Liver Disease

Normal Serum Albumin

3.4 - 5.0 g/dL

Normal ALT

10-25 units/L

A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following is an expected lab finding? a. Presence of IGG antibodies b. Presence of enzyme immunoassay c. Aspartate aminotransferase (AST) 35 units/L d. Alanine aminotransferase (ALT) 15 IU/L

b. enzyme immunoassay a. IGG presence in hep A c. this finding is WNL d. this finding is WNL

Interferon alfa 2b has been Rx to treat a client with chronic hepatitis B. The nurse should assess the client for which of the following adverse effects? a. retinopathy b. constipation c. flu like symptoms d. hypoglycemia

c. Flu-like effects are most common adverse effects myalgia, arthralgia, headache, nausea, fever,and fatigue.

The nurse is doing d/c teaching for a client who has cirrhosis and ascites. Which of the following foods used by the client as snacks should the nurse instruct the client to avoid? a. whole wheat bread b. cookies c. potato chips d. hard candy

c. a low-sodium diet is recommended for clients who have cirrhosis and ascites.

The nurse is assessing a client who is in the early stages of cirrhosis of the liver. Which focused assessment is appropriate? a. peripheral edema b. ascites c. anorexia d. jaundice

c. early manifestations are subtle and are GI in nature anorexia, nausea, vomiting, and changes in bowel patterns

Normal Ammonia level

35 - 65 mcg/dL

Which of the following is normal for a client during the icteric phase of viral hepatitis a. tarry stool b. yellow sclera c. shortness of breath d. light, frothy urine

b. yellow sclera Liver inflammation and obstruction block the normal flow of bile. Excess bilirubin turns the skin and sclera yellow and the urine dark and frothy.

College freshman are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on: a. water sanitation b. single dormitory rooms c. vaccination for hep D d. safe sex practices

d. safe sex practices

Normal PT result

1.5 - 2.5 times the control

A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The nurse expects to assess for: Hand tremors. Malaise. Stomatitis. Weight loss.

Hand Tremors Hepatic encephalopathy results from the accumulation of neurotoxins in the blood; therefore, the nurse wants to assess for signs of neurological involvement. Flapping of the hands (asterixis), changes in mentation, agitation, and confusion are common. These clients typically have ascites and edema so they also experience weight gain. Malaise and stomatitis are not related to neurological involvement.

Which of the following interventions should the nurse anticipate incorporating into the client's plan of care when hepatic encephalopathy initially develops? a. inserting a NG tube b. restricting fluids to 1000 mL/day c. administering IV salt poor albumin d. implementing a low protein diet

d. When hepatic encephalopathy develops , measures are taken to reduce ammonia formation. Protein is restricted in the diet. salt and fluid restrictions = ascites

The nurse should teach the client with liver disease to avoid which OTC medications after discharge? a. ranitidine b. psyllium c. ascorbic acid d. acetaminophen

d. acetaminophen is metabolized in the liver, it should be avoided.

The nurse is assessing a client with chronic hep B who is receiving lamivudine. What information is most important to communicate to the physician? a. the client's daily record indicated a 3 kg. weight gain over 2 days. b. the client is complaining of nausea c. the client has a temperature of 99 orally d. the client has fatigue

a. the fluid weight gain is of concen since the drug should be used with caution with impaired renal function. Dosage adjustment may be needed.

What diet should be implemented for a client who is in the early stages of cirrhosis? a. high calorie, high carb b. high protein, high carb c. low fat, low protein d. high carb, low sodium

a. high calorie, high carb To provide an adequate supply of nutrients. Early stages of cirrhosis, there is no need to restrict fat, protein, or sodium

The client who has esophageal varices is started on propranolol. The nurse explains to a new nurse orintee that this drug is ordered for this particular client to do which of the following? a. prevent esophageal bleeding b. decrease systemic BP c. decrease portal hypertension d. decrease myocardial workload

a. prevent esophageal bleeding

The nurse is caring for a client who had a liver biopsy apron 15 minutes ago. The client is supine in bed, the nurse notes that the client's skin is pale and cool, and he reports lightheadedness. The nurse's immediate response is to do which of the following? select all a. place the client on his right side b. leave client in supine position c. obtain vital signs d. check urine output e. call emergency response team

a. right side c. vital signs the liver is highly vascular and prone to bleeding after a biopsy Right side applies pressure to the vessels in the liver VS: hypotension, tachycardia

A client has advanced cirrhosis of the liver. The client's spouse asks the nurse why his abdomen is swollen, making it very difficult for him to fasten his pants. How should the nurse respond to provide the most accurate explanation of the disease process? a. he must have been eating too many foods with salt in them. Salt pulls water with it b. the swelling in his ankles must have moved up closer to his heart so the fluid circulates better c. he must have forgotten to take his water pill d. blood is not able to flow readily through the liver now, and the liver cannot make protein to keep fluid inside the blood vessels.

d. Portal hypertension and hypoalbuminemia as a result of cirrhosis cause a fluid shift into the peritoneal space causing ascites.

