Reference no: EM133482863
A 74-year-old male patient came to the hospital for the evaluation of general weakness, nausea, vomiting, upper abdominal pain and headache that started 10 days ago. The patient drank approximately 350-700 mL (1-2 bottles) of Soju, a Korean spirit containing 25% of alcohol, per day for 50 years. Until recently, he had never experienced any chronic illness. In the family history, his younger brother died of hepatocellular carcinoma 10 years ago. His blood pressure was 100/60 mmHg, body temperature was 36.2°C, pulse was 72 per minute and his respiration rate was 20 cycles per minute. On physical examination, no abnormal finding including stigmata of chronic liver disease, was found.
In the complete blood cell count, hemoglobin was 13.1 g/dL, hematocrit was 35.6% and leucocytes and platelets increased to 16,400/mm3 and 558,000/mm3, respectively. Results of blood biochemical test were as follows: total bilirubin 3.8 mg/dL, albumin 3.3 g/dL, AST/ALT 48/54 IU/L, γ-GT 544 U/L (normal <50), alkaline phosphatase 316 IU/L (normal 39-117). Viral markers were HBsAg (-), anti-HBs (+), and anti-HCV (-). In tumor marker tests, α-FP and CEA were slightly higher than normal value, that is, 12.4 ng/mL (normal <8.4) and 5.4 ng/mL (normal <3.0), respectively, but CA 19-9 was within normal range, 2.8 U/mL.
Abdominal ultrasonography disclosed a 6.5 cm sized mass in the left medial segment of the liver. The mass was not enhanced in the arterial phase of abdominal CT and intrahepatic bile ducts of the left lobe were dilated to the peripheral portion from the mass. It was not visualized by endoscopic retrograde cholangiography suggesting obstruction of the bile duct branches by the tumor. His physician suspects liver carcinoma.
1. Which assessment findings are helpful to you for your plan of care? State your rationale.
2. Trace the pathophysiologic process of this case and highlight the expected and actual presentations of the patient.
3. As the assigned nurse, and with the assessment you had, make 3 priority nursing care plans appropriate for the patient's case.
4. With the suspicion of the attending physician on having Liver Cancer, as a nurse you must be responsible and competent to remember, what are the possible surgical treatments for Liver Cancer? What are your nursing responsibilities?