Lenny Levitt, a 49-year-old carpenter, has just been diagnosed with cirrhosis, which is a consequence of his alcohol abuse over the past 25 years

Lenny Levitt, a 49-year-old carpenter, has just been diagnosed with cirrhosis, which is a consequence of his alcohol abuse over the past 25 years. Although he understands that he has an alcohol problem and recently entered an alcohol rehabilitation program, he is still drinking. At 5 feet 8 inches tall, Mr. Levitt, who formerly weighed 160 pounds, now weighs 130 pounds. According to family members, he is showing signs of mental deterioration, such as forgetfulness and an inability to concentrate. He is jaundiced and appears thin, although his abdomen is distended with ascites. Laboratory findings indicate elevated serum concentrations of AST, ALT, and ammonia; reduced albumin levels; and hyperglycemia.

3. Estimate Mr. Levitt’s energy and protein needs. Describe the general diet you might recommend for him. What suggestions do you have for increasing his energy intake?

4. Explain the significance of Mr. Levitt’s elevated blood ammonia levels. What are some signs that would indicate that he is undergoing mental decline?

5. Describe each of the following complications of liver disease: portal hyper-tension, jaundice, and gastroesophageal varices. What complication may result if the esophageal varices are not treated?