A client is receiving from hepatitis A has fatigue and malaise. the client asks the nurse when his strength will return? Which of the following response by the nurse is most appropriate? a. your fatigue should be gone by now. We will evaluate you for a secondary infection b. your fatigue is an adverse effect from your drug therapy. It will disappear when your treatment regimen is complete c. It is important for you to increase your activity level. That will help decrease your fatigue d. it is normal for you to feel fatigued. The fatigue should go away in the next 2-4 months.

d. during the convalescent or posticteric stage of hepatitis, fatigue and malaise are the most common complaints.

The nurse is reviewing the chart information for a client with increased ascites. The data include: Temp 37.2 HR 118 Shallow Respers 26 BP 128/76 SpO2 89% on Room air. Which action should receive priority by the nurse? a. assess heart sounds b. obtain an order for blood cultures c. prepare for a paracentesis d. raise the head of bed

d. raise the head of bed

What would be the nurse's best response to the client's expressed feelings of isolation as a result of having hepatitis? a. don't worry. it's normal to feel that way b. your friends are probably afraid of contracting hepatitis from you c. I'm sure you're imagining that d. tell me more about your feelings of isolation

d. verbalize more feelings of isolation

The nurse is planning a home visit for a client with hepatitis A. In order to prevent transmission the nurse should focus teaching on: a. proper food handling b. insulin syringe disposal c. alpha interferon d. use of condoms

a. proper food handling

The client who has liver disease asks the nurse why he bruises so easily. Which of the following information should the nurse include in the response? a. your liver is unable to make the proteins that are needed to make clotting factors b. your liver can no longer metabolize drugs and render tham inactive c. your liver is breaking down blood cells too rapidly d. your liver can't store Vitamin C any longer

a. the liver synthesizes clotting factors. These proteins are needed for adequate clotting, so their reduction leads to increased risk of bleeding.

A nurse is teaching a client who has hep B about home care. Which of the following should the nurse include in the teaching? select all a. limit physical activity b. avoid alcohol c. take acetaminophen for comfort d. wear a mask when in public places e. eat small frequent meals.

a. limit activity (helps in the recovery) b. avoid alcohol e. eat small frequent meals Acetaminophen is metabolized in the liver and should be avoided Hep B is a blood borne pathogen, wearing a mask is not necessary.

The client has just had a liver biopsy. Which of the following nursing actions would be the priority after the biopsy. a. monitor pulse and BP every 30 minutes b. ambulate every 4 hours for the first day as long as client can tolerate this c. measure urine specific gravity every 8 hours for the next 48 hours d. maintain NPO status for 24 hours post-biopsy.

a. the liver is the most vascular organ in the body. Therefore, a liver biopsy may cause hemorrhage. The nurse should assess for signs of hemorrhage (increased pulse and decreased BP) every 30 minutes.

Normal AST

8-38 units/L

The nurse has an order to administer 2 oz of lactulose to a client who has cirrhosis. How many mL of lactulose should the nurse administer? ______mL

60 mL 30 mL = 1 oz.

During an outbreak of hepatitis A traced to a food handler at a local restaurant, the nurse teaches staff at the restaurant that the most cost-effective means of protecting customers from further outbreaks is to: Use gloves when handling food if there are any cuts or scrapes on the hands. Wash hands thoroughly before handling food and after using the bathroom. Test all new employees for hepatitis antigen. Insist that all food handlers be immunized against hepatitis A.

Wash hands Hepatitis A is transmitted by an oral-fecal route from an infected person handling food, water, and fish or through direct contact from the hands. Hepatitis immunization is not cost effective. Testing new employees for the antigen does not prevent a current employee from contracting hepatitis A and spreading it. Hepatitis is rarely transmitted by blood or body fluids.

