Chapter 6 - Adult Health

Hepatitis D

Spread through blood products and unprotected sex with an infected person

Hepatitis B

Spread through body fluids, urine,semen, from mother to infant soon or right after birth. Symptoms; abdominal pain, jaundice, nausea, vomiting, fever, joint pain

What instructions should be given to someone taking the prescription sucralfate?

Take the medication 1 hours before meals

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

Buring on urination

What interventions should be included in the plan of care for a client who has cirrhosis of the liver?

Implement fall precautions, initate a low sodium diet, measure abdominal girth daily.

What do ulcerative colitis and Chron's disease share?

Both illnesses are inflammatory in nature

Which lab test would you expect from a client with chronic kidney disease?

BUN 35 mg/dL, serum creatinine 8 mg/dL

Which activity can spread hepatitis A?

Eating uncooked foods

A client has just been diagnosed with acute pyelonephritis. What education would the nurse offer this client regarding fluids?

Significantly increase fluid intake

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

"It is ok to warm the dialysate in a microwave."

A nurse is planning a low-protein diet for a client who has chronic renal failure. The client states, "Why do I have to be concerned with protein?" Which of the following responses is appropriate?

"Protein breakdown produces waste product that can build up in your body."

How long is the continuous ambulatory peritoneal dialysis?

24 hours, 7 days a week

Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following?

Ammonia

When caring for a client with cirrhosis, which symptom(s) should the nurse report immediately?

Change in mental status

A client with a feeding tube is to receive medication. The medication supplied is an enteric-coated tablet. Which of the following would be most appropriate?

Check with the pharmacist to see if a liquid form is available

Which of the following manifestations of colitis can result from anemia?

Chronic blood loss

What type of medication should the nurse administer to a client experiencing an acute exacerbation of ulcerative colitis.

Corticosteroid medication

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic?

Current medication use

Which nursing assessment is most important in a client diagnosed with ascites?

Daily measurement of weight and abdominal girth

Which laboratory reports for a client who has cirrhosis should the nurse expect?

Decreased platelets

What do you look for when assessing an African American with possible jaundice?

Hard palate

Which type of jaundice is the result of increased destruction of red blood cells?

Hemolytic

A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms?

Keep a 1-2 week symptom and food diary to identify food triggers

A nurse is assisting with the care of a client who has cirrhosis of the liver with ascites. Which of the following actions should the nurse take?

Measure the client's abdominal girth every 8 hours.

pH: 7.26, PacO2: 30mm Hg HCO3: 14 mEq/L - Which acid-imbalances does this indicate?

Metabolic acidosis

What is a hallmark of the diagnosis of nephrotic syndrome?

Protein in the urine (proteinuria)

What type of diet should someone with Chron's disease eat?

low fat, low fiber, and high protein diet with restricted lactose intake.

Which of the following statements made by the client should the nurse identify as being consistent with peptic ulcer disease?

"I feel so much better after eating."

What following statements by a patient with chronic renal failure would be considered anticipatory grief?

"I just can't believe that my whole life is going to be ruined by dialysis."

A client returns to the floor after a laparoscopic cholecystectomy. The nurse should assess the client for signs and symptoms of what serious potential complication of this surgery?

Bile duct injury

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which characteristic would the nurse be most likely to find?

Black and tarry appearance

What foods should someone with Chron's disease include in their diet?

Grilled chicken breast

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

Increased serum creatinine level

What does a purple colored stoma indicate?

Obstruction of blood flow to the stoma and is a medical emergency.

What do foods high in potassium do to a client with chronic kidney disease?

Potassium levels can increase dangerously high with impaired kidney function.

Ways to prevent hepatitis A

Proper hand washing

What food choice would be good for someone with cholecystitis?

Roast turkey

A nurse is assisting in the post-dialysis plan of care for a client who is receiving hemodialysis treatment for chronic kidney disease. Which of the following interventions should the nurse include in the plan of care?

Monitor the client for bleeding

Hepatitis C

Most commonly spread by exposure to contaminated blood or needles. Increase risk for liver cancer.

What is a risk factor for contracting hepatitis c?

Multiple tattoos

A nurse is reinforcing discharge about self-administered peritoneal dialysis. Which of the following statements indicates an understanding?

"The amount of liquid output should be greater than what was put in it."

A client's NG tube has become clogged after the nurse instilled a medication that was insufficiently crushed. The nurse has attempted to aspirate with a large-bore syringe, with no success. What should the nurse do next?

