Liver Function/Hepatic Panel

Question 1

Liver Function/Hepatic Panel =

Answer 1

Assesses the liver’s ability to clear bilirubin, total
protein, and albumin

Question 2

Serum Albumin half-life and Reference Ranges =

Answer 2

Half-life of 21 days

3.5-5.2 g/dL

Question 3

Serum Prealbumin half-life and Reference Ranges =

Answer 3

Half-life 2 days; detects current nutritional status within a patient’s body

19-39 mg/dL

Question 4

Serum Prealbumin protein depletion ranges =

Answer 4

0-5 mg/dL = severe
protein depletion

5-10 mg/dL = moderate protein depletion

10-15 mg/dL (mild protein depletion)

Question 5

Serum Albumin & Serum Prealbumin Trending Upward

causes =

Answer 5

Severe infections
Congenital disorders
Severe dehydration
Hepatitis
Chronic inflammation Tuberculosis
Overdose of cortisone medications
CHF
Renal Disease Cancer

Question 6

Serum Albumin & Serum Prealbumin Trending Upward

presentation =

Answer 6

Clinical features are dependent on the cause (i.e. renal, cardiac, TB, etc.

Question 7

Serum Albumin & Serum Prealbumin Trending Upward

Clinical Implications =

Answer 7

Assess integumentary daily

Collaborate with the interprofessional team regarding nutrition

Question 8

Serum Albumin & Serum Prealbumin Trending Downward

causes =

Answer 8

Infection
Nutritional compromise Inflammation
Liver disease
Crohn’s disease
Burns
Malnutrition
Thyroid disease2

Question 9

Serum Albumin & Serum Prealbumin Trending Downward

presentation =

Answer 9

Peripheral edema
Non-healing wound Hypotension

Question 10

Serum Albumin & Serum Prealbumin Trending Downward

clinical implications =

Answer 10

Low levels occur with prolonged hospital stay

Serum Albumin: < 3.0 g/dL nutritionally compromised

< 2.8 g/dL generalized symmetrical peripheral edema, poor wound healing, potential drug toxicity

Serum Pre-Albumin: < 10 g/dL significant nutritional risk, poor wound healing, generalized edem

Question 11

Serum Bilirubin Reference
Ranges =

Answer 11

0.3-1.0 mg/dL

Critical value: > 12 mg/dL

Question 12

Serum Bilirubin Trending Upward

causes =

Answer 12

Cirrhosis
Hepatitis
Hemolytic anemia
Jaundice
Transfusion reaction
Bile duct occlusion Chemotherapy

Question 13

Serum Bilirubin Trending Upward

presentation =

Answer 13

Patients with severe disease might have fatigue, anorexia, nausea, fever, and, occasionally, vomiting

Might have loose, fatty stools

Question 14

Serum Bilirubin Trending Upward

clinical implications =

Answer 14

Patients with advanced disease are at risk for osteoporosis and bleeding due to deficiencies of fat soluble vitamins

Question 15

Ammonia (NH3) Reference
Ranges =

Answer 15

15-60 μg/dL

Evaluates liver function and metabolism. The liver converts ammonia from blood to urea. If the liver is damaged, then increased ammonia levels are noted.

Question 16

Ammonia (NH3) Trending Upward

causes =

Answer 16

Cirrhosis
Severe hepatitis
Reye’s syndrome
Severe heart disease
Kidney failure
Severe bleeding of stomach
or intestines (GI system)

Question 17

Ammonia (NH3) Trending Upward

presentationHepatic encephalopathy Confusion
Lethargy
Dementia
Daytime sleepiness Tremors Breakdown of fine
motor skills Numbness and tingling
(peripheral nerve
impair)
Speech impairment =

Answer 17

Hepatic encephalopathy Confusion
Lethargy
Dementia
Daytime sleepiness
Tremors
Breakdown of fine
motor skills
Numbness and tingling
(peripheral nerve impair)
Speech impairment

Question 18

Ammonia (NH3) Trending Upward

clinical implications =

Answer 18

Might need to alter communication and education, and designate patient as an increased fall risk, if encephalopathy present

Question 19

Model for End-Stage Liver Disease (MELD) and MELD-Na =

Answer 19

predicts the survival for adult patients with advanced liver disease.