A patient with acute hepatic dysfunction demonstrates slow slurred speech and cold clammy skin. Which of the following should the nurse suspect is occurring with this patient?
1. increased ammonia level
2. hypoglycemia
3. cerebral embolism
4. bleeding esophageal varices
2
Rationale: Since liver failure interferes with normal carbohydrate metabolism, the patient may develop hypoglycemia secondary to decreased gluconeogenesis. The patient should be closely monitored for the development of hypoglycemic symptoms which include slow thinking, slurred speech, nervousness, tachycardia, and cold clammy skin. The symptoms that the nurse assessed in the patient do not indicate an increased ammonia level, a cerebral embolism, or bleeding esophageal varices.
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