CH.49 Brunner's Hepatic

the nurse identifies which type of jaundice in an adult experiencing a transfusion reaction? a. obstructive b. nonobstructive c. hemolytic d. hepatocellular

c. hemolytic

which medication is used to decrease portal pressure, halting bleeding of esophageal varices? a. nitroglycerin b. spironolactone c. cimetidine d. vasopressin

d. vasopressin

the nurse completing a POC for a client with cirrhosis who has ascites and pitting edema +4 of feet and legs identifies a nursing diagnosis of risk for impaired skin integrity. which nursing intervention is appropriate for this problem? a. reposition client Q 4hour b. perform passive ROM QID c. restrict dietary protein intake d. arrange for a low air loss bed

d. arrange for a low air loss bed

the nurse is completing a morning assessment of a client with cirrhosis. which info obtained by the nurse will be of the most concern? s. skin on client's abdomen has multiple spider-shaped blood vessels b. client gained 2kg for previous day c. client reports nausea and anorexia d. client's hands flap back and forth when arms are extended

d. client's hands flap back and forth when arms are extended

which is an age-related change of the hepatobiliary system? a. increased drug clearance capability b. enlarged liver c. decreased prevalence of gallstones d. decreased blood flow

d. decreased blood flow

a client has an elevated ammonia concentration and is exhibiting changes in mental status. the nurse suspect which condition? a. cirrhosis b. asterixis c. portal hypertension d. hepatic encephalopathy

d. hepatic encephalopathy

which type of jaundice seen in adults is the is the results of increased destruction of red blood cells? a. obstructive b. nonobstructive c. hemolytic d. hepatocellular

c. hemolytic

a client with cirrhosis has a massive hemorrhage from esophageal varices. balloon tamponade is used to temporarily control hemorrhage and stabilize the client. in planning care, the nurse gives the highest priority to which goal? a. controlling bleeding b.. relieving client's anxiety c. maintaining airway d. maintaining fluid volume

c. maintaining airway

which assessments are important in a client diagnosed with ascites? a. palpation of abdomen for a fluid shift b. foul smelling breath c. measurement of abdominal girth d. weight

c. measurement of abdominal girth

a client has undergone a liver biopsy. which postprocedure position appropriate? a. trendelenburg b. on the left side c. on the right side d. high fowler

c. on the right side

which term describes the passage of a hollow instrument into a cavity to withdraw fluid ? a. dialysis b. ascites c. paracentesis d. asterixis

c. paracentesis

what is the most common cause of esophageal varices? a. ascites b. asterixis c. portal HTN d. jaundice

c. portal HTN

clients with chronic liver dysfunction have problems with insufficient vitamin intake. which may occur as a result of a vitamin C deficiency? a. hypoprothrombinemia b. night blindness c. scurvy d. beriberi

c. scurvy

which position should be used for a client undergoing a paracentesis? a. supine b. prone c. trendelenburg d. upright at the edge of the bed

d. upright at the edge of the bed

which condition indicates an overdose of lactulose? a. fecal impaction b. hypoactive bowel sounds c. constipation d. watery diarrhea

d. watery diarrhea

a client reporting SOB is admitted with diagnosis of cirrhosis. a nursing assessment reveals an enlarged abdomen with striae, an umbilical hernia, and pitting edema +4 of feet and legs. what is the most important data for nurse to monitor? a. bilirubin b. hemoglobin c. albumin d. temp

c. albumin

a young client diagnosed with anorexia fatigue, and jaundice is diagnosed with hep b and has just been admitted to the hospital. the client asks the nurse how long the stay in the hospital will be. in planning care for the client, the nurse identifies impaired psychological issues and assigns the highest priority to which client outcome? a. identifying source of exposure to hepatitis b. reducing spread of disease c. minimizing social isolation d. establishing stable home environment

c. minimizing social isolation

what initial measure can the nurse implement to reduce risks of injury for a client with liver disease? a. apply soft wrist restraints b. raise all 4 side rails on the bed c. pad side rails d. prevent visitors, so as to not agitate the client

c. pad side rails

nurse is teaching a client with acute encephalopathy and ascites about an appropriate diet. the nurse determines that the teaching has been effective when the client chooses which food choice menu? a. ham and cheese sandwich, baked beans, coffee b. pancakes with butter and honey, orange juice c. omelet with green peppers, onions, and mushrooms, cheese with milk d. baked chicken with sweet potato fries, cornbread, tea

b. pancakes with butter and honey, orange juice

a nurse is gathering equipment and preparing to assist with a sterile bedside procedure to withdraw fluid from a client's abdomen. the procedure tray contains the following equipment: trocar, syringe, needles, and drainage tube. the client is placed in high fowlers and a BP cuff is secured around the arm in preparation for which procedure? a. liver biopsy b. paracentesis c. abdominal ultrasound d. dialysis

b. paracentesis

the nurse is assessing a client with hepatic cirrhosis for metal deterioration. for what clinical manifestations wil the nurse monitor? select all that apply a. aggitiation b. alterations in mood c. insomnia d. report of headache e. decreased deep tendon reflexes

a. aggitiation b. alterations in mood c. insomnia

a nurse is teaching a client about the types of chronic liver disease. the teaching is determined to be effective when the client correctly identifies which type of cirrhosis as being caused by scar tissue surrounding portal areas? a. alcoholic cirrhosis b. compensated cirrhosis c. postnecrotic cirrhosis d. biliary cirrhosis

a. alcoholic cirrhosis

when caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? a. change in the client's handwriting and/ or cognitive performance b. constipation for more than 2 days c. weight loss of 2 pounds in 3 days d. anorexia for more than 3 days

a. change in the client's handwriting and/ or cognitive performance

which liver function study is used to show the size of the liver and hepatic blood flow and obstruction? a. radioisotope liver scan b. angiography c. EEG d. MRI

a. radioisotope liver scan

when caring for a client with cirrhosis, which symptom(s) should th nurse report immediately? a. annorexia and dyspepsia b. change in mental status c. diarrhea or constipation d. fatigue and weight loss

b. change in metal status

clients diagnosed with esophageal varices are at risk for hemorrhagic shock. which is a sign of potential hypovolemia? a. bradycardia b. hypotension c. polyuria d. warm moist skin

b. hypotension

which term is used to describe a chronic liver disease in which scar tissue surrounds the portal areas? a. biliary cirrhosis b. compensated cirrhosis c. alcoholic cirrhosis d. postnecrotic cirrhosis

c. alcoholic cirrhosis