Chapter 49: Assessment and Management of patient s with hepatic disorders

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor?

"You must have the second one in 1 month and the third in 6 months."

The nurse is preparing a care plan for a client with hepatic cirrhosis. Which nursing diagnoses are appropriate? Select all that apply.

1. Risk for injury related to altered clotting mechanisms 2. Activity intolerance related to fatigue, general debility, muscle wasting, and discomfort 3. Disturbed body image related to changes in appearance, sexual dysfunction, and role function

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately?

Change in the client's handwriting and/or cognitive performance

A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition?

Hepatic encephalopathy

Clients diagnosed with esophageal varies are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia?

Hypotension

A client with hepatic cirrhosis questions the nurse about the possible use of an herbal supplement—milk thistle—to help heal the liver. What is the most appropriate response by the nurse?

Silymarin from milk thistle has anti-inflammatory and antioxidant properties that may have beneficial effects, especially in hepatitis. However, you should always notify your primary care provider of any herbal remedies being used so drug interactions can be evaluated.

A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has?

cirrhosis

A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has?

obstructive jaundice

Which term is used to describe a chronic liver disease in which scar tissue surrounds the portal areas?

Alcoholic cirrhosis

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct?

Endoscopic retrograde cholangiopancreatography (ERCP)