Adv med-surg Test 1

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. What nursing intervention is the priority?

Observe the client for increasing confusion.

A nurse is evaluating a client's understanding of peritoneal dialysis. Which information in the client's response indicates an understanding of the purpose of the procedure?

Removing toxins in addition to other metabolic wastes

A client who is obese and has a history of alcohol abuse is admitted to the hospital with the diagnosis of acute pancreatitis. Which is the initial priority expected client outcome in response to therapy at this time?

Report decreased pain

A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. What should the nurse instruct the client to do considering the client's condition?

Report signs of bleeding no matter how slight.

Which medication requires the nurse to monitor the client for signs of hyperkalemia?

Spironolactone

A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted diet. The client asks why this diet is necessary. Which information should the nurse include in a response to the client's questions?

This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.

A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen?

To help prevent potassium loss

What's the most common surgical procedure for BPH? (benign prostate hyperplasia

Transurethral resection of the prostate (TURP)

A client's laboratory report indicates hyperkalemia. Which responses should the nurse expect the client to exhibit? Select all that apply.

Vomiting Muscle weakness Irregular heart rate

The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling?

With meals

CKD patient itch why?

because of the urea under the skin (pruritus)

How soon should urine flow if the donated kidney was from a cadaver?

2 days to 2 weeks *pt will need to be dialyzed during this time*

Anuria

< less than 100 mL/day

Oliguria

< less than 400 mL/day

Chronic kidney disease - Stage 1 GFR

> 90 mL/min

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What isthe primary cause of the client's ascites?

A decrease in plasma protein to maintain adequate capillarytissue circulation

A client with chronic renal failure has been on hemodialysis for 2 years. The client communicates with the nurse in the dialysis unit in an angry, critical manner and is frequently noncompliant with medications and diet. The nurse can best intervene by first considering that the client's behavior is most likely for which reason?

A defense against underlying depression and fear

A nurse is caring for a client with renal failure. The client wants to go back home but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. What role does the nurse play here?

Advocate

The nurse is teaching a client receiving peritoneal dialysis about the reason dialysis solution is warmed before it is instilled into the peritoneal cavity. Which information will the nurse share with the client?

Because it encourages removal of serum urea by preventing constriction of peritoneal blood vessels

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)?

Bilirubin level

A nurse is reviewing the clinical record of a client with a diagnosis of benign prostatic hyperplasia (BPH). Which test result will the nurse check to confirm the diagnosis?

Biopsy of prostatic tissue

A client with acute kidney injury states, "Why am I twitching and my fingers and toes tingling?" Which process should the nurse consider when formulating a response to this client?

Calcium depletion

A client was diagnosed with cancer of the head of the pancreas two months ago. The client is admitted to the hospital with weight loss, severe epigastric pain, and jaundice. When performing the client's assessment, the nurse expects the client's stool to be what color?

Claycolored

A nurse evaluates that a client with chronic kidney disease understands an adequate source of high biologic- value (HBV) protein when the client selects which food from the menu?

Cottage cheese

A nurse anticipates that dialysis will be necessary for a 12-year-old child with chronic kidney disease when the child begins to exhibit which symptom?

Hypervolemia

A client is admitted to the hospital with slight jaundice and reports of pain on the left side and back. A diagnosis of acute pancreatitis is made. Which common response to acute pancreatitis should the nurse monitor in the client?

Hypovolemia

How soon should urine flow if the donated kidney was from a living donor?

Immediate urine flow

The nurse is assessing a pediatric client diagnosed with chronic renal failure exhibiting alterations in growth patterns. When educating the client's parents about the child's growth, which statement is accurate?

"Resistance to growth hormone associated with your child's diagnosis is causing poor growth."

A nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations should the nurse assess in the client? Select all that apply.

Ascites Pruritus Jaundice

A client who is receiving peritoneal dialysis reports severe respiratory difficulty. What immediate action should the nurse implement?

Auscultate the lungs.