A client with a Sengstaken Blakemore tube has a sudden drop in SpO2 and increase in respiratiory rate to 40 breaths/min. The nurse should do which of the following in order. a. affirm airway obstruction by the tube b. remove the tube c. deflate the tube by cutting with bedside scissors d. apply oxygen via face mask

a. Affirm airway obstruction c. Deflate the tube by cutting with bedside scissors b. Remove the tube d. Apply O2 via face mask

The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which of the following discharge instructions is appropriate for the client? a. spray the house to eliminate infected insects b. tell family members to try and stay away from the client c. tell family members to wash hands frequently d. disinfect all clothing and eating utensils

c. wash hands

Normal Bilirubin levels (adult) Total Direct Indirect

0.1 - 1.2 0.1 - 0.3 calculate by subtracting direct from total

A client diagnosed with chronic cirrhosis has ascites and pitting peripheral edema as well as hepatic encephalopathy. Which of the following nursing interventions are appropriate to prevent skin breakdown? (Select all that apply.) Abdominal and foot massages every 2 hours Range of motion every 4 hours Asking client to sit in a chair for 30 minutes each shift Alternating air pressure mattress Turning and repositioning every 2 hours

Alternating air pressure mattress Turning and repositioning every 2 hours

A client hospitalized with cirrhosis, ascites, and mild hepatic encephalopathy suddenly vomits 200 mL of bright red blood. Which of the following is the priority action by the nurse? Insert a nasogastric tube. Contact the physician. Place the client in Fowler's position. Check the stool for occult blood.

Fowler's Postion The highest priority is protecting the airway so the nurse positions the client in Fowler's position to prevent aspiration of blood. The physician is notified after the client is in a safe position. The physician may or may not order a nasogastric tube or a stool for occult blood.

The nurse monitors a client with cirrhosis for the development of hepatic encephalopathy. Which of the following would be an indication that hepatic encephalopathy is developing? a. decreased mental status b. elevated blood pressure c. decreased urine output d. labored respirations

a. decresed mental status

A nurse is developing a care plan for a client with hepatic encephalopathy. Which of the following are goals for the care of this client? select all a. preventing constipation b. administering lactulose c. monitoring coordination while walking d. checking the pupil reaction e. providing food and fluids high in carbs f. encouraging physical activity

a. preventing constipation (constipation = ammonia) b. lactulose = reduces blood ammonia c. monitor coordination looking for encephalopathy d. pupil reaction for encephalopathy e. high carbs because the liver is not storing glucose Physical activity should be limited

When planning care for a client with viral hepatitis, the nurse should review laboratory reports for which of the following abnormal lab values? a. prolonged PT time b. decreased blood glucose c. elevated serum potassium level d. decreased serum calcium level

a. the PT may be prolonged because of decreased absorption of vitamin K and decreased production of prothrombin by the liver.

A client is to be d/c with a Rx for lactulose. The nurse teaches the client and the client's spouse how to administer this medication. Which of the following statements would indicate that the client has understood the information? a. I'll take it with Maalox b. I'll mix it with apple juice c. I'll take it with a laxative d. I'll mix the crushed tablets in some gelatin

b. apple juice The taste of lactulose is a problem for some clients. Mixing it with fruit juice, water or milk makes it more palatable. Lactulose should not be given with antacids, or laxatives. Lactulose is a liquid, does not come in pill form.

The nurse is assessing a client with cirrhosis who has developed hepatic encephalopathy. the nurse should notify the physician of a decrease in which lab serum that is a potential precipitating factor for hepatic encephalopathy? a. aldosterone b. creatinine c. potassium d. protein

c. Potassium Hypokalemia is a precipitating factor in hepatic encephalopathy.

A client with cirrhosis is admitted to the hospital. Which of the following assessments made by the nurse would indicate the development of portal hypertension? a. hematemesis b. asterixis c. elevated BP d. confusion

a. Bleeding esophageal varices result in vomiting of blood and possible hemorrhage and death.

When caring for a client who has cirrhosis, the nurse notices flapping tremors of the wrist and fingers. How should the nurse chart this finding? a. Trousseau's sign noted b. Caput medusa noted c. Fetor hepaticus noted d. Asterixis noted

d. Asterixis "liver flap"

The nurse caring for a client scheduled for an abdominal paracentesis for ascites instructs the client to: Scrub the abdomen before the procedure. Avoid eating or drinking for 6 hours prior to the procedure. Empty the bladder before the procedure. Report excess flatus following the procedure.

