Mr. V is a 55-year-old alcoholic who checked into a clinic, complaining that he has been experiencing a persistent cough and feeling more fatigued, nauseous, and irritable.

Mr. V is a 55-year-old alcoholic who checked into a clinic, complaining that he has been experiencing a persistent cough and feeling more fatigued, nauseous, and irritable. In addition, he is experiencing more frequent memory lapses. His stomach is distended, but on palpation, his liver is small in size and firm, indicating cirrhosis. Lab tests indicate a decrease in hemoglobin, albumin, and prothrombin levels with elevated serum bilirubin and ammonia levels.

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1. Describe the various stages through which Mr. V’s liver has progressed and the implications of the current stage. (See Cirrhosis—Alcoholic Liver Disease.)

2. Provide a specific rationale for each of Mr. V’s manifestations and blood values. (See Alcoholic Liver Disease—Pathophysiology, Signs and Symptoms.)

3. a. Is it possible to reverse the damage to the liver at this stage? What is the prognosis? b. Choose four significant complications that are likely to occur, and discuss the predisposing factors and effects on the liver. (See Pathophysiology and Treatment.)