Question

Case Study num33

Mrs. F has a history of mild heart problems, but she has been admitted to the medical-surgical floor for management of her liver failure. She is a white-haired woman in her sixties with a puffy face, overweight, and presents with yellowish skin and sclera, mild generalized edema (swelling), spider nevi (broken capillaries), high blood pressure, increased respiratory rate, and a heart rate of 59 bpm (normal is 60-100 bpm). When you ask whether she has noticed any changes lately, Mrs. F complains about dizziness and lightheadedness. She also mentions weight gain and that her slacks are too tight. She says “They told me this disease would interfere with my digesting lipid, so I thought I'd lose weight!”

1. Mrs. F’s blood work has come back and shows that she has low plasma osmolarity and decreased levels of plasma proteins. The doctor says “this explains her edema!” How are plasma proteins related to edema?

2. Mrs. F has spider nevi, broken skin capillaries. Normally, broken skin capillaries do not cause visible blemishes, but hers are bleeding more than usual. Could this be due to her liver problems?

Answer 1

1)People suffering from severe malnutrition and liver diseases have decreased plasma proteins and and low osmolarity because due to the reduction in plasma proteins leads to decreased plasma colliod osmatic pressure which in turn leads to enema.

2)Yes, it is related to Mrs.F liver problems.

Because liver makes bile and it is needed for absorbing lipid soluble vitamins.The vitamins are A,D,E and K.So if liver is damaged bile production will be reduced and inturn the absorption of vitamins are also decreases.The role of vitamin K is to clot blood so if the vitamins are not absorbed so there will be no blood clotting vitamin.

Due to Mrs.F liver problems her blemishes are bleeding more than usual.