A client who experienced extensive burns is receiving intravenous fluids to replace fluid loss. The nurse should monitor for which initial sign of fluid overload?

Crackles in the lungs

What clinical finding does a nurse anticipate when admitting a client with an extracellular fluid volume excess?

Distended jugular veins

When admitting a client with benign prostatic hyperplasia, which assessment made by the nurse is most relevant?

Distention of the lower abdomen

A nurse on the Code Blue/Arrest team responds to a code that is called for a client with hyperkalemia who is experiencing cardiac standstill. What would an appropriate immediate treatment plan include?

Sodium bicarbonate

To prepare for hemodialysis, a client with end-stage kidney disease is scheduled for surgery, specifically for the creation of an internal arteriovenous fistula in one arm and placement of an external arteriovenous shunt in the other arm. When considering care for these sites, which difference will the nurse consider?

The graft is more subject to hemorrhage, clotting, and infection than the fistula is.

A nurse is teaching a newly admitted client who has acute pancreatitis about dietary restrictions. What should the education include?

Use of IV fluids

Calcium reabsorption

taking calcium into the bone -High calcium levels, signals the thyroid gland to release calcitonin.

Discharge planning for a client with chronic pancreatitis includes dietary teaching. Which statement indicates to the nurse that the client needs more teaching?

"I can eat foods high in fat now that the acute stage is over."

A client is receiving epoetin for the treatment of anemia associated with chronic renal failure. Which client statement indicates to the nurse that further teaching about this medication is necessary?

"I realize it is important to take this medication because it will cure my anemia."

A client with acute kidney injury is to receive peritoneal dialysis and asks why the procedure is necessary. Which is the nurse's best response?

"It helps perform some of the work usually done by the kidneys."

A client with acute kidney injury is to receive peritoneal dialysis and asks why the procedure is necessary. Which is the nurse's best response?

"It helps perform some of the work usually done by the kidneys."

A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations should a nurse assess in the client? Select all that apply.

Jaundice Acute pain Increased amylase

What does dialysis do?

removes excess fluids and wastes produces restores chemical and electrolyte imbalance

A student nurse is caring for a client with chronic kidney failure who is to be treated with continuous ambulatory peritoneal dialysis (CAPD). Which statement by the student nurse indicates to the primary nurse that the student nurse understands the purpose of this therapy?

"It uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

To prepare a client for discharge, the nurse is providing dietary instructions to a client who had a pancreaticoduodenectomy (Whipple procedure). What should the nurse include in the instructions?

The surgery has interfered with the fat digestion mechanism; a lowfat diet is needed.

A client with biliary cirrhosis receives serum albumin therapy. What isthe most effective method for the nurse to evaluate the client's response to therapy?

Weight daily

The nurse is assessing a client with severe cirrhosis and discovers fetor hepaticus. What did the nurse assess?

Breath

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective?

Decreased ammonia

A client with a history of chronic kidney disease is hospitalized. Which assessment findings will alert the nurse to kidney insufficiency?

Edema and pruritus

Which nursing intervention should the nurse consider to be a priority for clients with fluid overload?

Ensuring client safety

Which part of the nephron secretes creatinine required for elimination?

Proximal tubule

How do you assess the effectiveness of erythropoietin injections?

patient will be asymptomatic duuuuh

A client is admitted to the hospital with severe back and abdominal pain, nausea and occasional vomiting, and an oral temperature of 101° F (38.3° C). The client reports drinking six to eight beers a day. A diagnosis of acute pancreatitis is made. Based on the data presented, what symptom is the primary nursing concern for this client?

Acute pain

A nurse is performing the physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observe what skinconditions? Select all that apply.

Ecchymoses Telangiectasis

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for which complication?

Hepatitis B

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks, "What is a pseudocyst?" Which information should the nurse include in a response to this question?

Walledoff space of pancreatic enzymes and exudate

A client with cirrhosis of the liver and ascites is scheduled to have a paracentesis. What should the nurse do to prepare the client for the procedure?

