Chapter 58, Care of Patients with Liver Problems

A patient diagnosed with hepatitis A asks the nurse how this disease may have been contracted. Which answer by the nurse is correct?

"You may have consumed foods contaminated with the virus.

A patient with Laennec's cirrhosis has an increased abdominal girth of 12 cm over the measured abdominal girth from a previous admission. Which condition does the nurse suspect in this patient?

Ascites

A patient who has liver disease has undergone a percutaneous needle biopsy. Which is the priority nursing assessment for the patient after this procedure?

Assess for bleeding

The nurse asks a patient with liver disease to raise the arms to shoulder level and dorsiflex the hands. A few moments later, the hand begins to flap upward and downward. How does the nurse correctly document this in the medical record?

Asterixis

The nurse is assessing diagnostic test results for a patient with hepatitis. Which elevated test result does the nurse correlate to the presence of jaundice?

Bilirubin

When providing dietary teaching to a patient with hepatitis, what practice does the nurse recommend?

Consuming increased carbohydrates and moderate protein

When caring for a patient with Laennec's cirrhosis and portal hypertension, which point is essential for the nurse to emphasize to the patient and family?

Do not consume alcohol

The nurse is caring for a patient with cirrhosis and profound ascites. Which assessment finding causes the nurse to notify the provider?

Inaudible breath sounds

Which statement about hepatitis A is accurate?

It is transmitted by the fecal-oral route.

The nurse teaches a patient with hepatic encephalopathy that certain food should be consumed in moderation while the patient's serum ammonia level is elevated. Which food does the nurse instruct the patient to limit?

Lean meats

What teaching does the home health nurse give the family of a patient with hepatitis C to prevent the spread of the infection?

Members of the household must not share toothbrushes.

The community health nurse is exploring the cause of an outbreak of hepatitis A. Which individual does the nurse suspect may be the source?

Patients who were infected after eating at the same restaurant

Which problem for a patient with cirrhosis takes priority?

Potential for injury related to hemorrhage

The nurse administers lactulose to a patient with cirrhosis for which purpose?

Promotes gastrointestinal excretion of ammonia

A patient with a history of esophageal varices has just been admitted to the emergency department after vomiting a large quantity of blood. Which action does the nurse take first?

Pulse and blood pressure

What is a feature of hepatic abscess?

Right upper abdominal pain is a common manifestation.

Which statement by a patient with cirrhosis indicates that further instruction is needed about the disease?

"My liver is scarred, but the cells can regenerate themselves and repair the damage.

When providing discharge teaching to a patient with cirrhosis, it is essential for the nurse to emphasize avoidance of which of these?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The RN has just received the change-of-shift report for the medical unit. Which patient should the RN see first?

Patient with portal-systemic encephalopathy (PSE) who has become increasingly difficult to arouse