HESI Case Study- Cirrhosis – Flashcards
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PN will look for decrease from the normal value in what laboratory test for a client with cirrhosis?
answer
serum albumin
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PN should observe for which clinical manifestations as the result of the prolonged APTT and PTT/INR?
answer
epistaxis
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PN knows which other clinical manifestation is a result of cirrhosis?
answer
fruity breath
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PN should observe for hyperkalemia because of which med Roberta is taking?
answer
Spironolactone
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Which action?
answer
document the finding in the client's record
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What approach should the PN use?
answer
challenge Roberta about her denial in a nonjudgemental manner
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What response?
answer
The type of liver damage that you have occurs after years of drinking, and that is what makes me think you are an alcoholic
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Who should the PN notify regarding Roberta's action to leave AMA?
answer
Client's HCP
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What action?
answer
Document that the client left the hospital AMA
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What is the primary underlying cause of hepatic encephalopathy?
answer
increased serum albumin
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Which outcome indicates to the PN that the lactulose and neomycin are having desired effect?
answer
increased mental altertness
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PN initiates which activity-level during the acute phase of Roberta's cirrhosis?
answer
bedrest
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What intervention?
answer
measure abdominal growth daily
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What intervention?
answer
position Roberta in the bed with her feet slightly elevated
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What action?
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apply O2
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When should NS be completed?
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4:30PM
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What selections?
answer
-baked chicken sandwich and fruit smoothie -grilled fish, spinach salad, apple, and iced tea
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Lifestyle management choices?
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-stop alcohol consumption -stop aspirin containing meds -talk to HCP before taking OTC meds
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Best choice for PN to contact?
answer
social worker
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How should PN respond?
answer
I really need you to find a way to help the client
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