Instruct the client to void.

A nurse is caring for a client with a diagnosis of benign prostatic hyperplasia (BPH). Which information about this condition is important for the nurse to consider when caring for this client?

It predisposes to hydronephrosis.

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. What does the nurse conclude about the amount of fluid prescribed?

It will compensate for both insensible and expected output over the next 24 hours.

A client with an inoperable cancer of the head of the pancreas involving the common bile duct has a T-tube inserted. During the first 48 hours after insertion of the tube, what should the nurse do?

Maintain Ttube patency via gravity drainage

A client is admitted to the hospital with a diagnosis of severe chronic kidney disease. Which assessment findings should the nurse expect the client to exhibit? Select all that apply.

Paresthesias Hypertension

A client is at high risk for developing ascites because of cirrhosis of the liver. How should the nurse assess for the presence of ascites?

Percuss the client's abdomen and listen for dull sounds.

The nurse is caring for a client admitted with fluid overload. Which tasks are most appropriate to be delegated to the patient care associate? Select all that apply.

Documenting vital signs Documenting urine output Repositioning the client every one or two hours

A nurse is caring for a client with end-stage kidney disease after a kidney transplant. Which finding indicates the transplant is successful?

Decreasing serum creatinine

A client with acute kidney injury moves into the diuretic phase after 1 week of therapy. For which clinical indicators during this phase should the nurse assess the client? Select all that apply.

Dehydration Hypovolemia

During the infusion of dialysate during peritoneal dialysis, the client exhibits symptoms of severe respiratory difficulty. What should the nurse do?

Drain the fluid from the client's peritoneal cavity

If a client on peritoneal dialysis develops symptoms of severe respiratory difficulty during the infusion of the dialysate solution, what should the nurse do?

Drain the fluid from the peritoneal cavity.

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the primary healthcare provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis?

Hyperkalemia

A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. What does the nurse conclude isthe most likely cause of this client's ascites?

Impaired portal venous return

A nurse is caring for a client who is admitted to the hospital with ascites and a diagnosis of cirrhosis of the liver. What does the nurse conclude is the probable cause of ascites?

Impaired portal venous return

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? Select all that apply.

Lethargy Muscle twitching

A client in end-stage kidney disease is receiving peritoneal dialysis. What should the nurse do when caring for this client?

Position the client from side to side if fluid is not draining adequately.

A nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective?

Potassium decreases to 4.2 mEq/L (4.2 mmol/L)

A client with hepatitis B (HBV) develops cirrhosis and is hospitalized. One potential sequela of chronic liver disease is fluid and electrolyte imbalance. The nurse determines that this may be attributed to a decrease in serum albumin level. Which of these conditions results from this imbalance?

Reduction of colloidal osmotic pressure in the blood

A nurse teaches a client with chronic renal failure that salt substitutes cannot be used in the diet. What is the rationale for the nurse's instruction?

Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats.

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit?

Will meet the client's nutritional needs without causing the discomfort precipitated by eating

What are the 3 types of kidney transplant rejections?

1) hyperacute - within 48 hours after surgery 2) acute - 1 week to 2 years after surgery 3) chronic - occurs from 1 month to years

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply.

Administer analgesics Teach relaxation exercises Monitor cardiac rate and rhythm

A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client?

Sodium retention and fluid accumulation

The nurse is teaching a client about the prescribed diet after a Whipple procedure for cancer of the pancreas. Which statement should the nurse include in the dietary teaching?

"Lowfat meals should be eaten to prevent interference with your fat digestion mechanism."

A client with end-stage kidney disease says to the nurse, "I heard that it is inevitable that I will need a kidney transplant. If so, which one of my kidneys will be removed?" Which is the best response by the nurse?

"Neither of your kidneys will be removed unless they are infected."

After a TURP procedure what is the primary concern?

