Cirrhosis

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?1. "He must have been eating too many foods with salt in them. Salt pulls water with it."2. "The swelling in his ankles must have moved up closer to his heart so the fluid circulates better."3. "He must have forgotten to take his daily water pill."4. "Blood is not able to flow readily through the liver now, and the liver cannot make protein to keep fluid inside the blood vessels."

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The nurse is reviewing the chart information for a client with increased ascites. The data include the following: temperature 98.9°F (37.2°C), heart rate 118 bpm, shallow respirations 26/min, blood pressure 128/76 mm Hg, and SpO2 89% on room air. The nurse should first:1. assess heart sounds2. obtain a prescription for blood cultures.3. prepare for a paracentesis.4. raise the head of the bed.

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he nurse is caring for a client with esophageal varices. The nurse should discuss which laboratory report finding with the healthcare provider (HCP)?1. normal serum albumin2. Decreased ammonia3. Slightly decreased levels of calcium4. Elevated PT/INR

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The nurse monitors a client with cirrhosis for the development of hepatic encephalopathy. Which would be an indication that hepatic encephalopathy is developing?1. decreased mental status2. elevated blood pressure3. decreased urine output4. labored respirations

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What diet should be implemented for a client who is in the early stages of cirrhosis?1. high-calorie, high-carbohydrate2. high-protein, low-fat3. low-fat, low-protein4. high-carbohydrate, low-sodium

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Which position would be appropriate for a client with severe ascites?1. Fowler's2. side-lying3. reverse Trendelenburg4. Sims

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A client had a liver biopsy 1 hour ago. The nurse should first:1. auscultate lung sounds.2. check for fever.3. obtain a CBC.4. apply packing to the biopsy site.

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A client with cirrhosis who has ascites receives 100 mL of 25% serum albumin IV. Which finding would best indicate that the albumin is having its desired effect?1. reduced ascites2. increased serum albumin level3. decreased anorexia4. increased ease of breathing

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The nurse is preparing a client for a paracentesis. The nurse should:1. have the client void immediately before the procedure2. place the client in a side lying position.3. initiate an IV line to administer sedatives.4. Place the client on nothing by mouth (NPO) status 6 hours before the procedure

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A nurse is develòping with a care plan for a client with hepatic encephalopathy. Which are goals for the care for this client? Select all that Apply.1. Prevent constipation.2. Administer lactulose to reduce blood ammonia levels.3. Monitor coordination while walking4. Check the pupil reaction.5. Provide food and fluids high in carbohydrate.6. Encourage physical activity.

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A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has asterixis. The nurse should:1. assess for gastrointestinal (GI) bleeding.2. withhold the lactulose.3. increase protein in the diet.4. monitor serum bilirubin levels.

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A client with cirrhosis begins to develop ascites. Spironolactone is prescribed to treat the ascites. The nurse should monitor the client closely for which drug-related adverse effect?1. constipation2. hyperkalemia3. irregular pulse4. dysuri

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Which health promotion activity should the nurse suggest that the client with cirrhosis add to the daily routine at home?1. Supplement the diet with daily multivitamins.2. Abstain from drinking alcohol.3. Take a sleeping pill at bedtime.4. Limit contact with other people whenever possible.

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A client with jaundice has pruritus and areas of irritation from scratching. What measures can the nurse suggest the client use to prevent skin breakdown? Select all that apply.1. Avoid lotions containing calamine.2. Add baking soda to the water in a tub bath.3. Keep nails short and clean.4. Rub the skin when it itches with knuckles instead of nails.5. Massage skin with alcohol.6. Increase sodium intake in diet

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A client's serum ammonia level is elevated, and the healthcare provider (HCP) prescribes 30 mL of lactulose. Which effect is common for this drug?1. increased urine output2. improved level of consciousness3. Increased bowel movements4. nausea and vomiting

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The healthcare provider (HCP) instructs a client with alcohol-induced cirrhosis to stop drinking alcohol. The expected outcome of this intervention is:1. absence of delirium tremens.2. having a balanced diet.3. improved liver function.4. reduced weight.

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The nurse is assessing a client who is in the early stages of cirrhosis of the liver. Which focused assessment is appropriate?1. peripheral edema2. ascites3. anorexia4. jaundice

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The nurse is assessing a client with cirrhosis who has developed hepatic encephalopathy. The nurse should notify the healthcare provider (HCP) of a decrease in which serum lab value that is a potential precipitating factor for hepatic encephalopathy?1. aldosterone2. creatinine3. potassium4. protein

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The nurse is providing discharge instructions for a client with cirrhosis. Which statement best indicates that the client has understood the teaching?1. "I should eat a high protein, high carbohydrate diet to provide energy."2. "It is safer for me to take acetaminophen for pain instead of aspirin."3. "I should avoid constipation to decrease chances of bleeding."4. "If I get enough rest and follow my diet, it is possible for my cirrhosis to be cured."

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