PN2RN Adult Health- Metabloic Quiz

A client with liver disease has developed ascites; the nurse is collaborating with the client to develop a nutritional plan. The nurse should prioritize which of the following in the client's plan?

Reduction in sodium intake

A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the client's cognition and behavior. What is the nurse's most appropriate response?

Report this finding to the primary provider due to the possibility of hepatic encephalopathy

A client with portal hypertension has been admitted to the medical floor. The nurse should prioritize what assessments?

Daily weights and abdominal girth measurement

A nurse is caring for a client with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the client has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease?

Asterixis

A nurse is caring for a client who has been admitted for the treatment of advanced cirrhosis. What assessment should the nurse prioritize in this client's plan of care?

Assessment for variceal bleeding

A nurse has entered the room of a client with cirrhosis and found the client on the floor. The client states that she fell when transferring to the commode. The client's vital signs are within reference ranges and the nurse observes no apparent injuries. What is the nurse's most appropriate action?

Have the client assessed by the primary provider due to the risk of internal bleeding

When assessing the client's abdomen, what is the first thing the nurse will do?

Inspection

Diagnostic testing has revealed that a client's hepatocellular carcinoma (HCC) is limited to one lobe. The nurse should anticipate that this client's plan of care will focus on what intervention?

Lobectomy

The nurse is examining a client who reports they have pain in the RUQ of their abdomen. The nurse knows which of the following is not located in the RUQ?

Spleen

A client with end-stage liver disease has developed hypervolemia. What nursing interventions would be most appropriate when addressing the client's fluid volume excess? Select all that apply.

-Administering diuretics -Implementing fluid restrictions - Enhancing client positioning

A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply.

-Immunization -Use of standard precautions

A client with a diagnosis of esophageal varices has undergone endoscopy to gauge the progression of this complication of liver disease. Following the completion of this diagnostic test, what nursing intervention should the nurse perform?

Keep client NPO until the client's gag reflex returns