Nursing Diagnosis is Risk for bleeding related to esophageal varices as evidenced by prolonged prothrombin timeCreate NCP for this patient.Thank you! Peritoneal fluid examination showed 40 cells/mm3 and a very high protein level of 8g/dL withnegative acid-fast bacilli (AFB). Peritoneal fluid cytology was negativeHe had negative hepatitis B and C serology. Retroviral screening, Mantoux test and sputum AFBwere negative.Ultrasonography of the abdomen revealed a hepatomegaly of 18.2cm with an enlarged caudatelobe and an architecture characteristic of chronic parenchymal liver disease.There was moderate ascites and bilateral pleural effusions. There was evidence of early portalhypertension. The initial colour doppler studies failed to show any abnormalities.Liver biopsy revealed effaced architecture with the liver parenchyma was separated into nodulesby thick fibrous septae. Hepatocytes showed ballooning and degeneration.There was no steatosis, bile stasis, necro-inflammation or interphase hepatitis. These findingswere compatible with established liver cirrhosis.The health provider places orders for the following:Kеep Spo2> 92%Кеep HOB > 30 degreesInsert 2 large bore Parenteral IV lines (PIV's)500 mL NS IV bolus STAT100 mL/hr NS IV continuous infusionHydrocodone/Acetaminophen 5-500 mg 1-2 tabs q4h PRN moderate to severe painDiphenhydramine 25 mg PO q8h PRN itchingOndansetron 4 mg IV q6h PRN nauseaLactulose 20 mg PO qồhAfter 24 hours upon admission patient experienced vomiting 2 times of fresh blood moderate inamount.Repeat laboratory done, result patient's hemoglobin is 7 g/dL, the hematocrit is 12%, and theplatelets are 75,000. The patient has a prolonged PT and PTT.EGD was requested, which later revealed esophageal varices.The physician placed a right subclavian triple lumen catheter and there is NS infusing at 100 mL/hr.The iCú nurse administered vitamin K.Additional orders on the chart from the gastroenterologist include the following:Octreotide (Sandostatin) 5-mcg bolus followed with continuous infusion 500 mcg in 250 mL D5NSat 25 mcg/hr.Type and cross of 6 units of PRBCS STAT and transfuse 2 units of PRBCS over 2 hours each andadminister furosemide (Lasix) 20 mg IVP in between each unit.Repeat CBC 1 hour after the transfusion is completed.

Esophageal varices are abnormal, enlarged veins in the esophagus that leak blood and eventually…

Answered: Nursing Diagnosis is Risk for bleeding…

Nursing Diagnosis is Risk for bleeding related to esophageal varices as evidenced by prolonged prothrombin time Create NCP for this patient. Thank you!

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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