Attach a syringe filled with warm water and attempt to in-and-out motion or aspirating.

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client?

Infection typically occurs due to ingestion of contaminated food and water

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

Inflammation of all layers of intestinal mucosa

What is used to decrease potassium level seen in acute renal failure?

Sodium polystyrene sulfonate

Hepatitis E

Spread by fecal/oral route. Causes acute hepatitis, which usually goes away on its own.

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?

The kidneys can improve over a period of months

A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response?

"You may have eaten contaminated restaurant food."

How long should metformin be held prior to using IV contrast?

24 to 48 hours prior to the procedure.

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

Alcohol abuse and smoking

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan?

Assess the AV fistula for a bruit and thrill

Which of the following terms describes the involuntary flapping movements of the hands associated with metabolic liver dysfunction?

Asterixis

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?

Azotemia

Why should you monitor the client for bleeding following hemodiaysis treatment?

Because heparin is given during the treatment and places the client at risk for bleeding.

A client who has suffered with recurrent renal calculi has learned that the stones were composed of calcium oxalate. In providing dietary education to this client, which food contains the highest levels of oxalate and should be limited?

Chocolate

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?

Decrease in the blood flow through the kidneys

The physician orders cholestyramine for a client with cirrhosis. The nurse determines that the drug is effective when the client exhibits which of the following?

Decreased complaints of pruritis

What does low-fat foods do to the gallbladder?

Decreases stimulation of the gallbladder, thereby reducing associated symptoms.

What is an adverse side effect for the prescription lactulose (given to a person with cirrhosis)

Diarrhea

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?

Diminshed erythroproitein production

What laboratory findings indicates that the client's GI tract is digesting and absorbing blood?

Elevated BUN

Expected lab values for a client with chronic kidney disease.

Elevated creatinine

A client has been admitted to the renal unit of the hospital with acute pyelonephritis, and is undergoing parenteral antibiotic treatment. What signs and symptoms would this client exhibit?

Flank pain, elevated temperature, malaise

What types of foods should a client with chronic kidney disease try to reduce?

Foods high in potassium

What does elevated creatinine indicate?

Founded in chronic renal failure because of gradual damage to kidneys that occur over time.

A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray?

Fried Chicken

What is a risk factor for peptic ulcers?

History of ibuprofen use

A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action?

Inform the health care provider and assess the client for signs of infection

A client with decreased renal function is to receive a low-protein diet. The client asks the nurse why he needs this type of diet. The nurse would incorporate which reason into the response?

Lessen workload on the kidneys

Which medication should be held prior to completing radio-logical studies of the kidneys performed which use IV contrast dye?

Metformin

A client is being treated for renal calculi and suspected hydronephrosis. Therefore, the nurse should maintain a record of the kidney's function. Which of the following measures can the nurse take to help achieve the objective?

Monitor intake and output

The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated?

Obtaining a blood pressure reading from the right arm

Which of the following medications is classified as a proton pump inhibitor (PPI)?

Omprazole

Foods that are high in potassium that someone with chronic kidney disease should avoid

Orange juice and bananas

When assessing the impact of medications on the etiology of acute renal failure, the nurse recognizes which of the following as the drug that is not nephrotoxic?

Penicillin

Which is an expected finding of end-stage kidney disease?

Pruritus

A nurse is collecting data from a client who is 12 hr post-op following a colectomy with colostomy placement. Which of the following should the nurse report to the provider?

Purplish colored stoma

Where should the nurse palpate to monitor for pain at McBurney's point?

RLQ

Potential causative factor for acute kidney injury?

Recent CT scan with contrast dye

A nurse educator is teaching a group that specializes in liver disorders. Which of the following is an important education topic regarding ingestion of medications?

The effect of liver problems on medication metabolism

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem?

Ulcerative colitis

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?

Urinary calculi

Ways to prevent hepatitis B

Vaccinations

A nurse is reinforcing teaching with a client who has received treatment for kidney stones. The nurse should remind the client to increase intake of what?

WATER

A nurse is collecting data from a client who has acute appendicitis. Which of the following findings should the nurse ecpect?

WBC 17,000/mm

A nurse is reinforcing teaching about cimetidine with a client who has peptic ulcer disease. Which of the following information should the nurse include in the teaching?

Wait at least 1 hour after taking the medication before taking an antacid.

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:

Water and sodium retention secondary to a severe decrease in the glomerular filtration rate

Hepatitis A

a form of viral hepatitis transmitted in food or an infected persons feces, causing fever, dark urine, light stool, jaundice