Adult Week 5 Biliary Disorder EAQ
A client is scheduled for a cholecystectomy and asks the primary nurse about the function of the gallbladder. What should the nurse identify is the function of the gallbladder when providing pre-operative teaching? 1. stores and concentrates bile 2. releases bile into pancreatic duct 3. connects the common bile duct and pancreas 4. controlw sthe flow of fat through sphincter of Oddi
1
A client is admitted to the hospital with a diagnosis of cirrhosis of the liver. What signs of hepatic encephalopathy should the nurse assess the client? SATA 1. mental confusion 2. increased cholesterol 3. brown-colored stools 4. flapping hand tremors 5. musty, sweet breath odor
1 4 5 -
A nurse is caring for a client admitted with ascites and diagnosis of cirrhosis of the liver. What should the nurse conclude is the cause of ascites? 1. impaired portal venous return 2. inadequate secretion of bile salts 3. excess production of serum albumin 4. decreased interstitial osmotic pressure
1. an enlarged liver impairs venous return, leading to increased portal vein hydrostatic pressure and a sluid shift into the abdominal cavity
A nurse is assessing a client with severe liver disease. what assessment finding will the nurse expect? 1 . icterus 2. urticaria 3. uremic frost 4. hemangioma
1. icterus (jaundice)
A client returns from surgery after an abdominal cholecystectomy for a gangrenous gallbladder. For which postoperative complication, associated with the location of surgical site, should the nurse assess for the client? 1. atelectasis 2. hemorrhage 3. paralytic ileus 4. wound infection
1. subcostal incisional pain causes client to splint and avoid deep breathing, which impedes air exchange in the alveoli
A client with jaundice associated with hepatitis expresses concern over the change in skin color. What does the nurse explain is the cause of this color change? 1. stimulation of the liver to produce an excess quantity of bile pigments 2. inability of the liver to remove normal amounts of bilirubin from the blood 3. increased destruction of RBCs during acute phase of the disease 4. decreased prothrombin levels, leading to multiple sites of intradermal bleeding
2
A nurse reviews lab results for a client with acute pancreatitis. Which test is most significant in determining the client's response to treatment? 1. platelet count 2. amylase level 3. RBC count 4. erythrocyte sedimentation rate
2 - serum amylase usually eeturns to normal 3 days after treatment
What clinical findings should the nurse be alert for when assessing for peritonitis? SATA 1. jaundice 2. boardlike abdomen 3. abdominal tenderness 4. decreased bowel sounds 5. rapid decrease in coagulation ability
2,3,4
The nurse is providing care to a client with ascites s/t liver failure. What is appropriate to include in this client's care? SATA 1. high protein diet 2. low sodium diet 3. daily abdominal girth measurements 4. encourage increased PO fluid intake 5. daily weights
2,3,5
A nurse educator of college health course is discussing tattoos with the class. Which type of hepatitis associated with tattoos should the nurse include in the teaching plan? 1. A 2. C 3. D 4. E
2. Hepatitis C is a blood born-e pathogen transmitted via contaminated tattoo needles
A nurse is caring for a client who is positive for hepatitis A. What precautions should the nurse take? 1. wear a gown when entering the client's room 2. use caution when bringing in the client's food 3. use gloves when removing the client's bedpan 4.wear a protective mask when entering patient's room
3 -virus is present in stool of clients
A client with chronic pancreatitis should have what dietary instructions? 1. low fat low protein diet 2. avoid foods high in carbs 3. avoid ingesting alcohol 4. eat a bland diet with no snacks in between
3. alcohol will cause the most damage - should be high in protein, average in carbohydrates - snacks in high calories are recommended
A nurse is caring for a client with chronic inflammation of the bowel. What should the nurse monitor for in the client? 1. ileus 2. pain 3. perforation 4. obstruction
3. because of chronic inflammation, the colon becomes thin and may perforate, causing peritonitis
Discharge planning for a client with chronic pancreatitis includes dietary teaching. What statement indicates that the client needs more teaching? 1. I must eat foods high in calories 2. I should avoid alcoholic beverages 3. I will eat more but in smaller amounts 4. I can eat foods high in fat now that the acute stage is over
4
A client with a history of pancreatitis is shceduled for surgery to excise a pseudocyst of the pancreas. the client asks what a pseudocyst is. 1. malignant growth 2. pocket of undigested food particles 3. sac filled with pus from necrotic pancreatic tissue 4. walled off space of pancreatic enzymes and exudate
4 - pseudocyst is a walled-off space that contains fluid, pnacreatic enzymes, tissue debris, and inflammatory exudate
A client reports pain four hours after a liver biopsy. The nurse identifies that there is a leakage of a large amount of bile on the dressing over the biopsy site. What should the nurse do first? 1. tell the client to remain flat on back 2. medicate client for pain 3. monitor the client's VS every 10 min 4. call the primary health provider immediately
4. - client should be on the right side to compress liver capsule against the chest wall
A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. He is on regular diet. What should the nurse instruct the client to do considering the client's condition? 1. avoid foods high in phytonadione 2. check pulse several times a day 3. drink a glass of milk when taking aspirin 4. report signs of bleeding no matter how slight
4. people with liver cirrhosis are ARF bleeding
A client with liver dysfunction states that his gums have been bleeding spontaneously. Nurse identifies small hemorrhagic lesions on the client's face. Which vitamin does the nurse conclude the client needs? 1. vitamin D 2. vitamin E 3. vitamin A 4. vitamin K
vitamin K activates blood clotting factors