Which assessment findings are expected in a patient experiencing a left hemispheric brain attack?

A. Administer some insulin: Insulin is not appropriate unless there is evidence of hyperglycemia, which is not suggested by the symptoms described.

B. Prepare the patient to receive a blood transfusion: The symptoms described are not indicative of a need for a blood transfusion but rather suggest adrenal insufficiency.

C. Administer IV glucose: Addisonian crisis can be triggered by stress and dehydration, leading to low blood sugar and symptoms such as weakness and confusion. Administering IV glucose can help manage hypoglycemia and provide immediate support.

D. Collect some urine and assess for glucosuria: The symptoms are more acute and related to adrenal insufficiency rather than glucosuria.

26. A patient is admitted to the emergency department (ED) following an overdose of acetaminophen (Tylenol) and is diagnosed with cirrhosis. Which laboratory finding is consistent with the diagnosis?

1. elevated serum protein hyperproteinemia
2. decreased serum liver enzymes (ALT).
3. elevated number of platelets thrombocytosis)
4. decreased level of clotting factors.

Correct answer:

A. Elevated serum protein hyperproteinemia: In cirrhosis, serum protein levels, particularly albumin, are often decreased due to impaired liver synthesis.

B. Decreased serum liver enzymes (ALT): In cirrhosis, liver enzyme levels such as ALT (alanine aminotransferase) are typically elevated due to liver damage and inflammation.

C. Elevated number of platelets (thrombocytosis): Cirrhosis often leads to thrombocytopenia (decreased platelet count) due to splenomegaly and decreased production of thrombopoietin.

D. Decreased level of clotting factors: The liver synthesizes most clotting factors, and in cirrhosis, the production of these factors is impaired, leading to decreased levels and increased bleeding risk.