Empty bladder It is important to empty the bladder prior to the procedure so that the bladder is not inadvertently punctured. It is not necessary for the client to abstain from food or drink; rather the client should be well hydrated. The physician will do the scrub. Flatus is unrelated to the procedure.

Spironolactone (Aldactone) is prescribed for a client with chronic cirrhosis and ascites. The nurse should monitor the client for which of the following medication-related side effects? Constipation Tachycardia Jaundice Hyperkalemia

Hyperkalemia Spironolactone (Aldactone) is a potassium-sparing diuretic, so clients should be monitored closely for hyperkalemia. Diarrhea, dizziness, and headaches are other more common side effects. Tachycardia, jaundice, and constipation are not expected side effects of spironolactone (Aldactone).

A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse expect to administer to this client? select all a. diuretic b. beta blockers c. opioid analgesic d. lactulose e. sedative

a. diuretic to facilitate excretion of fluid b. beta blocker to prevent varices bleeding d. lactulose aid in eliminating ammonia in the stool Opiods and sedatives are metabolized in the liver, therefore should not be given to a patient with cirrhosis

Which of the following positions would be appropriate for a client with severe ascites? a. Fowlers b. side lying c. reverse trendelenburg d. sims

a. fowlers Ascites can compromise the action of the diaphragm and increase the client's risk for respiratory problems.

The client with cirrhosis of the liver asks the nurse why he has edema. The nurse would make which response to explain how edema results from pathophysiologic changes in cirrhosis? a . the edema occurs because you liver produces fewer proteins that help draw fluid into the blood stream b. the high osmotic pressure of proteins in your blood pushes fluid into body tissues c. because of the liver disease, the kidney's are able to filter less fluid, so the body canot excrete it as urine very easily d. your body is metabolizing sex hormones more quickly, leading to fluid retention.

a. the liver is responsible for the production of albumin, which in turn is responsible for maintaining colloidal osmotic pressure. With less production of albumin, the osmotic pressure decreases and edema develops.

The nurse is developing a plan of care for the client with viral hepatitis. The nurse should instruct the client to: a. obtain adequate bed rest b. increase fluid intake c. take antibiotic therapy as ordered d. drink 8 oz of an electrolyte solution every day

a. treatment of hepatitis consists of bedrest with bathroom privileges.

A client with jaundice has pruritus and states that he has areas of irritation from scratching. What measures can the nurse discuss to prevent skin breakdown? select all a. avoid lotions containing calamine b. take baking soda baths c. keep nails short and clean d. rub with knuckles instead of nails e. massage skin with alcohol f. increase sodium intake in diet

b. baking soda bath c. keep nails short and clean d. rub with knuckles instead of nails

The client is diagnosed with obstructive jaundice. The nurse should ask the client about which of the following manifestations? a. clear, pale urine b. clay colored stools c. lactose intolerance d. ankle edema

b. clay-colored stools indicate that no bile is reaching the intestine and suggests obstructive jaundice

Which of the following expected outcomes would be appropriate for a client with viral hepatitis? The client will: a. demonstrate a decrease in fluid retention r/t ascites b. verbalize the importance of reporting bleeding gums or bloody stools c. limit use of alcohol to tow or three drinks per week d. restrict activity to within the home to prevent disease transmission

b. importance of reporting bleeding gums or bloody stools.

The nurse is caring for a client who has ascites, and the provider Rx spironolactone. The client asks why this drug is being used. What is the best response by the nurse? a. this drug will help increase the level of protein in your blood b. the drug will cause an increase in the amount of the hormone aldosterone your body produces c. this medication is a diuretic but does not make the kidneys excrete K+ d. this will help you excrete larger amount of ammonia

c. K+ sparing diuretic

The physician orders oral neomycin as well as a neomycin enema for a client with cirrhosis. the expected outcome of this therapy is to: a. reduce abdominal pressure b. prevent straining during defecation c. block ammonia formation d. reduce bleeding within the intestine

c. Neomycin is administerd to decrease the bacterial action on protein in the intestines, which results in ammonia production. This ammonia, if not dexoxified by the liver, can result in hepatic encephalopathy and coma.

