Prep U: Liver
The nurse is preparing to interview a client with cirrhosis. Based on an understanding of this disorder, which question would be most important to include?
"How often do you drink alcohol?"
A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?
A liver biopsy
A nurse is taking health history data from a client. Use of which of the following medications would especially alert the nurse to an increased risk of hepatic dysfunction and disease in this client? Select all that apply.
Acetaminophen Ketoconazole Valproic acid
What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention?
Albumin infusion
A local public health nurse is informed that a cook in a local restaurant has been diagnosed with hepatitis A. What should the nurse advise individuals to obtain who ate at this restaurant and have never received the hepatitis A vaccine?
An immune globulin injection
The nurse is assessing a client with cirrhosis of the liver. Which stool characteristic would the nurse expect the client to report?
Clay-colored or whitish
The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?
Hemolytic
Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia?
Hypotension
Which of the following laboratory test results would the nurse associate with obstructive jaundice?
Increased direct bilirubin
A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?
Loss of 2.2 lb (1 kg) in 24 hours
The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient?
Respiratory assessment related to increased thoracic pressure
Which of the following diagnostic studies definitely confirms the presence of ascites?
Ultrasound of liver and abdomen
A client has received a diagnosis of portal hypertension. What does portal hypertension treatment aim to reduce? Select all that apply.
fluid accumulation venous pressure
A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications?
metabolism of medications
Which of the following is the most effective strategy to prevent hepatitis B infection?
vaccine
The nurse is preparing a care plan for a client with hepatic cirrhosis. Which nursing diagnoses are appropriate? Select all that apply.
Disturbed body image related to changes in appearance, sexual dysfunction, and role function Activity intolerance related to fatigue, general debility, muscle wasting, and discomfort Risk for injury related to altered clotting mechanisms
A client with hepatitis C develops liver failure and GI hemorrhage. The blood products that most likely bring about hemostasis in the client are:
cryoprecipitate and fresh frozen plasma.
A client with advanced cirrhosis has a prothrombin time (PT) of 15 seconds, compared with a control time of 11 seconds. The nurse expects to administer:
phytonadione (Mephyton).
The nurse is caring for a client suspected of having stones that have collected in the common bile duct. What test should the nurse prepare the client for that will locate these stones?
Endoscopic retrograde cholangiopancreatography (ERCP)
During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus?
Following proper hand-washing techniques
A patient who had a recent myocardial infarction was brought to the emergency department with bleeding esophageal varices and is presently receiving fluid resuscitation. What first-line pharmacologic therapy does the nurse anticipate administering to control the bleeding from the varices?
Octreotide (Sandostatin)
Which is the most common cause of esophageal varices?
portal hypertension