-Blood clots avoid by implementing continuous bladder irrigation (CBI)

Signs and symptoms of anemia

-Low RBCs -Pale & tired -Short of breath -confused *monthly Sub-Q injection of erythropoietin along with transfusion for CKD patients with severe anemia

How do you differentiate prostate cancer from an enlarged prostate?

-PSA (prostate-specific antigen) -biopsy

How are the WBC's in an immunocompromised patient with high risk for infection?

-Really low WBC count

What are the only ways a doctor can diagnose a kidney transplant rejection

-Renal/kidney scan -Biopsy

Low urinary output in CKD patients

-Strict I/O monitoring -Weight patient same time of day, same scale, same clothes -Monitor facial swelling (mostly in the morning) -Assess lung sounds for crackles

Kidney transplant patients should avoid?

-contact sports for 3 months -lap style seat belts

A client with a long history of alcohol abuse develops acute pancreatitis. What should be done to best prevent stimulation of the pancreas?

Administer the histamine H2receptor antagonist as prescribed.

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis?

Administering prescribed anticholinergic medication

A client is admitted to the hospital for acute pancreatitis. The nurse obtains the client's vital signs, performs a physical assessment, and reviews the client's health history. What is the priority intervention by the nurse?

Assess the client for alcohol withdrawal symptoms.

A nurse is caring for a client with end-stage renal disease who has a mature arteriovenous (AV) fistula. Which nursing care should be included in the client's plan of care? Select all that apply.

Auscultate for a bruit. Palpate the site to identify a thrill. Avoid drawing blood from the affected extremity.

A client is diagnosed with chronic pancreatitis. Which dietary instruction is most important for the nurse to share with the client?

Avoid ingesting alcoholic beverages

A nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information should the nurse include in the teaching session? Select all that apply.

Avoiding aspirin and aspirin-containing products Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement

A client with chronic renal failure stops responding to the treatment. On examination, the primary healthcare provider determines that the client is terminally ill. What is the best nursing intervention in this situation?

Encourage the family members to provide pallative care to the client.

The nurse reviews a medical record and is concerned that the client may develop hyperkalemia. Which disease increases the risk of hyperkalemia?

End-stage renal disease

Which type of cytokine is used to treat anemia related to chronic kidney disease?

Erythropoietin

A nurse is caring for a client who had surgery for cancer of the pancreas. Which nutrients will the nurse most closely observe after surgery?

Fats and carbohydrates

After surgery for cancer of the pancreas, the client's nutrition and fluid regimen are influenced by the remaining amount of functioning pancreatic tissue. The nurse considers both the exocrine and the endocrine functions of the pancreas and expects that, postoperatively, the client's dietary regimen will be focused on the management of what substances?

Fats and carbohydrates

Which complications does the nurse expect in the client with a renal disorder who has a blood urea nitrogen (BUN)/creatinine ratio of 28? Select all that apply.

Fluid volume deficit Obstructive uropathy

A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which clinical manifestations should the nurse expect the client with hypocalcemia to exhibit? Select all that apply.

Fractures Osteomalacia Eye calcium deposits

The primary healthcare provider instructs the nurse to monitor serum creatinine and blood urea nitrogen in a client who is on therapy for burn wounds. Which medication most likely has been prescribed to the client?

Gentamicin sulfate

A client with Laënnec cirrhosis has a Sengstaken-Blakemore tube in place. The client becomes increasingly confused and tries to climb out of bed. The client's breath becomes fetid. What is the nursing priority?

Implement fall precautions/prevention measures

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that mostlikely caused the ascites should the nurse consider when planning care?

Increased pressure in the portal vein

A nurse is caring for a client who had a pancreaticoduodenectomy for cancer of the pancreas. The nurse provides education about hypoinsulinism, a long-term complication related to this type of surgery. The nurse evaluates that the teaching is understood when the client states that he will seek medical supervision if he experiences which symptom?

Increased thirst

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding?

Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

Institute fall prevention/safety measures.

A nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in this client's diet? Select all that apply.

