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Hematemesis and tarry stools are clinical signs of which serious potential complications of cirrhosis?

Hematemesis and tarry stools are clinical signs of which serious potential complications of cirrhosis?

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Hematemesis and tarry stools are clinical signs of which serious potential complications of cirrhosis?
TROINTESTINAL DISORDERS SURG • S/P appendectomy requiring blood transfusions 30 years ago • S/P open-reduction internal fixation of right femur secondary to MVA 5 years ago FH • Father died at age 52 from liver disease of unknown etiology • Mother had rheumatoid arthritis and ulcerative colitis, died from massive stroke at age 66 • Maternal aunt, age 71, with Graves disease • Patient has no siblings SH • Educated through eighth grade • Department store men's clothing manager and salesman, 17-year career Married for 19 years with 1 daughter, age 10 • H/O ethanol abuse, quit 5 years ago following MVA, previously drank 3 cases of beer/ week x 15 years • H/O IVDA (heroin) and intranasal cocaine, quit 5 years ago • Has smoked approximately 1/2 ppd for many years Meds • Propranolol 10 mg po TID Spironolactone 50 mg po QD • Furosemide 20 mg po QD • MVI 1 tablet po QD • Occasional ibuprofen or acetaminophen for headache • Patient has H/O non-compliance with his medications All NKDA ROS Increasing abdominal girth • (-) complaints of abdominal pain, fever, chills, nausea, vomiting, hematemesis, tarry stools, loss of appetite, cough, chest pain, SOB, lightheadedness, weakness, blood in the urine, diarrhea, constipation, and dry mouth Patient Case Question 1. Hematemesis and tarry stools are clinical signs of which seri- ous potential complication of cirrhosis?
Transcribed Image Text:TROINTESTINAL DISORDERS SURG • S/P appendectomy requiring blood transfusions 30 years ago • S/P open-reduction internal fixation of right femur secondary to MVA 5 years ago FH • Father died at age 52 from liver disease of unknown etiology • Mother had rheumatoid arthritis and ulcerative colitis, died from massive stroke at age 66 • Maternal aunt, age 71, with Graves disease • Patient has no siblings SH • Educated through eighth grade • Department store men's clothing manager and salesman, 17-year career Married for 19 years with 1 daughter, age 10 • H/O ethanol abuse, quit 5 years ago following MVA, previously drank 3 cases of beer/ week x 15 years • H/O IVDA (heroin) and intranasal cocaine, quit 5 years ago • Has smoked approximately 1/2 ppd for many years Meds • Propranolol 10 mg po TID Spironolactone 50 mg po QD • Furosemide 20 mg po QD • MVI 1 tablet po QD • Occasional ibuprofen or acetaminophen for headache • Patient has H/O non-compliance with his medications All NKDA ROS Increasing abdominal girth • (-) complaints of abdominal pain, fever, chills, nausea, vomiting, hematemesis, tarry stools, loss of appetite, cough, chest pain, SOB, lightheadedness, weakness, blood in the urine, diarrhea, constipation, and dry mouth Patient Case Question 1. Hematemesis and tarry stools are clinical signs of which seri- ous potential complication of cirrhosis?
For the Disease Summary for this case study, see the CD-ROM. PATIENT CASE Patient's Chief Complaints Provided by wife: "My husband's very confused and he has been acting strangely. This morn- ing, he couldn't answer my questions and seemed not to recognize me. I think that his stom- ach has been swelling up again, too. He stopped drinking four years ago, but his cirrhosis seems to be getting worse." HPI S.G. is a 46 yo white male with a history of chronic alcoholism and alcoholic cirrhosis. He was admitted to the hospital from the outpatient clinic with abdominal swelling and con- fusion. He has unintentionally gained 15 lbs during the past four weeks. According to his wife, the patient has not been sleeping well for several weeks, has been feeling very lethar- gic for the past three days, can't seem to remember appointments lately, and, uncharac- teristically, has lost his temper with her several times in the last month. S.G.'s boss at work had also telephoned her last week concerned about his "unusual and violent behavior on the job." PMH • Pneumonia 9 years ago that resolved with antimicrobial therapy • Cirrhosis secondary to heavy alcohol use diagnosed 4 years ago with ultrasound and liver biopsy (micronodular cirrhosis) • H/O uncontrolled ascites and peripheral edema • H/O two upper GI hemorrhages from esophageal varices • H/O anemia • H/O E. coli-induced bacterial peritonitis 4 years ago • H/O acute pancreatitis secondary to alcohol abuse • No history to suggest cardiac or gallbladder disease • No previous diagnosis of viral or autoimmune hepatitis
Transcribed Image Text:For the Disease Summary for this case study, see the CD-ROM. PATIENT CASE Patient's Chief Complaints Provided by wife: "My husband's very confused and he has been acting strangely. This morn- ing, he couldn't answer my questions and seemed not to recognize me. I think that his stom- ach has been swelling up again, too. He stopped drinking four years ago, but his cirrhosis seems to be getting worse." HPI S.G. is a 46 yo white male with a history of chronic alcoholism and alcoholic cirrhosis. He was admitted to the hospital from the outpatient clinic with abdominal swelling and con- fusion. He has unintentionally gained 15 lbs during the past four weeks. According to his wife, the patient has not been sleeping well for several weeks, has been feeling very lethar- gic for the past three days, can't seem to remember appointments lately, and, uncharac- teristically, has lost his temper with her several times in the last month. S.G.'s boss at work had also telephoned her last week concerned about his "unusual and violent behavior on the job." PMH • Pneumonia 9 years ago that resolved with antimicrobial therapy • Cirrhosis secondary to heavy alcohol use diagnosed 4 years ago with ultrasound and liver biopsy (micronodular cirrhosis) • H/O uncontrolled ascites and peripheral edema • H/O two upper GI hemorrhages from esophageal varices • H/O anemia • H/O E. coli-induced bacterial peritonitis 4 years ago • H/O acute pancreatitis secondary to alcohol abuse • No history to suggest cardiac or gallbladder disease • No previous diagnosis of viral or autoimmune hepatitis
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