A client has jaundice and ascites. Which laboratory values indicate hepatic disease? (Select all that apply.)
a. Albumin, 2.0 g/dL
b. Potassium, 3.0 mEq/L
c. Alanine aminotransferase (ALT), 45 IU/L
d. Aspartate aminotransferase (AST), 45 U/L
e. Unconjugated (indirect) bilirubin, 1 mg/dL
f. Ammonia, 120 mg/dL
A, C, D, E, F
Decreased albumin and increased ALT, AST, unconjugated bilirubin, and ammonia all indicate hepatic disease. When the liver is damaged, albumin is not produced by the hepatic cells. ALT and AST liver enzymes increase with liver disease. Bilirubin, the primary component of bile, can be measured as direct or indirect and, if elevated, can indicate impaired secretion. Elevated levels of ammonia indicate severe hepatocellular damage. Decreased potassium does not indicate poss-ible liver involvement but can be reduced by vomiting and diarrhea.
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