Low sodium High vitamins Moderate protein

A client with a history of cirrhosis of the liver develops heart failure. When ventricular bigeminy develops, the provider orders lidocaine. What alterations in lidocaine dosages does the nurse anticipate?

Lower because the drug is metabolized at a diminished rate

The nurse is providing postoperative care for a client who had an extensive surgical revision of the head of the pancreas. To decrease the risk of hemorrhage at the operative site, what action should the nurse take?

Maintain patency of the nasogastric tube.

A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. For which assessment signs of hepatic encephalopathy should the nurse assess this client? Select all that apply.

Mental confusion Flapping hand tremors Musty, sweet breath odor

Which medication should the nurse question when it is prescribed for a client with acute pancreatitis?

Meperidine

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment?

Moderate protein

A client is admitted to the hospital with jaundice. After numerous diagnostic tests, the healthcare provider makes the diagnosis of cancer of the pancreas. What does the nurse conclude is the most likely cause of the client's jaundice?

Obstruction of the common bile duct by the pancreatic neoplasm

A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's urine output decreases to less than 100 mL/24 hr, the creatinine clearance is 60 mL/min, and there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn for testing. Which serum level requires immediate intervention?

Potassium 6.1 mEq/L (6.1 mmol/L)

An older adult client is admitted to the hospital with a diagnosis of chronic kidney disease. The nurse reviews the client's medical record. Which clinical finding is a priority to be communicated to the primary healthcare provider?

Potassium level

A client with chronic kidney disease is receiving medication to manage anemia. Which primary goal should the nurse include in the care plan from this information?

Prevention of chronic fatigue

The healthcare provider prescribes finasteride for a client with benign prostatic hyperplasia. What information does the nurse provide to the client?

Protection should be worn during intercourse with a pregnant female.

A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end-stage renal disease (ESRD)?

Protein

A client with Laënnec cirrhosis has ascites and jaundice and is confused. What is the nursing priority when caring for this client?

Providing for the client's physical safety

The laboratory reports of a client reveal that the serum creatinine value is 7 mg/dL (618.8 mmol/L) and the blood urea nitrogen (BUN) value is 240 mg/dL (85.68 mmol/L). Which integumentary manifestations can be noticed in this client? Select all that apply.

Pruritus Ecchymosis Uremic frost

The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. What does the nurse identify as the purpose of these drugs?

Reduce antibody production

Neomycin is prescribed for a client with cirrhosis. What should the nurse explain is the reason for taking this medication?

Reduces the blood ammonia level

Know the stages for chronic kidney disease

Stage 1 - GFR > 90 mL/min Stage 2 stage 3 stage 4 stage 5 - GFR <15 mL/min (requires dialysis)

A client who has a history of alcohol abuse now has recurrent exacerbations of chronic pancreatitis. The nurse asks the client to obtain a stool specimen. When assessing the client's stool, what would the nurse expect to observe?

Steatorrhea

A client with end-stage kidney disease is receiving continuous ambulatory peritoneal dialysis. The nurse should monitor the client for which peritoneal dialysis complications? Select all that apply.

Tachycardia Cloudy outflow Abdominal pain

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan?

The importance of reporting personality changes to the primary healthcare provider

A client is to have hemodialysis. What must the nurse do before this treatment?

Weigh the client to establish a baseline for later comparison.

Furosemide (Lasix)

this drug is combined with the "ar" meds (ex: losartan) -balances high/low potassium levels *high potassium - give furosemide* *low potassium - give spironolactone*

A nurse is caring for a client with end-stage kidney disease who is about to receive a transplant. When the client returns from the postanesthesia care unit after a kidney transplant, how often should the nurse measure the client's urinary output?

1 hour

A nurse is caring for a client with acute kidney injury. Which findings should the nurse anticipate when reviewing the laboratory report of the client's blood level of calcium, potassium, and creatinine? Select all that apply.