The nurse is assessing a client with hepatitis and notices that the AST and ALT lab values have increased. Which of the following statements by the client requires further instruction by the nurse? a. I requre increased periods of rest b. I follow a low-fat, high carb diet c. I eat dry toast to relieve my nausea d. I take acetaminophen for arthritis pain

d. acetaminophen should be avoided

Which assessments made by the nurse could indicate the development of portal hypertension in a client with cirrhosis? select all a. hemorrhoids b. bleeding gums c. muscle wasting d. splenomegaly e. ascites

a. hemorrhoids d. splenomegaly e. ascites bleeding gums indicate a vitamin K deficiency muscle wasting is seen during malnourishment

Which of the following health promotion activities would be appropriate for the nurse to suggest that the client with cirrhosis add to the daily routine at home? a. supplement the diet with daily multivitamins b. limit daily alcohol intake c. take a sleeping pill at bedtime d. limit contact with other peep whenever possible

a. multivitamis

A client with ascites and peripheral edema is at risk for impaired skin integrity. To prevent skin breakdown, the nurse should: a. institute ROM q4hours b. massage the abdomen once a shift c. use an alternating air pressure mattress d. elevate the lower extremities

c. edematous tissue is easily traumatized and must receive meticulous care.

A client's serum ammonia level is elevated, and the physician orders 30 mL of lactulose. Which of the following is an adverse effect of this drug? a. increased urine output b. improved LOC c. increased bowel movements d. nausea and vomiting

c. increased bowel movements Lactulose increases intestinal motility, thereby trapping and expelling ammonia in the feces.

A client with cirrhosis has diarrhea after several doses of lactulose. Which of the following interventions is appropriate for the nurse to implement? a. monitor fluid and electrolyte balance b. monitor the serum ammonia level c. decrease the frequency of the lactulose dose d. perform skin care in the perianal area

c. the frequency of the dose should be decreased

The visiting nurse is caring for a client with a dx of hep A. The nurse is developing a teaching plan for the client and family. What must the nurse include in this plan? select all a. client should sleep in a single room away from family b. sexual intamacy between client and significant other is prohibited c. everyone would wash hands frequently to prevent transmission d. plan for frequent periods of rest during recovery e. eat small frequent meals to minimize nausea

c. wash hands d. frequent rest periods e. small frequent meals

The nurse would evaluate teaching as effective when a client with chronic hepatitis C states which of the following? "I will avoid donating blood and will use barrier protection for sex." "I understand that I must return to the doctor every year for a follow-up liver biopsy." "Even though there is no treatment for this disease, I plan to live a long life." "I will not need to reduce my alcohol intake and I will use only acetaminophen for pain relief."

Avoid donating blood Use barrier protection for sex Hepatitis C is spread through contact with blood and bodily fluids. The client with chronic hepatitis C should avoid alcohol and medications that will further damage the liver. Liver biopsies are done for cirrhosis, not hepatitis. There are viral treatment medications but they do not guarantee a long life.

The nurse is teaching a client and family about how to prevent the transmission of Hep A. The nurse explains that: a. sexual contact should be avoided b. frequent hand washing can prevent transmission c. avoid contact with blood and body fluids d. hepatitis commonly leads to long term liver disease

b. Hep A is transmitted via the fecal oral route so frequent hand washing is the best mode of prevention

Lactulose is ordered for the client with cirrhosis. Which of the following serum laboratory tests should the nurse monitor to determine if the drug is having the desired effect? a. albumin b. ammonia c. sodium d. lactate

b. ammonia lactulose is used to decrease the absorption of ammonia in the intestines so it is eliminated through the bowel, thereby lowering serum ammonia.

A nurse on a medical surgical unit is admitting a client who has hepatitis B with ascites. Which of the following actions should the nurse include in the plan of care? a. initiate contact precautions b. weigh client weekly c. measure abdominal girth 7.5cm or 3 in above the umbilicus d. provide a high calorie, hight carbohydrate diet

d. A high-calorie, high-carbohydrate diet A. standard precautions b. daily weights c. abdominal girth is measured over the largest part of the abdomen

A client with cirrhosis is receiving lactulose. During the assessment the nurse notes increased confusion and asterixis. The nurse should: a. assess for GI bleeding b. hold the lactulose c. increase protein in the diet d. monitor serum bilirubin levels

a. Clients with cirrhosis can develop hepatic encephalopathy caused by increased ammonia levels. Asterixis is a characteristic symptom of increased ammonia levels. GI bleeding can cause increased ammonia levels.

The nurse should teach the client with viral hepatitis to: a. limit caloric intake and reduce weight b. increase carbs and protein in the diet c. avoid contact with others and live separately d. intensify routine exercise and increase strength

b. low fat, high protein, high carb diet is encouraged for a client with hepatitis to promote liver rejuvenation.

