Cirrhosis Sherpath
A nurse is caring for a patient who has been diagnosed with cirrhosis; the disease is in the early stages. Which clinical manifestation would the nurse expect the patient to exhibit? Fatigue Jaundice Skin lesions Peripheral neuropathy
A
An elevation in which laboratory value can lead to increased confusion and lethargy in the patient with cirrhosis? Ammonia Potassium Total bilirubin Prothrombin time (PT)/international normalized ratio (INR)
A
The nurse is preparing to administer spironolactone to a patient with cirrhosis. Which finding would lead the nurse to withhold the dose of spironolactone? Hyperkalemia Confusion and lethargy Decreased bowel sounds Petechiae and ecchymosis
A
The nurse is providing care to a confused patient with hepatic encephalopathy who refuses to stay in bed and is at risk for falling. Which intervention will the nurse implement to keep the patient safe? Provide a low bed with the wheels locked. Raise all four side rails on the patient's bed. Obtain a prescription for soft-cloth restraints. Have one nurse stay in the patient's room around the clock
A
The nurse is providing discharge teaching to a male patient with cirrhosis about managing his care at home. Which statement made by the patient indicates a need for further teaching? "I will weigh myself every other day." "I will stay away from drinking alcohol." "I can use lotion to decrease any itching." "I should get out of bed and move slowly."
A
Which item should the nurse remove from the dinner tray of a patient with cirrhosis? Bacon Broccoli Potatoes Ice cream
A
What should the nurse include in a focused assessment when caring for a patient admitted to the hospital with a diagnosis of cirrhosis? Select all that apply. Assess the lower extremities. Assess skin integrity and color. Measure abdominal circumference. Auscultate the abdomen for bowel sounds. Assess for pupil reaction and accommodation.
A,B,C
Which interventions should the nurse include in the plan of care for a patient with cirrhosis who is experiencing excess fluid volume? Select all that apply. Obtain a daily weight. Auscultate lung sounds. Elevate lower extremities. Encourage deep breathing. Monitor prothrombin time (PT)/international normalized ratio (INR) and partial thromboplastin time (PTT).
A,B,C
Which laboratory values will the nurse expect to be decreased in the patient with cirrhosis? Select all that apply. Albumin Calcium Potassium Ammonia Alkaline phosphatase
A,B,C
A nurse is caring for a patient with a long-standing history of cirrhosis. Which findings on admission would cue the nurse to ask for further information from the patient or caregiver? Select all that apply. Uses acetaminophen for pain Lethargic and oriented to person Weight has stayed at 165 pounds Diminished lung sounds in both bases Consumes 1 to 2 alcoholic beverages per week
A,B,E
What should the nurse include in the teaching for a patient with cirrhosis who has an elevated prothrombin time (PT)/international normalized ratio (INR)? Take lactulose as prescribed. Use an electric razor for shaving. Keep your lower extremities elevated. Limit your daily intake of foods with sodium.
B
Which laboratory value must the nurse assess before administration of lactulose? Total bilirubin Ammonia level Alkaline phosphatase level Prothrombin time (PT)/international normalized ratio (INR)
B
Which pathologic change would cue the nurse to assess for excess fluid volume in a patient with cirrhosis? Potassium retention Hyperaldosteronism Ammonia reabsorption Prolonged clotting times
B
Which priority assessments should the nurse make before a patient undergoes a transjugular intrahepatic portosystemic shunt (TIPS) procedure? Select all that apply. Sodium level Ammonia level Prothrombin time Last bowel movement Level of consciousness
B,C
A nurse is reviewing medications with a patient who is being discharged after having an esophageal variceal bleed. The patient questions why propranolol is being prescribed when blood pressure is low. What is the nurse's best response? "Propranolol works in conjunction with vasopressin to provide systemic vasoconstriction." "This medication is prescribed by the primary health care provider to stop disease exacerbations." "The propranolol keeps your blood pressure within the normal range to ward off hypertensive crises." "Propranolol will help decrease the portal pressure to prevent further bleeding from existing varices."
D
The nurse is caring for a patient with cirrhosis and an elevated prothrombin time/international normalized ratio (PT/INR). Which complication is this patient most at risk for developing? Ascites Malnutrition Hepatic Encephalopathy Gastrointestinal hemorrhage
D
The nurse is preparing to administer a unit of fresh frozen plasma to a patient with cirrhosis admitted for a transjugular intrahepatic portosystemic shunt (TIPS) procedure. The patient's caregiver asks why the patient will be receiving fresh frozen plasma. What is the nurse's best response? "The fresh frozen plasma will help the patient make more red blood cells and platelets." "Fresh frozen plasma will expand the patient's blood volume to improve the blood pressure." "The fresh frozen plasma will be enough to stimulate the bone marrow to make red blood cells." "Fresh frozen plasma provides the patient with the necessary clotting factors that the liver is not producing."
D
The nurse is reviewing the admission history and physical examination findings for a patient with a history of cirrhosis who is being admitted for the third time in 6 months. Which laboratory finding would indicate the patient has not followed the plan of care previously discussed at discharge? Albumin level 2.8 g/dL Sodium level 133 mEq/dL Potassium level 3.4 mEq/dL Blood alcohol level 160 mg/dL
D
Which intervention should the nurse include when planning care to improve the nutritional status of a patient with cirrhosis? Provide the patient with preferred foods Implement fluid restriction of 1500 mL per day. Monitor the ammonia level and metabolic panels. Give the patient smaller meals and snacks throughout the day.
D
