A client with liver cirrhosis has been advised to follow a high-protein diet. The nurse evaluates the effectiveness of the diet if the total protein level is which of the following values?
A. 6.9 g/dL.
B. 4.9 g/dL.
C. 2.9 g/dL.
D. 0.9 g/dL.
Correct Answer: A. 6.9 g/dL.
The normal value for total serum protein is 6 to 8 g/dL. The client with liver cirrhosis has low total protein levels secondary to inadequate nutrition. Protein deficiency is often associated with liver disease. The principal cause of protein deficiency is decreased dietary intake. Deficiencies in digestion and absorption that are common in alcoholics contribute to protein deficiency in alcoholic liver disease.
Option B: 4.9 mg/dl is a low value for total serum protein. The protein requirements in most patients with compensated chronic liver disease are not different from normal but increase during episodes of hepatocellular deterioration. Increased demand for protein after liver injury drains nitrogen from other organs such as muscle.
Option C: 2.9 mg/dl is a very low total serum protein level. Circulating proteins synthesized by the liver, such as albumin and clotting factors, are frequently decreased in chronic liver disease. Vitamin deficiencies that are common in liver disease contribute to abnormalities of protein metabolism. Hepatic regeneration following hepatic resection or injury is adversely affected by protein and vitamin deficiencies and by alcohol ingestion.
Option D: 0.9 mg/dl is an abnormally low total serum protein value. This is because some conditions affect the amounts of albumin or globulin in the blood. A low A/G ratio may be due to an overproduction of globulin, underproduction of albumin, or loss of albumin, which may indicate the following: an autoimmune disease. cirrhosis, involving inflammation and scarring of the liver.