Patient Data Exhibits Initial testing is complete, and the nurse reviews the laboratory and imaging results. Choose the most likely options for the information missing from the statements by selecting from the lists of options provided. The nurse recognizes that the client likely has dropdown. Laboratory findings that support diagnosis of this disease process include dropdown and dropdown.

Rationale for Correct Choices: Alcoholic cirrhosis: The client has a history of chronic heavy alcohol use, jaundice, RUQ tenderness, a distended abdomen, and abnormal liver ultrasound findings, all consistent with alcoholic cirrhosis. The presence of regenerative nodules and a nodular liver surface on imaging further supports this diagnosis. Aspartate aminotransferase (AST): The AST is elevated at 120 U/L (normal range: 10–40 U/L), which commonly occurs in alcoholic liver disease. In alcoholic cirrhosis, AST levels often exceed ALT and indicate ongoing hepatocellular injury. Ammonia: The client’s ammonia level is elevated at 90 mcg/dL (normal: 15–45 mcg/dL), suggesting impaired hepatic clearance and early signs of hepatic encephalopathy, both seen in advanced liver disease such as cirrhosis. Rationale for Incorrect Choices: Acute pancreatitis: The client does not report severe epigastric pain radiating to the back, which is typical for pancreatitis. There is also no elevation of serum lipase or amylase, and imaging does not show pancreatic inflammation or edema. Hepatitis A: Hepatitis A usually presents with acute onset of symptoms like fever, malaise, and dark urine. It is typically short-term and not associated with the chronic liver changes (nodular liver, regenerative nodules) found in this client. Chloride: While slightly elevated, the chloride level is not specific to liver disease and has minimal diagnostic value in cirrhosis. It is not typically used as a marker for hepatic dysfunction or alcoholic liver disease. White blood cell count: The WBC count is elevated (16,000/mm³), but this can be attributed to various causes such as inflammation or infection. It does not specifically support the diagnosis of cirrhosis like AST and ammonia levels do.