Medical Surgical Liver Overview #4

Question

Which laboratory results support the diagnosis of liver failure? Select all that apply.

Answers

  1. Increased bilirubin
    • Rationale:

      This answer is correct because increased bilirubin levels in the body is associated with liver dysfunction. The liver is unable to clear the body of excess bilirubin which causes jaundice in the body, which produces clinical manifestations such as dark urine, yellowed skin, and yellowing sclera.

  2. Increased albumin
    • Rationale:

      This answer is not correct because decreased (not increased) albumin is most associated with liver dysfunction. The liver produces albumin so it is unable to perform that duty. This can cause fluid to leak out of the bloodstream, leading to various clinical manifestations including generalized edema and ascites.

  3. Increased clotting factors
    • Rationale:

      This answer is not correct because clotting factors will decrease (not increase) when the liver is not functioning properly. The liver produces these clotting factors so production will be decreased as the liver decreases in functional ability. The client will have bleeding tendencies so the nurse should monitor for this.

  4. Decreased HDL
    • Rationale:

      This answer is correct because if the liver is not functioning properly, the cholesterol produced and taken in by food can not be cleared properly, leading to abnormal cholesterol levels in the body, including decreased HDL, increased LDL, and increased total cholesterol levels.

  5. Decreased erythropoietin
    • Rationale:

      This answer is not correct because the liver does not produce erythropoiesis. The kidney produces this hormone, which stimulates red blood cell production in the bone marrow.

Overview

Laboratory results that are associated with liver dysfunction or failure include increased bilirubin, decreased HDL, increased LDL, increased total cholesterol.

Explanation

Learning Outcomes

Cholesterol is a fat-like substance found in all cells of the body. Normally, the liver produces all the cholesterol the body needs. What an individual eats also provides cholesterol. The liver has many functions in the body. Functions include transport of bile, cholesterol, albumin, and clotting factor production. If the liver is not functioning properly, the cholesterol produced and taken in by food can not be cleared properly, leading to increased cholesterol levels. Also, there is a build up of excessive bile, producing elevated bilirubin. Laboratory results become abnormal as the liver begins to fail, including increased bilirubin, decreased HDL, increased LDL, increased total cholesterol, increased liver function values (ALT and ALT), decreased clotting factor levels, and decreased albumin levels. Other clinical manifestations of liver failure include ascites, portal vein hypertension, esophageal varices, and bleeding tendencies.

Test Taking Tip

Remember that erythropoietin is produced in the kidney, not the liver. Clotting factors are produced in the liver, but the kidney has to help out with more blood cells!

Video Rationale