liver disorders

Which factor may lead to hepatic encephalopathy for a patient with cirrhosis? Select all that apply. One, some, or all responses may be correct.

constipation decreased fluid volume GI bleeding

Which instruction would the nurse include when teaching a spouse and patient with hepatitis C about preventing the spread of infection?

do not share toothbrushes

Which instruction would the nurse include when teaching a patient who has been prescribed lamivudine for treatment of chronic hepatitis B?

do not stop taking abruptly

Which laboratory finding signifies an immune response to liver disease?

elevated serum globulin

hepatitis a

fecal oral route

Which intervention will the nurse include in the plan of care for a patient who is to undergo paracentesis later today?

have the pt void before the procedure

Which factor may lead to the development of hepatic encephalopathy in a patient with cirrhosis? Select all that apply. One, some, or all responses may be correct.

hypokalemia, high protein diet, GI bleeding

Which condition is the nurse concerned about for a patient with cirrhosis who has a weight gain of 2 kg, distention of the abdomen, a heart rate of 92 beats/min, and a blood pressure of 88/58 mm Hg?

hypovolemia

Which statement by a patient with cirrhosis would cause the nurse to suspect that the patient has stage I hepatic encephalopathy?

i am unable to sleep during the night

The presence of immunoglobulin G (IgG) hepatitis A virus (HAV) antibodies would indicate which condition?

immunity to HAV after previous HAV infection

If a health care worker believes that he or she may have been exposed to hepatitis A, which immediate action will help prevent disease development?

immunoglobulin

The nurse will notify the health care provider about which assessment finding for a patient with cirrhosis and profound ascites?

inaudible breath sounds

A positive result from a hepatitis B surface antigen (HBsAg) test would indicate which condition for a patient who was previously treated for the hepatitis B virus (HBV)?

infectious status of the patient

Clay-colored stools and dark urine are typically characteristic of which complication of viral hepatitis?

intrahepatic obstruction

Which assessment finding would the nurse expect for a patient with hepatitis B? Select all that apply. One, some, or all responses may be correct.

itching tea colored urine RUQ tenderness

A patient with hepatic encephalopathy may require which pharmacologic therapy to help decrease serum ammonia levels?

lactulose

Which foods should be consumed in moderation for a patient with hepatic encephalopathy while the patient's serum ammonia level is elevated?

lean meats

Which nursing intervention would help prevent bile leakage and abscess formation after liver transplantation?

maintaining tube in t dependent

Which statement indicates understanding of how to observe for esophageal bleeding in the patient with cirrhosis?

melena

When educating the family of a patient with hepatitis C, the nurse would make which recommendation to help prevent the spread of infection?

members toothbrush

Which statement indicates the need for better understanding about assessment findings of each stage of portal systemic encephalopathy?

muscle twitching occurs in stage II

Which statement by a patient with cirrhosis indicates the need for further instruction about the disease?

my liver is scarred, but the cells can regenerate

The nurse will emphasize which point when instructing a patient with Laennec cirrhosis and portal hypertension?

Do not consume any alcohol

Which diet instruction would the nurse give to a patient with active hepatitis?

Eat small meals at frequent intervals.

Which type of cirrhosis is caused by hepatitis C?

Post necrotic

Lactulose may be prescribed for which purpose for a patient with cirrhosis?

Promote GI excretion of ammonia

Hepatitis A is most likely to be spread by which person?

restaurant oysters

Decreased serum total protein indicates which classification of liver disease?

chronic

The nurse will respond in which way to a patient with long-standing alcoholic liver disease who has a decrease in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) from previously assessed levels?

"These decreases may indicate liver deterioration

The nursing team consists of a registered nurse (RN), a licensed practical nurse (LPN), and a nursing assistant. Which patient must be assigned to the RN?

A patient with end-stage cirrhosis who needs teaching about a low-sodium diet

The nurse would prioritize care for which patient?

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

At which time will the nurse administer a prescribed antibiotic for a patient who underwent paracentesis and is showing signs of spontaneous bacterial peritonitis (SBP)?

After a sample of fluid is sent to the laboratory for culture

A transjugular intrahepatic portal-systemic shunt (TIPS) may be placed to prevent which complication for a patient with ascites?

Bleeding esophageal varices

Which action will the nurse take for a patient with cirrhosis who reports having difficulty getting to sleep and staying asleep?

Discuss this early sign of serious complications with the health care provider.

Which instruction would the nurse include when teaching a patient with viral hepatitis about care at home? Select all that apply. One, some, or all responses may be correct.

Do not consume any alcohol. avoid acetaminophen

Which physiologic change would the nurse expect for a patient with severe liver disease who has developed hepatorenal syndrome? Select all that apply. One, some, or all responses may be correct

Increased creatinine levels Correct3 Increased osmolarity of urine Correct4 Increased blood urea nitrogen (BUN)

The nurse will emphasize avoidance of which drug for a patient with cirrhosis?

NSAIDS

Which patient would the nurse attend to first?

Patient with severe ascites who has a temperature of 101.4°F (38°C

Which instruction about dietary supplements would the nurse include in discharge teaching for a patient with cirrhosis?

Use only supplements prescribed by the health care provider.

The nurse will instruct a patient recently diagnosed with cirrhosis of the liver to avoid which substance to prevent further fibrosis of the liver and allow the liver to heal and regenerate? Select all that apply. One, some, or all responses may be correct.

alcohol cigarettes illicit drugs acetaminophen

The serum level of which enzyme is elevated in patients with biliary obstruction?

alkaline phosphatase

Portal hypertension related to cirrhosis can result in which complication? Select all that apply. One, some, or all responses may be correct.

ascites, hemorrhoids, esophageal varices

Which instruction would the nurse include when teaching a patient who has liver disease with ascites about necessary dietary changes?

avoid using table salt

Elevation of which laboratory value is associated with jaundice for a patient with hepatitis?

bilirubin

The nurse will immediately notify the health care provider about which clinical finding for a patient with liver disease who has portal hypertension?

blood tinged emesis

Which term will the nurse use to document round, pinpoint, red-purple lesions for a patient with possible liver dysfunction?

petechiae

Which medication prescription would the nurse question for a patient with portal hypertension and portal system encephalopathy who is receiving spironolactone?

potassium chloride

Which issue is the priority when caring for a patient with cirrhosis?

potential for injury related to hemorrhage

Which person has the greatest risk for developing hepatitis A?

raw oysters

In which way will the home care nurse modify a patient's home environment to manage side effects of lactulose?

request a bedside commode

Which action will the nurse take immediately for a patient with severe cirrhosis of the liver who has a urine output of 400 mL for the past 2 days, despite adequate IV fluid administration?

request an order for BUN and serum creatinine

Which precaution is necessary to implement for a patient with hepatitis A?

standard

Supplementation with which vitamin may be needed for a patient with cirrhosis if the patient is at risk for alcohol withdrawal?

thiamine

Which information would the nurse provide to an asymptomatic patient who is worried about possible hepatitis C virus (HCV) exposure several years ago?

you may have serious long term damage