Liver and Obesity EAQs

a client diagnosed as having the hepatitis B virus (HBV). The nurse reviews the client's health history for situations in which exposure may have occurred. Which event does the nurse determine is most likely the source of this infection? (A) the client received a small tattoo on the arm 3 months ago; (B) the client assisted in the emergency birth of a baby 2 weeks ago; (C) The client worked for a month in an underdeveloped area in a foreign country 4 months ago; (D) The client attended an ecological conference in a large urban center 2 months ago.

(a) The client received a small tattoo on the arm 3 months ago... Any situation in which a needle is inserted under the skin is a potential source of hepatitis. Hepatitis B is transmitted through blood and secretions, not contaminated water or by casual proximity to others. .

avoiding shellfish in the diet limits the risk for contracting which type of Hepatitis

A

Which type of hepatitis is commonly spread by consuming contaminated food and water or by fecal contamination?

A and E.

which type of hepatitis develops into a chronic form of the disease?

B, C, D.

with cirrhosis there is a comprise in the storage of

DEKA and B complex and folic acid as well as iron

which hepatitis is associated with possible contaminated food, water, traveling

Hepatitis A.

which effect would the nurse anticipate when preparing to administer IV albumin to a client with ascites?

Intravascular fluid volume will increase. Serum albumin is administered to maintain blood volume and normal oncotic (osmotic) pressure; it does this by pulling fluid from the interstitial spaces into the intravascular compartment; this can potentially increase the blood pressure.

which response would the nurse give to the parents of a child diagnosed with hepatitis A who express concern that other family members may contract hepatitis because they only have one bathroom?

all family members, including your child, need to wash their hands after using the bathroom.

after a subtotal gastrectomy, a client demonstrates signs of dumping syndrome. About 90 minutes after initial attack, the client reports feeling shaky. Which would the nurse determine is the cause of the latter effect?

an overproduction of insulin that occurs in response to the rise in blood glucose-- the rapid absorption of carbohydrates from the food mass causes an elevation of blood glucose, and the insulin response often causes transient hypoglycemic symptoms.

shiny and taut abdomen

ascites

discharge instructions to a client diagnosed with cirrhosis and varices.

avoiding aspirin and aspirin-containing products; abstain from alcohol; avoid acetaminophen and products containing acetaminophen. Also, avoid coughing, sneezing, and straining to have a BM.... these activities increase pressure in the portal venous system and increase the client's risk of variceal hemorrhage. A high carbohydrate diet is encouraged as the diseased liver's ability to synthesize and store glucose is diminished.

which condition is it most important for the nurse to assess for in a client admitted to the hospital for acute gastritis and ascites secondary to alcohol use and cirrhosis?

blood in the stool. erosion of blood vessels may lead to hemorrhage, a life-threatening situation further complicated by decreased prothrombin production, which occurs with cirrhosis.

the nurse designs a health education program specifically for a client who had a gastrectomy. The plan would include which information?

explanation about how to limit and prevent dumping syndrome. Symptoms of dumping syndrome occur to some degree in about 50% of all individuals who have undergone a gastrectomy. They include weakness, syncope, palpitations, diaphoresis, nausea, diarrhea. It is important to explain to the client that such symptoms can be minimized by reclining after meals, eating small meals, and omitting concentrated and highly refined carbs. Eating habits must be modified to prevent rapid emptying of the stomach.

which condition would be prevented by the addition of spironolactone to the medication regimen of a client with cirrhosis of the liver who has been taking chlorothiazide?

hypokalemia. spironolactone stimulates sodium excretion and prevents excretion of potassium.

increased serum albumin causes

hypovolemia.

a client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

institute fall prevention and safety measures-- high ammonia levels contribute to deterioration of mental function and then to hepatic encephalopathy and hepatic coma; SAFETY IS A PRIORITY.

anastomotic leakage is caused by

leakage around, or separation of, sutures or staples where the stomach is stapled or the loop of jejunum is anastomosed to a new outlet from the stomach, or where it is attached to the proximal jejunum.

which client factors would the nurse consider to have the greatest effect on the effectiveness of bariatric surgery?

motivation to cooperate with required lifestyle changes. Bariatric surgery requires the client to engage in significant postop lifestyle changes (radially modifying habits, taking nutritional supplements, meeting numerous emotional challenges, engaging in exercise); clients who cannot cooperate with the postoperative program are not considered candidates for bariatric surgery.

should you wear a mask for contact precautions when dealing with feces/urine of hepA patients?

no. hepatitis is not transmitted via the airborne route, so a mask is not necessary.

does appetite increase with cirrhosis?

no. the appetite decreases because of the pressure on the abdominal organs from the ascites and the liver's decreased ability to metabolize food.

When should Immunoglobin to prevent infection with hepatitis A be given?

once exposure to the virus has already occur in order to prevent getting the virus.

vitamin K name

phytonadione

meal considerations for pts with cirrhosis

pt with cirrhosis and ascites will require moderate to low fat and low sodium intake (penne pasta, spinach, banana, and decaffeinated iced tea).

which precautions are used for hepatitis A and when?

standard precautions and contact precautions (gown, NO mask, and gloves) when handling articles contaminated by urine and feces.

obstructive jaundice occurs because

the bile duct becomes obstructed and bile enters the bloodstream.