Cirrhosis – Flashcard

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is a documentation of the presence of asterixis. How should the nurse assess for its presence? a. Dorsiflex the client's foot b. measure the abdominal growth c. ask the client to extend the arms d. instruct the client to lean forward

the nurse is reviewing the laboratory results in a client with cirrhosis and notes that the ammonia level is elevated. Which diet does the nurse anticipate to be prescribed for this client? a. low protein diet b. high protein diet c. moderate fat diet d. high carbohydrate diet

The nurse recognizes early signs of hepatic encepphalopathy in the patient who a. manifests asterixis b. becomes unconscious c. has increasing oliguira d. is irritable and lethargic

A patient with advanced cirrhosis has a nursing diagnosis of imbalance nutrition: less than body requirements r/t anorexia and inadequate food intake. An appropriate midday snack for the patient would be a. peanut butter and salt free crackers b. a fresh tomato sandwich with salt free butter c. popcorn with salt free butter and herbal seasoning d. canned chicken noodle soup with low protein bread

During the treatment of the patient with bleeding esophageal varices, it is most important that the nurse a. prepare the patient for immediate portal shunting surgery b. perform guaiac on all stools to detect occult blood c. maintain the patient's airway and prevent aspiration of blood d. monitor for cardiac effects of IV vasopressin and nitroglycerin

A patient with cirrhosis that is refractory to other treatments for esophageal varices undergoes a peritoneovenous shunt. As a result of this procedure, the nurse would expect the patient to experience a. an improved survival rate b. decreased serum ammonia levels c. improved metabolism of nutrients d. improved hemodynamic function and renal perfusion

In discussing long-term management with the patient with alcoholic cirrhosis, the nurse advises the patient that a.a daily exercise regimen is important to increase the blood flow through the liver b. cirrhosis can be reversed if the patient follows a regimen of proper rest and nutrition c. abstinence from alcohol is the most important factor in improvement of the patients condition d. the only over the counter analgesic that should be used for minor aches and pains is acetaminophen

A patient with cirrhosis asks the nurse about the possibility of a liver transplant. The best response by the nurse is, a. Liver transplants are only indicated in children with irreversible liver disease b. if you are interested in a transplant, you really should talk to your doctor about it c. Rejection is such a problem in liver transplants that it is seldom attempted in patients with cirrhosis d. Cirrhosis is an indication for transplantation in some cases. Have you talked to your doctor about this?

Laboratory test results that the nurse would expect to find in a patient with cirrhosis include a. serum albumin: 7.0 g/dL b. bilirubin: total 3.2 mg/dL c. serum cholesterol: 260 mg/dL d. aspartate amniotransferase: 6.0 U/L

The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's response is based on the knowledge that a. a lack of clotting factors promotes the collection of blood in the abdominal cavity b. portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space. c. decreased peristalsis in the GI tract contributes to gas formation and distention of the bowel d. bile salts in the blood irritate the peritoneal membranes, causing edema and pocketing of fluid

The nurse is teaching a client who is scheduled for a paracentesis. Which of the following statements by the client to the nurse indicates that teaching has been successful? a. I will be in surgery for less than a hour b. I must not void prior to the procedure c. The physician will remove 2-3 liters of fluid d. I will lie on my back and breathe slowly

The nurse knows that the plan of care for a client with severe liver disease should include which of the following actions? a. Administer kayexelate enemas b. offer a low protein, high carbohydrate diet c. insert a Sengsteken-Blakemore tube d. administer salt poor albumin IV

The nurse performs teaching with a client undergoing a paracentesis for treatment of cirrhosis. The client asks what position he will be in for the procedure. The nurse's reply should be based on an understanding that the MOST appropriate position for the client is which of the following? a. Sitting with his lower extremities well supported b. Side lying with a pillow between his knees c. Prone with his head turned to the left side d. Dorsal recumbent with a pillow at the back of his head

The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this patient by assessing which of the following? a. Relief of constipation b. Relief of abdominal pain c. Decreased liver enzymes d.Decreased ammonia levels

When planning care for a patient with cirrhosis, the nurse will give highest priority to which of the following nursing diagnoses? a. Imbalanced nutrition: less than body requirements b. Impaired skin integrity related to edema, ascites, and pruritus c. Excess fluid volume related to portal hypertension and hyperaldosteronism d. Ineffective breathing pattern related to pressure on diaphragm and reduced lung volume

When caring for a patient with liver disease, the nurse recognizes the need to prevent bleeding resulting from altered clotting factors and rupture of varices. Which of the following nursing interventions would be appropriate to achieve this outcome (select all that apply)? a. Use smallest gauge possible when giving injections or drawing blood. b.Teach patient to avoid straining at stool, vigorous blowing of nose, and coughing. c. Advise patient to use soft-bristle toothbrush and avoid ingestion of irritating food. d. Apply gentle pressure for the shortest possible time period after performing venipuncture. e. Instruct patient to avoid aspirin and NSAIDs to prevent hemorrhage when varices are present.

A patient with type 2 diabetes and cirrhosis asks the nurse if it would be okay to take silymarin (milk thistle) to help minimize liver damage. The nurse responds based on knowledge that a. Milk thistle may affect liver enzymes and thus alter drug metabolism. b. Milk thistle is generally safe in recommended doses for up to 10 years. c.There is unclear scientific evidence for the use of milk thistle in treating cirrhosis. d. Milk thistle may elevate the serum glucose levels and is thus contraindicated in diabetes.

When caring for a patient with a biliary obstruction, the nurse will anticipate administering which of the following vitamin supplements (select all that apply)? a.Vitamin A b.Vitamin D c.Vitamin E d.Vitamin K e. Vitamin B