Liver Disorders

Which assessment finding would the nurse expect for a patient with hepatitis B?

Itching tea colored urine right upper quadrant tenderness

Which action will the nurse take to help alleviate resp distress for a patient with ascites?

Elevate the head of the bed

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

Have the patient void before the procedure is performed (doing so prevents bladder injury)

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

NSAIDs

Which factor may lead to hepatic encephalopathy for a patient with cirrhosis?

constipation decreased fluid volume GI bleeding

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

request an injection of immunoglobulin

Portal hypertension related to cirrhosis can result in which complication?

Ascites Hemorrhoids Esophageal varices

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

Do not consume any alcohol (laennec cirrhosis is otherwise known as alcoholic cirrhosis)

Which instruction would the nurse include when teaching a patient with viral hepatitis about care at home?

Do not consume any alcohol Avoid meds containing acetaminophen

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 factor may lead to the development of hepatic encephalopathy in a patient with cirrhosis?

Hypokalemia High protein diet GI bleeding (The development of hepatic encephalopathy is believed to be the result of the shunting of the portal venous blood into the central circulation so that the liver is bypassed. A build up of ammonia and gamma aminobutyric acid (GABA) is the result. Factors that may precipitate hepatic encephalopathy include a high protein diet, infections, hypovolemia, hypokalemia, and constipation.

Which finding would the nurse expect for a patient with late stage cirrhosis?

Icterus swollen abdomen prolonged aPTT

Which assessment finding is consistent with a diagnosis of viral hepatitis?

Icterus (yellowish sclera) fever, jaundice, itching, clay colored stool, dark urine, right upper quadrant tenderness, nausea

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

Which assessment finding would the nurse expect for a patient with hepatitis B?

Itching, tea, colored, urine, right upper quadrant tenderness

When providing community education, the nurse would emphasize that which group should receive immunization for hepatitis B?

Men who prefer sex with men

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

You may have serious long term damage even without symptoms.

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?

alcohol cigarettes illicit drugs acetaminophen

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

alkaline phosphatase

Which term will the nurse use to document hand flapping that occurs a few movements after dorsiflexion of the hands when the arms are raised to shoulder level for a patient with liver disease?

asterixis

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

bilirubin

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

bleeding esophageal varices

Decreased serum total protein indicates which classification of liver disease?

chronic

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

eat small meals at frequent intervals (more preferable than 3 standard meals because these patients often experience nausea, vomiting, and dietary intolerance)

Which lab finding signifies an immune response to liver disease?

elevated serum globulin

The presence of immunoglobulin G IgG hepatitis A virus HAS antibodies would indicate which condition?

immunity to HAV after previous HAV infection

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

inaudible breath sounds

Which nutritional recommendation will the nurse make when educating the spouse of a patient with cirrhosis about the patient diet?

include a multivitamin

Which physiologic change would the nurse expect for a patient with severe liver disease who has developed hepatorenal syndrome?

increased creatinine levels increased osmolarity of urine increased BUN

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

intrahepatic obstruction (may happen when the bile ducts are blocked)

Which patient condition would cause the nurse to question the use of neomycin for a patient with hepatic encephalopathy?

kidney failure (aminoglycoside drugs are nephrotoxic)

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

lactulose

Which med may cause intestinal bloating and cramping for a patient who is being treated for hepatic encephalopathy?

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

petechiae

Which type of cirrhosis is caused by hepatitis C?

postnecrotic

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

potential for injury related to hemorrhage

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

promote GI excretion of ammonia

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

request a bedside commode

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

standard precautions

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

thiamine

In which way will the nurse respond to a patient diagnosed with hepatitis A who asks the nurse how this disease may have been contracted?

you may have consumed foods contaminated with the virus