1) Calcium: 7.6 mg/dL (1.9 mmol/L) 3) Potassium 6.0 mEq/L (6.0 mmol/L) 5) Creatinine: 3.2 mg/dL (194 mcmol/L)

The nurse is providing care for a client diagnosed with invasive pancreatic cancer. The client has a permanent biliary drainage tube (T-tube) inserted to provide palliative care. Which action should the nurse take postoperatively?

Cleanse the area around the insertion site to prevent skin breakdown.

The nurse is caring for four different clients admitted with fluid overload. Which client should be considered a priority requiring immediate care?

Client A

Most reliable lab test to determine kidney function?

Creatinine

causes of intrarenal AKI

NSAIDS

A nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis?

Serum lipase

When do you see edema in kidney disease?

In the morning - usually on the face and around the eyes.

Calcium resorption

Loosening calicum from the bone -decreased calcium levels, parathyroid gland signals for resorption

A client newly diagnosed with cancer of the pancreas is scheduled for surgery. The client says to the nurse, "Wouldn't I be better off with some other treatment instead of surgery?" What response by the nurse is the best?

"Surgery is the recommended approach. Why don't you discuss this further with the healthcare provider?"

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. Which is an appropriate nursing response?

"The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best?

"The major risk is bleeding postprocedure."

A client is admitted to the hospital with Laënnec cirrhosis and chronic pancreatitis. Bile salts (bile acid factor) are prescribed, and the client asks why they are needed. What is the nurse's bestresponse?

"They aid absorption of fatsoluble vitamins."

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond?

"This medication helps you lower the high ammonia level caused by your liver disease."

A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas?

Ammonia level

A nurse reviews the laboratory results of a client with acute pancreatitis. Which test is most significant in determining the client's response to treatment?

Amylase level

A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse shouldgive priority to which client history item?

Black, tarry stools

What clinical indicators should the nurse expect a client with hyperkalemia to exhibit? Select all that apply.

Confusion Weakness Dysrhythmias

A client is admitted to the hospital with a tentative diagnosis of urinary retention related to benign prostatic hyperplasia. The primary healthcare provider notes a secondary diagnosis of delirium related to urosepsis and prescribes the insertion of an indwelling urinary retention catheter. Which nursing action is most important at

Determine whether any unsafe behavior patterns exist.

When receiving hemodialysis, the client may develop hyponatremia. For which clinical findings associated with hyponatremia should the nurse assess the client? Select all that apply.

Diarrhea Seizures

After a surgical procedure for cancer of the pancreas with removal of the stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, what symptom exhibited by the client requires immediate attention by the nurse?

Hyperglycemia

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. What should the nurse monitor the client for?

Hyperkalemia

A client has end-stage kidney disease and is admitted for a kidney transplant. Which information should the nurse share when teaching about the donor?

Must have matching leukocyte antigen complexes

A client with cancer of the pancreas has a pancreaticoduodenectomy (Whipple procedure). The nurse expects that the client will have which tube after surgery?

Nasogastric

What will the nurse do to assess a client's response to ongoing serum albumin therapy for cirrhosis of the liver?

Obtain the client's weight at least once every day.

A client with an obstruction of the pancreatic ducts has been diagnosed with acute pancreatitis. The client's physical condition continues to deteriorate despite supportive care, and a subtotal pancreatectomy is performed. The nurse should monitor the client for what postoperative complication?

Paralytic ileus

The nurse is taking care of a client with cirrhosis of the liver and ascites. Which lunch is the best choice for a client with this disorder?

Penne pasta, spinach, banana, and decaffeinated iced tea

A nurse is notified that the latest potassium level for a client in acute kidney injury is 6.2 mEq (6.2 mmol/L). Which action should the nurse take first?

Take vital signs and notify the primary healthcare provider.

A client has a tentative diagnosis of primary biliary cirrhosis. What skin change does the nurse expect to observe when performing a physical assessment?

Telangiectasia

A primary health care provider prescribes total parenteral nutrition for a client with cancer of the pancreas. A central venous access device is inserted. What does the nurse identify as the mostimportant reason for using this type of access?

The amount of blood in a major vein helps to dilute the solution.