M/S ch 47 Liver, Gallbladder, Pancreas

A client with esophageal varices is scheduled to undergo injection sclerotherapy. Which of the following client's statements indicate that the teaching was successful? -"The physician will use a balloon to compress the vessels." -"I might need to have this procedure done again." -"It's seems odd that a rubber band can block off the vessels." -"A catheter will be inserted through my belly to fix the vessels."

"I might need to have this procedure done again."

A client with cirrhosis is complaining to the nurse of itching. The client asks the nurse if the itching is because he has been taking warm baths. What is the best response by the nurse? -"The itching is caused by the accumulation of bile salts." -"The itching is related to dry skin from the warm baths." -"The itching is most likely a side effect from some of the medications used in treatment." -"The itching is related to a psychological response from the illness."

"The itching is caused by the accumulation of bile salts."

The nurse is caring for a client with cirrhosis of the liver. What symptoms exhibited by the client would indicate to the nurse that he is experiencing central nervous system effects of the disease? (multiple answer)

-Asterixis -Positive Babinski reflex -Fetor hepaticus

The nurse is admitting a client to their room at the hospital and observes that the client's skin and sclera are jaundice. What does the nurse expect the client's total bilirubin levels to be?

3.0 mg/dL

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?

A liver biopsy

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed?

Abdominal paracentesis

When inspecting the abdomen of a client with cirrhosis, the nurse observes that the veins over the abdomen are dilated. The nurse documents this finding as what?

Caput medusae

A client comes to the clinic and informs the nurse that he is there to see the physician for right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder do these symptoms correlate with?

Cholelithiasis

When assessing a client with cirrhosis of the liver, which stool characteristics is the client likely to report?

Clay-colored or whitish

Which of the following interventions would be appropriate for a client who has undergone surgery for a liver disorder and has started shivering? -Provide the client with warm fluids. -Cover the client with a light blanket. -Ensure that the room temperature is below 70 °F. -Place the client on a hypothermia blanket.

Cover the client with a light blanket.

A client is seeing the physician for a suspected tumor of the liver. What laboratory study results would indicate that the client may have a primary malignant liver tumor?

Elevated alpha-fetoprotein

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)

A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include? -Hepatitis B is transmitted primarily by the oral-fecal route. -Hepatitis A is frequently spread by sexual contact. -Hepatitis C increases a person's risk for liver cancer. -Infection with hepatitis G is similar to hepatitis A.

Hepatitis C increases a person's risk for liver cancer.

A client has developed drug-induced hepatitis from a drug reaction to antidepressants. What treatment does the nurse anticipate the client will receive to treat the reaction?

High-dose corticosteroids

A client had an open cholecystectomy with a T-tube insertion, and the nurse is measuring the bile drainage every 8 hours. When should the nurse notify the physician?

If more than 500 mL of bile drainage is present in 24 hours

A client with severe acute pancreatitis has a glucose level of 750 mg/dL. What does the nurse understand is the cause of this level of hyperglycemia?

Imbalance of glucagon, insulin, and somatostatin

Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes? -Increased appetite and thirst -Vomiting and diarrhea -Low blood pressure and pulse -Decreased urination and constipation

Increased appetite and thirst

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?

Lactulose

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. What intervention should the nurse consider?

Measure abdominal girth according to a set routine.

A client is scheduled to have a laparoscopic cholecystectomy as an outpatient. The client asks the nurse when he will be able to resume normal activities. What information should the nurse provide?

Normal activities may be resumed in 1 week.

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

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?

Reduce fluid accumulation and venous pressure.

The nurse is asking the client with acute pancreatitis to describe the pain. What pain symptoms does the client describe related to acute pancreatitis?

Severe mid-abdominal to upper abdominal pain radiating to both sides and to the back

The nurse is administering furosemide to promote urinary excretion of excess fluids for a client with cirrhosis. When administering furosemide to this client, what should the nurse closely monitor?

Sodium/Postassium level

The nurse is reviewing laboratory work that is consistent with a client being positive for hepatitis and in the incubation phase of the illness. What should the nurse be concerned with at this stage of the illness?

The client is infectious.

The nurse would expect to observe which of the following when assessing a client with cholelithiasis? -Stools that contain blood and mucus -Bowel sounds that are absent -Stools that appear small and dry -Urine that appears dark brown

Urine that appears dark brown

A female client with chronic hepatitis B has been prescribed recombinant interferon alpha-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client? -Avoid calcium-rich foods. -Maintain an exercise regimen. -Use strict birth control methods. -Avoid hot water baths or soaks.

Use strict birth control methods.

A client with carcinoma of the head of the pancreas is scheduled for surgery. What should a nurse administer to the client before surgery?

Vitamin K

A client with gallstones tells the nurse, "The doctor has to do something. Isn't there something he can give me to dissolve them?" What medication does the nurse know may help dissolve the gallstones?

chenodiol (Chenix)

A client with cirrhosis is complaining of severe pruritus related to the accumulation of bile salts. What can be prescribed for the client to relieve the itching?

cholestyramine (Questran)

A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding?

octreotide (Sandostatin)

A client with hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which of the following most likely would be ordered? -Chenodiol -Ursodiol -Tacrolimus -Interferon alpha-2b, recombinant

tacrolimus (Prograf)