You are the critical care nurse practitioner covering the ICU at a busy teaching hospital

Week 9-2 Question

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Week 9-2 Question

The differential diagnosis of liver failure includes Amanita phalloides mushroom poisoning, HELLP ( hemolysis, elevated liver enzyme, low platelets) syndrome of pregnancy, acetaminophen poisoning, alcoholic hepatitis, and Liver Cirrhosis due to alcohol (Berardi et al., 2020).
The potential risk factors for liver failure for this patient include a family history of liver disease, exposure to toxins or chemicals, type 2 diabetes, and obesity. One of the most probable risk factors is that the patient is abu
sing alcohol, hence a possibility of the condition (Berardi et al.,2020)
Appropriate diagnosis of acute liver failure requires diagnostic criteria. The diagnostic criteria are that a careful history must first be obtained, including a physical examination and various laboratory tests. As part of the laboratory tests, the aspartate aminotransferase is usually below 300 units/liter, while the alanine aminotransferase is usually 100 units/liter. The total bilirubin and alkaline phosphates are also measured (Zhao et al., 2018). The blood vessels and liver is also looked at using magnetic resonance imaging (MRI) or Abdominal Computerized Tomography (CT). The tests can be vital in looking at the acute liver failure causes.
The medical management of acute liver failure should consider various priorities. The management included supportive care, which requires prevention and managing complications and offering particular treatment upon knowing the etiology. The next aspect is determining the prognosis, which may even consider the liver transplantation process (Stravitz & Lee, 2019). I will also ensure that appropriate assessment is done regarding normal electrolytes, acid-base level maintenance, the need for intravenous fluids, and hemodynamic stability. The patient needed to start using proton pump inhibitors for prophylaxis of GI bleed. Besides, hypoglycemia should be monitored so that the blood glucose remains between 160 to 200
Pretransplant work-up for liver transplant includes an interview followed by a stress echocardiogram. Abdominal ultrasound and CT scan are then performed, while further MRI scan of the liver can be performed (Ahmad et el.,2018). Several blood tests are also performed. In addition, TB screening and the status of vaccinations are all checked.
Transfusions should be avoided in a potential transplant candidate since the process may heighten the risk of postoperative complications, patient mortality, graft failure, cytomegalovirus infection, respiratory complications, and longer hospital stays (Ahmad et el., 20

References

Ahmad, M., Mathew, J., Iqbal, U., & Tariq, R. (2018). Strategies to avoid empiric blood product administration in liver transplant surgery. Saudi Journal of Anaesthesia, 12(3), 450. https://doi.org/10.4103%2Fsja.SJA_712_17

Berardi, G., Tuckfield, L., DelVecchio, M. T., & Aronoff, S. (2020). Differential diagnosis of acute liver failure in children: A systematic review. Pediatric Gastroenterology, Hepatology & Nutrition, 23(6), 501. https://doi.org/10.5223%2Fpghn.2020.23.6.501

Stravitz, R. T., & Lee, W. M. (2019). Acute liver failure. The Lancet, 394(10201), 869–881.https://doi.org/10.1016/S0140-6736(19)31894-X

Zhao, R. H., Shi, Y., Zhao, H., Wu, W., & Sheng, J. F. (2018). Acute-on-chronic liver failure in chronic hepatitis B: An update. Expert Review of Gastroenterology & Hepatology, 12(4), 341–350. https://doi.org/10.1080/17474124.2018.1426459

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For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
Student paper example
Citing Sources
The Writing Center is a great resource