Synonym/Acronym
NH3.
Rationale
To assist in diagnosing liver disease such as hepatitis and cirrhosis and evaluating the effectiveness of treatment modalities. Also used to assist in diagnosing infant Reye syndrome.
Patient Preparation
There are no food, fluid, or medication restrictions unless by medical direction. Smoking should be restricted for 8 hr prior to the study.
Normal Findings
Method: Enzymatic.
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Study type: Blood collected in completely filled lavender- [EDTA] or green-top [Na or Li heparin] tube; related body system: . Specimen should be transported tightly capped and in an ice slurry.
Blood ammonia (NH3) comes from two sources: deamination of amino acids during protein metabolism and degradation of proteins by colon bacteria. The liver converts ammonia in the portal blood to urea, which is excreted by the kidneys. When liver function is severely compromised, especially in situations in which decreased hepatocellular function is combined with impaired portal blood flow, ammonia levels rise. Inherited enzyme defects that prevent the breakdown of ammonia or conditions that affect the ability of the kidneys to excrete ammonia can also result in increased blood levels. Ammonia is potentially toxic to the central nervous system and may result in encephalopathy or coma if toxic levels are reached.
Factors That May Alter the Results of the Study
Increased In
Decreased In
N/A
Potential Nursing Problems: Assessment & Nursing Diagnosis
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Before the Study: Planning and Implementation
Teaching the Patient What to Expect
After the Study: Implementation & Evaluation Potential Nursing Actions
Avoiding Complications
Skin
Treatment Considerations
Bleeding
Safety Considerations
Confusion
Fall, Risk
Fatigue
Nutritional Considerations
Clinical Judgement
Follow-Up and Desired Outcomes