Mrs. F has a history of mild heart problems, but she has been admitted to the medical-surgical floor for management of her liver failure. She is a white-haired woman in her sixties with a puffy face, overweight, and presents with yellowish skin and sclera, mild generalized edema (swelling), spider nevi (broken capillaries), high blood pressure, increased respiratory rate, and a heart rate of 59 bpm (normal is 60-100 bpm). When you ask whether she has noticed any changes lately, Mrs. F complains about dizziness and lightheadedness. She also mentions weight gain and that her slacks are too tight. She says “They told me this disease would interfere with my digesting lipid, so I thought I'd lose weight!”How is the liver related to lipid digestion?A. The liver creates lipocytes, which are cells that store lipids.B. The liver creates bile, a soapy compound that emulsifies lipids.C. The liver creates vitamin K, which is needed for lipid absorption.D. The liver creates digestive enzymes, which are needed to break down lipids.Question 2.One of the liver’s functions is the production of bile, which helps emulsify lipids in the intestinal contents so they can be effectively digested.Is there any reason to think Mrs. F’s liver is not performing this function?Choose the answer that best describes the evidence for altered bile production.A. Mrs. F’s yellowish skin and sclerae indicate that bilirubin is depositing in her skin instead of being made into bile by the liver.B. Mrs. F’s spider nevi indicate a problem with her hemoglobin.C. Mrs. F’s weight gain indicates that she is not producing enough bile to regulate lipid digestion.D. Mrs. F’s high blood pressure indicates that the liver is not producing enough bile for her vessels to vasodilate.Question 3: Mrs. F’s blood work has come back and shows that she has low plasma osmolarity and decreased levels of plasma proteins and plasma K+. You can see how plasma proteins are related to her liver failure, since the liver synthesizes plasma proteins. But why does she have low K+ levels?Which of the liver functions below is most likely to affect Mrs. F’s K+levels?A.The liver creates lipoproteins.B. The liver destroys aldosterone.C. The liver converts ammonia to urea.D. The liver stores and releases glucose.E. The liver makes bile, which is needed to absorb lipid-soluble vitamins.Question 4. (This one can have multiple answers). Mrs. F has spider nevi, broken skin capillaries. Normally, broken skin capillaries do not cause visible blemishes, but hers are bleeding more than usual. Could this be due to her liver problems?Which of the liver functions below is most likely to affect Mrs. F’s clotting?A. The liver stores and releases glucose.B. The liver destroys aldosterone.C. The liver creates many plasma proteins.D. The liver detoxifies many medications.E. The liver makes bile, which is needed to absorb lipid-soluble vitamins.Question 5. As Mrs. F stands up, you notice that she is limping. She tells you that she banged her foot against a chair several days ago, and it is still sore. When you examine it, you see a swollen, dark purple little toe on her right foot.What is the significance of this sign?What further assessment would be most appropriate for Mrs. F’s bruised toe?A. It may indicate an inner ear problem, so she should be referred to an ear, nose, and throat specialistB. It may indicate a cerebellar problem, so she should have a CAT scan.C. It might indicate that she is a drinker, so she should be tested with a breathalyzer.D. She may have trouble absorbing calcium, so you should check to see if the toe is broken.E. It was just a random accident, but her liver’s ability to metabolize painkillers should be assessed before treating it