Module 11

The fam of a pt newly dx with hepatitis A asks the nurse what they can do to prevent illness. Which is an appropriate response?

An injection of immunoglobulin will need to be given to prevent or minimize the risk of exposure

The nurse discovers a bluish discoloration of the periumbilical area on a pt who has been admitted with severe pancreatitis. How would the nurse document this finding?

Cullen's sign

Pt with chronic HCV infection is admitted to hospital. Which factors contribute to pt's high risk for development of cirrhosis?

DM alc consumptino elevated cholesterol

A patient is dx with chronic cholecystitis. Which assessment finding would the nurse expect?

Flatulence (also dyspepsia and heartburn)

A pt with T2DM has been dx with NAFLD. Which info would the nurse include in the teaching plan?

Following measures to gain tighter glucose control

Which hepatitis is transmitted mother to fetus?

Hepatitis B

which statement by a student nurse indicates a need for further teaching about nutritional therapy in pts with acute pancreatitis?

I will include high fat foods in the pts dietary plan

Which statement from a male pt with acute hepatitis C indicates understanding?

I will need to be checked for chronic HCV and other liver problems

The pt with cirrhosis is learning self-care. Which statement indicates that the patient needs more teaching?

If I notice a fast HR or irregular beats, that is normal for cirrhosis

A pt w/T2DM asks if its okay to take milk thistle to minimize liver damage. Which info provides rationale for the RN's response?

Milk thistle may affect liver enzymes and alter drug metabolism

A pt with cholecystitis receives a prescription for cholestyramine in powdered form. Which medication instruction would the nurse provide?

Mix the medication with 4-6oz of milk

A pt returns to the surgical center for his post-op visit after a cholecystectomy. The wife asks whether she should be concerned about having cholelithiasis as well. Which info about risk factors would the nurse provide?

Obesity increases the risk, especially in women

A pt receiving tx for cholelithiasis experiences severe nausea and 6 episodes of vomiting. which intervention would the nurse plan for the pt?

Performing gastric decompression

For which purpose would a pt with pancreatic cancer receive radiation therapy?

Relieve pain

A pt with hepatitis A is being discharged. which instruction would be given?

Wash hands carefully after bowel movements

Which finding would the nurse expect in a pt who has cholecystitis?

abdominal rigidity

Which tests might be ordered for pts admitted with symptoms of cholecystitis?

abdominal ultrasound and ERCP

Which prescribed tx would the nurse expect to administer to a pt with pancreatitis who has a BP of 80/70?

albumin

Pt w acute HBV will be discharged tomorrow. Which measures will the nurse include in teaching?

allow fr rest periods during the day avoid foods hot/cold eat small/freq meals

The HCP prescribes lactulose for a pt with hepatic encephalopathy. which data would the nurse monitor for effectiveness of this medication?

ammonia levels

Which assessment finding would the nurse expect in a pt with high ammonia level associated w hepatic encephalopathy?

asterixis

what guidance would the nurse provide to a pt dx with cirrhosis whose abdomen is distended and has a visible fluid wave?

avoid alc restrict Na take lactulose expect urinary freq

Pt underwent whipple. what are dietary instructions?

avoid high fat foods eat a diet high in proteins consume a high cal diet

RN caring for pt w/hepatitis C. Which nutritional interventions would she plan?

avoid serving hot/cold foods ensure that the pt drinks 2500-3000mL of water daily ensure pt has good breakfast and small/freq meals

The nurse suspects that a pt with cholelithiasis has developed choledocholithiasis. Increases in which assessment finding would support the nurse's suspicion?

bilirubin body temperature

Which med for pt with pancreatitis who has tingling around the lips?

calcium gluconate

A pt has severe abdominal pain dx with chronic pancreatitis secondary to choecystitis. Which tx option would the nurse anticipate be planned?

choledochojejunostomy

A pt with cholelithiasis is experiencing sever itching. Lab values show 2.1 mg/dL bilirubin level (normal is 0.3-1.9). Which medication is prescribed?

cholestyramine

A pt with cancer of the head of the pancreas is admitted to the hospital. Which manifestations would the nurse expect in this pt?

clay colored stools skin itching and irritation extreme upper abdominal pain that radiated to back

Which info about diet would the nurse provide for a pt who is dx with acute pancreatitis?

consume a low fat diet avoid consuming alcohol consume a high-carb diet

Which lab finding indicates resolution of pt acute pancreatitis?

dec serum amylase

Which dietary advice will the nurse give a patient after a cholecystectomy?

eat a high fiber diet have small/frequent meals avoid or keep fats to a minimum

Pt underwent liver transplant. What interventions would the nurse plan to prevent respiratory complications?

encourage the pt cough reposition frequently encourage pt to take deep breaths

which finding indicates a pt with advanced cirrhosis is experiencing a serious complication?

frequent nosebleeds and bruising

Which aspect would the nurse monitor for in a pt who has cholecystitis?

gums for bleeding

Which type of hepatitis may be diagnosed w an IgM antibody test?

hepatitis A

Which hepatitis virus is transmitted from mother to fetus?

hepatitis B

Pt w hx of alc abuse reports dull abdominal pain, yellow eyes, N/V. Lab shows elevated liver enzymes and inc serum a-fetoprotien. Which condition is expected?

hepatocellular cancer

A pt presents w fatigue, N/V, yellowish colored eyes. Lab reveals inc conjugated and unconjugated bilirubin in the urine. Which condition?

hepatocellular jaundice

Which clinical manifestations are seen with chronic hepatitis?

hepatomegaly and elevated liver enzymes

Which lab indicates worsening pancreatic function?

inc TG

Which dietary recommendation would the nurse give to a patient with chronic gallbladder disease?

include fat soluble vitamins

Pt admitted with severe acute pancreatitis. Which manifestations?

jaundice exocrine function pancreatic necrosis

A pt has been diagnosed with cholelithiasis. Which findings would indicate possible obstructed bile flow?

jaundice steatorrhea dark amber urine bleeding tendencies

Which assessment findings are associated with complication of cirrhosis of the liver?

pedal edema mental status changes black, tarry stools

`Which factors can lead to ascites?

portal HTN hyperaldosteronism dec serum colloidal oncotic pressure

The RN is giving discharge instructions to a pt and caregiver following a laparoscopic cholecystectomy. Which measures will be included in the discharge teaching?

resume normal activities gradually within one week eat a low fat diet for several weeks after the surgery report any bile colored drainage or pus from any incision

The nurse is caring for a pt with pancreatitis. which action would the nurse encourage to reduce risk for parotitis?

rinse mouth frequently

Which change in the gallbladder is associated with acute cholecystitis?

scarring of the wall

Pt reports loss of appetite, N/V, dark urine. Lab reveals HCV. Which med?

simeprevir

A nurse is caring for a pt who has cirrhosis of the liver. which clinical manifestations would the nurse expect to find?

small areas of bleeding into the skin vascular lesions formed by small blood vessels small dilated blood vessels with spider like branches

A pt admitted with cirrhosis of liver suddenly vomits blood. Which action would the nurse take?

stabilize pt and manage airway

Which info the nurse emphasize while teaching a pt ways to avoid exposure to hep B infection?

use disposable needles and syringes avoid sharing toothbrushes and razors avoid unsafe sex w/multiple partners and use condoms