Care of Patients with Disorders of the Liver, Gallbladder, and Pancreas

The physician has prescribed rifaximin (Xifaxan) for a patient with cirrhosis. The patient questions why he must take this medication. Which response by the nurse is most appropriate?

Rifaximin (Xifaxan) kills intestinal flora.

The nurse is caring for a patient with cirrhosis. The nurse is educating the patient about nutritional implications related to his diagnosis. Which statement indicates that the nurse's teaching has been successful?

"I should choose proteins like cottage cheese and quinoa instead of chicken."

The nurse is providing discharge teaching for a patient who underwent a laparoscopic cholecystectomy. Which statement indicates that the nurse's teaching has been successful?

"I should let these Steri-Strips fall off on their own."

The nurse is caring for a patient diagnosed with gallstones who requires a cholecystectomy. The patient is upset and asks the nurse why he cannot have lithotripsy instead. Which response is most appropriate for the nurse to make?

"Gallstones are usually treated with surgery. Tell me more about your concerns."

A patient has reported to the clinic with concerns about contracting hepatitis A from her boyfriend. What response by the nurse is most appropriate?

"Hepatitis A is not transmitted as a result of close contact with an infected individual."

The nurse is caring for a patient being treated for new onset of gallstones. The patient asks the nurse if he will have to have surgery. How should the nurse respond?

"Treatment for gallstones may include diet modification and weight loss, medications, or surgery."

The nurse is caring for a patient with esophageal varices with a new order for vasopressin (Pitressin). The nurse reviews the patient's history and notes that the patient's comorbidities include coronary artery disease (CAD), type 2 diabetes, gastroesophageal reflux disease (GERD), and fibromyalgia. The nurse should immediately notify the physician about which component of the patient's history?

CAD

A patient with advanced cirrhosis develops esophageal varices. The nurse anticipates that this complication will be addressed by which type of medication(s)? (select all that apply.)

IV vasopressin beta blockers Vitamin K

The nurse is caring for a patient admitted with suspected acute viral hepatitis. Which laboratory value would best support this diagnosis?

Increased prothrombin time

A nurse is caring for a patient who is 4 hours postoperative after a laparoscopic cholecystectomy. The patient reports abdominal fullness and mild discomfort. After verifying that the patient's vital signs are stable, what action is most important for the nurse to take next?

ambulate the patient

A 20-year-old college student who has not been immunized against hepatitis B virus (HBV) comes to the clinic and reports that he has been exposed to hepatitis B. The nurse anticipates that the health care provider will likely recommend which treatment?

an injection of Hepatitis B immune globulin

The nurse is planning skin care of the patient with ascites. Which actions should the nurse include? (select all that apply.)

apply emollients to decrease itching closely trim the patients fingernails change the patients position every 1-2 hours

The nurse caring for a patient recently admitted with acute pancreatitis. Which action(s) should the nurse include in the daily assessments? (select all that apply.)

auscultate bowel sounds measure abdominal girth monitor for effectiveness of pain control monitor urine output

The nurse is caring for a patient who presents to the emergency department with severe nausea and vomiting with stomach pain that radiates to his right scapula. The patient has a temperature of 101.2° F. The nurse anticipates that this patient will undergo workup for which problem?

cholecystitis

The nurse is caring for a patient with cirrhosis. Which assessment finding warrants the nurse's immediate attention?

confusion

The nurse is caring for a patient who underwent a cholecystectomy 3 days ago. Which assessment finding best indicates to the nurse that the bile flow is no longer obstructed from entering the bowel?

dark brown stool

The nurse is caring for a patient with hepatitis. The nurse explains that jaundice occurs in conjunction with hepatitis based on which underlying pathophysiology?

hepatitis causes liver congestion that obstructs flow

The nurse is caring for a patient diagnosed with acute pancreatitis who complains of significant pain. Which nursing action holds the highest priority for this patient?

instruct the patient to sit and lean forward

The nurse reinforces that the immunization for HBV is believed to provide _____ immunity.

lifetime

The nurse is aware that a definitive diagnosis of cirrhosis is made based on the results of which diagnostic or laboratory test?

liver biopsy

The nurse is speaking with a patient who has concerns about the development of cholelithiasis. The nurse correctly includes which risk factors for the condition? (select all that apply.)

obesity diabetes taking cholesterol-lowering drugs mexican american ethnicity

The nurse is discussing the impact of cirrhosis on liver function with the family of a dying patient. The nurse explains that, when the damage caused by cirrhosis blocks the blood flow through the liver, it can lead to which complication(s)? (select all that apply.)

portal hypertension decrease in metabolic processes of the liver decrease in clotting factors increase in ascites

The nurse explains that bile salts deposited in the skin cause jaundice and also cause ______.

pruritus

The nurse caring for a patient with acute pancreatitis assesses a bluish tinge around the patient's umbilicus. The nurse recognizes that this finding likely results from which underlying problem?

retroperitoneal hemorrhage

The nurse points out to a patient recently diagnosed with hepatitis B virus (HBV) that the virus is found which type(s) of body fluid(s) or secretions? (select all that apply.)

semen vaginal secretions breast milk human feces

In caring for a patient with hepatitis B, a nurse would employ which precautions?

standard precautions

The nurse is caring for a patient with cholelithiasis who is scheduled to undergo a cholescintigraphy (HIDA scan). Which statement accurately describes the purpose of the HIDA scan?

to diagnose abnormal contractions of the gallbladder