The nurse's assignment consists of the following four clients. From highest to lowest priority, in which order should the nurse assess the clients after receiving morning report? a. the client with cirrhosis who became confused and disoriented during the night b. the client with acute pancreatitis who is requesting pain meds c. the client who is 1 day posop following a whole cystectomy and had a T tube d. the client with hep B who has questions about his d/c

a. hepatic encephalopathy possible c. administer pain medications b. check to make sure client is doing breathing exercises d. discharge instructions

The nurse is planning care for a client being admitted with bleeding esophageal varices. Vital signs are: P: 100 R 22 BP 100/58 The nurse should prepare the client for which of the following? select all that apply a. administration if IV octreotide b. endoscopy c. administration of a blood product d. minnesoda tube insertion e. TIPS procedure f. immediate endotracheal intubation

a. IV octreotide b. endoscopy c. blood products

The client with cirrhosis receives 100 mL of 25% serum albumin IV. Which finding would best indicate that the albumin is having its desired effect? a. increased urine output b. increased serum albumin level c. decreased anorexia d. increased ease of breathing

a. Normal serum albumin is administered to reduce ascites.

The nurse is providing d/c instructions for a client with cirrhosis. Which of the following statements best indicates that the client has understood the teaching? a. I should eat a high protein, high carb diet to provide energy b. it is safer for me to take acetaminophen for pain instead of aspirin c. I should avoid constipation to decrease chances of bleeding d. If I get enough rest and follow my diet, it is possible for my cirrhosis to be cured

c. Straining to stool can cause hemorrhage

The nurse assesses that the client with hepatitis is experiencing fatigue, weakness, and a general feeling of malaise. The client tires rapidly during morning care. Based on this information, which of the following would be an appropriate nursing diagnosis? a. impaired physical mobility r/t malaise b. self care deficit related to fatigue c. ineffective coping r/t long term illness d. activity intolerance r/t fatigue

d. activity intolerance r/t fatigue

The nurse is preparing a community education program about preventing hepatitis B infection. Which of the following would be appropriate to incorporate into the teaching plan? a. hep B is relatively uncommon among college students b. frequent ingestion of alcohol can predispose an individual to development of hep B. c. good personal hygiene habits are most effective at preventing the spread of hep B d. the use of a condom is advised for sexual intercourse

d. condoms

When assessing a patient in the early stages of cirrhosis of the liver, what sign would be anticipated? a. jaundice b. peripheral edema c. acites d. anorexia

d. early manifestations of cirrhosis are vague and usually include GI symptoms such as anorexia, indigestion, nausea, vomiting, or bowel pattern problems.

A client hospitalized with severe ascites due to cirrhosis develops a fever and confusion. The nurse should: Inquire about headache and check for nuchal rigidity. Observe for neck vein distention and auscultate lung sounds. Auscultate bowel sounds and palpate the abdomen for tenderness. Measure abdominal girth and percuss for shifting dullness.

Auscultate bowel sounds and palpate the abdomen for tenderness The nurse should assess bowel sounds and palpate for tenderness since spontaneous bacterial infection can develop with ascites, producing fever and worsening encephalopathy. Headache and nuchal rigidity are symptoms of meningitis. Neck vein distention is associated with right-sided heart failure. Abdominal girth and shifting dullness are important in monitoring progress of ascites, not infection.

The nurse should evaluate results of which laboratory tests while caring for a client who has cirrhosis of the liver? select all a. PT b. U/A c. Serum lipase d. Serum troponin e. Serum albumin

a. PT e. Serum albumin Many clotting factors are produced in the liver, The client's ability to form these factory may be impaired with cirrhosis, butting the client at risk for bleeding. The liver synthesizes protein, which may be impaired with cirrhosis.

The nurse is preparing a client for a paracentesis. the nurse should: a. have the client void immediately before the procedure b. place the client in a side lying position c. initiate IV line to administer seditives d. place the client NPO status 6 hours before the procedure

a. the client should employ the bladder to prevent perforation.

A nurse is caring for a client who has advanced cirrhosis with worsening hepatic encephalopathy. Which of the following is an expected assessment finding? select all a. anorexia b. change in orientation c. asterixis d. ascites e. fector hepaticus

b. change in orientation c. asterixis e. fetor hepaticus (fruity breath odor) a. anorexia is present in a client with liver dysfunction d. ascites is present in a client with liver dysfunction