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Marcia Brown is a 42-year-old Pima Indian who works as a cook in a casino in Arizona. She has just been diagnosed with cholelithiasis. She is 5'4" tall and once weighed 210 pounds. One year ago, she underwent gastric bypass surgery and has lost 75 pounds. For several months, she had been experiencing episodes of pain in the right upper part of her abdomen. The pain usually began after eating and lasted for several hours. Lately, she began to experience nausea and vomiting with the pain and began to run a fever.

1. What are Marcia's risk factors for cholelithiasis?

2. What symptoms did Marcia have that are consistent with a diagnosis of cholelithiasis?

3. What is the cause of the pain associated with cholelithiasis?

4. What are the treatment options for cholelithiasis? Explain each.

Mrs. Juarez is diagnosed with cirrhosis and has developed ascites. Her appetite is poor, and she is losing weight.

5. What would you encourage her to do to minimize the risk of malnutrition?

A. Eat four to six times per day.

B. Try to eat three large meals per day.

C. Consume a liquid nutritional supplement with each meal.

D. Drink more fruit juice.

A patient is admitted to the hospital with decreased albumin, elevated alkaline phosphatase, and elevated bilirubin.

6. These clinical findings are evidence of:

A. Portal hypertension

B. Liver disease.

C. Esophageal varices.

D. Hepatic coma.

7. The most common complication of alcohol abuse is:

A. Chronic pancreatitis.

B. Alcoholic liver disease.

C. Chronic renal failure.

D. Heart arrhythmias.

8. Cirrhosis patients frequently develop insulin resistance and consequently must follow a diet that:

A. Maintains blood glucose control.

B. Is low in fiber.

C. Provides consistent vitamin K intake.

D. Is low in sodium.

9. What is the daily sodium restriction for a patient with ascites?

A. 2000 mg

B. 1200 mg

C. 1500 mg

D. 1800 mg

Answer :

Being a Pima Indian, having undergone gastric bypass surgery, and having previously weighed 210 pounds are all risk factors for cholelithiasis for Marcia Brown. She experienced right upper abdominal pain that got worse after eating and persisted for several hours, which is a symptom that is compatible with the diagnosis of cholelithiasis. She also had fever, nausea, and vomiting.

Gallstones in the gallbladder or bile ducts are the root of the discomfort felt with cholelithiasis. Medications to dissolve the gallstones, lithotripsy to break up the stones, or cholecystectomy surgery to remove the gallbladder are all possible treatments for cholelithiasis. The particular course of action depends on how serious the problem is and how complicated it is. It would be advised for Mrs. Juarez who has cirrhosis and ascites.to consume food four to six times daily in order to reduce the danger of malnutrition. Clinical signs of liver disease include decreased albumin, high alkaline phosphatase, and raised bilirubin. Alcoholic liver disease is the most frequent alcoholic liver disease complication. Patients with cirrhosis frequently develop insulin resistance, so maintaining blood glucose management through diet is crucial. A patient with ascites usually has to limit their sodium intake to roughly 2000 mg per day.

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