Case Study num33

Mrs. F has a history of mild heart problems, but she has beenadmitted to the medical-surgical floor for management of her liverfailure. She is a white-haired woman in her sixties with a puffyface, overweight, and presents with yellowish skin and sclera, mildgeneralized edema (swelling), spider nevi (broken capillaries),high blood pressure, increased respiratory rate, and a heart rateof 59 bpm (normal is 60-100 bpm). When you ask whether she hasnoticed any changes lately, Mrs. F complains about dizziness andlightheadedness. She also mentions weight gain and that her slacksare too tight. She says “They told me this disease would interferewith my digesting lipid, so I thought I'd lose weight!”

1. How is the liver-related to lipiddigestion?

2. Can you see any evidence that the liver is failing toperform this role in Mrs. F?

3. Mrs. F’s blood work has come back and shows that shehas low plasma osmolarity and decreased levels of plasma proteins.The doctor says “this explains her edema!” How are plasma proteinsrelated to edema?

4. Mrs. F has spider nevi, broken skin capillaries.Normally, broken skin capillaries do not cause visible blemishes,but hers are bleeding more than usual. Could this be due to herliver problems?