The nurse is caring for a client with right upper quadrant pain and jaundice. The client's alanine aminotransferase /aspartate aminotransferase (ALT/AST) levels are 7 times the normal values. What questions would be most helpful regarding the etiology for these findings? Select all that apply.

Question

Quizplus · Accepted Answer

ALT and AST are the enzymes released when hepatic cells are injured (hepatitis). There are smaller amounts in the cardiac, renal, and skeletal tissues, but ALT/AST are used to diagnose hepatic disorders. Besides viral hepatitis, liver injury can occur with excessive chronic alcohol intake (Option C), some over-the-counter medications (eg, acetaminophen), and certain herbal and dietary supplements (Option E). IV illicit drug use increases the risk for hepatitis B and C infection (Option B). (Option A) Black tarry stool (melena) is an expected finding from a gastrointestinal bleed (from the digested blood). Melena can be seen in clients with gastric or esophageal varices, which are often complications of hepatic disease (eg, cirrhosis). However, melena is not an etiology of liver injury. (Option D) Immunizations do not cause liver damage. It is possible to get a small elevation with an intramuscular injection, but not values this high. Educational objective: ALT/AST are enzymes indicating liver injury. Besides the obvious viral hepatitis, it can result from excess chronic alcohol intake or some over-the-counter drugs, including acetaminophen.

The Nurse Is Caring for a Client with Right Upper