | /3 |
| Q1. explain each of Murray symptoms | Clear and detailed explanation of all symptoms | Explanation of some symptoms | Limited explanation of symptoms | /3 |
| Q1. further assessment | Detailed and appropriate further assessment discussed | Mention of some further assessment | Limited or absences of further assessment | /3 |
| Q2. What follow-up care | Follow up care is inclusive and complete | Follow up care incomplete and needs development | Follow up care inadequate | /3 |
| Q2. interventions | Comprehensive discussion of interventions | Adequate discussion of interventions | Inadequate discussion of interventions | /3 |
| Q2. understand of community nurses scope/role | Demonstrate a detailed understanding of the community nurses role | Demonstrate an understanding of the community nurses role | Did not demonstrate an understanding of the community nurses role | /3 |
| Q3. risk factors of liver cirrhosis | Detailed outline of risk factors | Outline of risk factors | Inadequate or no risk factors outlined | /3 |
| Q3. lifestyle modifications | Provides succinct, relevant and clear Lifestyle modifications | Provides relevant lifestyle modifications | Does not provide adequate lifestyle modifications | /3 |
| Q4. Medications Pharmokinetics pharmodynamics | Comprehensive discussion of mediations including pharmokinetics and pharmodynamics | Adequate discussion of mediations including pharmokinetics and pharmodynamics | Inadequate discussion of mediations including pharmokinetics and pharmodynamics | /3 |
| Flow/organisation Critical thinking | Demonstrated excellent flow and use of critical thinking throughout | Demonstrated flow and use of critical thinking throughout | Did not demonstrate flow and use of critical thinking throughout | /3 /4 |
| Quality of sources | Excellent integration of peer-reviewed and high quality sources throughout response | integration of peer-reviewed and quality sources, some use of non-authorative resources | Over-reliance on grey-literature or non-authorative resources | /3 |
| APA referencing | Sources clearly identified. Adequate use of APA format [in text + reference list]. | Sources not identified, little to no use of APA format [in text + reference list]. | /3 | |
| /40 |