Which specific drug therapy will the nurse anticipate for management of the client who has septic shock?

Choice A reason: Increased serum calcium is not typically associated with advanced liver disease. Hypercalcemia (increased serum calcium) may be seen in conditions like hyperparathyroidism, certain cancers, or excessive vitamin D intake, but it is not a common finding in liver disease.

Choice B reason: Decreased serum ammonia is also not associated with advanced liver disease. In fact, patients with liver disease often have increased serum ammonia levels due to the liver's inability to effectively detoxify ammonia into urea. Elevated ammonia can lead to hepatic encephalopathy, a serious complication of liver disease.

Choice C reason: Increased ALT and AST are common laboratory findings in advanced liver disease. These liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are released into the bloodstream when liver cells are damaged or inflamed. Elevated levels indicate liver injury or dysfunction and are often used to assess the extent of liver disease.

Choice D reason: Decreased albumin is a typical finding in advanced liver disease. Albumin is a protein produced by the liver, and its levels drop when the liver is no longer able to synthesize it effectively. Low albumin levels can lead to edema and ascites due to decreased oncotic pressure in the blood vessels.

Choice E reason: Elevated bilirubin is expected in advanced liver disease. Bilirubin is a byproduct of red blood cell breakdown that is normally processed and excreted by the liver. When liver function is impaired, bilirubin accumulates in the blood, leading to jaundice, characterized by yellowing of the skin and eyes.

Choice F reason: Elevated prothrombin time (PT) is a common finding in advanced liver disease. The liver produces clotting factors necessary for blood coagulation, and when it is damaged, these factors are not produced adequately, leading to prolonged PT. This indicates a higher risk of bleeding and impaired clotting function.

Choice A reason: While performing a daily full head-to-toe assessment is important in comprehensive patient care, this answer does not specifically address why the nurse would be particularly concerned with assessing the abdomen in a burn patient.

Choice B reason: Assessing for a paralytic ileus secondary to reduced blood flow is crucial in patients with serious burns. Burns can lead to significant physiological stress, which can decrease blood flow to the gastrointestinal tract. This reduction in blood flow can cause a paralytic ileus, a condition where the intestines do not move properly, leading to abdominal distention, pain, and decreased bowel sounds. Early detection is vital to prevent complications.

Choice C reason: While nausea and vomiting related to pain medication are possible in burn patients, the primary concern in assessing the abdomen would be to identify more serious conditions such as a paralytic ileus. This answer does not capture the immediate criticality compared to assessing for paralytic ileus.

Choice D reason: Monitoring for increased motility that may result in cramps and diarrhea is not the primary concern in burn patients. In fact, burn patients are more likely to experience decreased gastrointestinal motility due to the stress response and reduced blood flow rather than increased motility.