Assessment and Management of Patients with Hepatic Disorders Flashcards
The nurse is educating a patient with cirrhosis about the importance of
maintaining a low-sodium diet. Which statement made by the patient
indicates that the education is effective?
a. “Peanut butter will be a good option for me since it will also add
protein.”
b. “Fresh fruit like the pear I ate for lunch will be a low-sodium option.”
c. “It’s alright if I just have a couple of hot dogs with ketchup at dinner.”
d. “Canned soup is a light meal that will be low in calories and healthy.”
B. “Fresh fruit like the pear I ate for lunch will be a low-sodium option.”
The nurse is caring for a patient with ascites as a result of hepatic
dysfunction. Which intervention will the nurse provide to determine if
the ascites is increasing? (Select all that apply.)
a. Measure urine output every 8 hours.
b. Assess and document vital signs every 4 hours.
c. Measure abdominal girth daily.
d. Perform daily weights.
e. Monitor number of bowel movements per day.
c. Measure abdominal girth daily.
d. Perform daily weights.
The nurse is concerned about potassium loss when a diuretic is
prescribed for a patient with ascites and edema. Which diuretic may be
prescribed that spares potassium and prevents hypokalemia?
a. Furosemide
b. Spironolactone
c. Acetazolamide
d. Bumetanide
b. Spironolactone
The nurse is caring for a patient with ascites due to cirrhosis of the liver.
Which position does the nurse determine will activate the renin
angiotensin–aldosterone and sympathetic nervous system and decrease
responsiveness to diuretic therapy?
a. Prone
b. Supine
c. Left-lateral Sims’
d. Upright
d. Upright
A patient is scheduled for a diagnostic paracentesis, but when
coagulation studies are reviewed, the nurse observes results outside of
normal parameters. How will the nurse proceed with preparation for the
paracentesis?
a. An ultrasound-guided paracentesis will be performed.
b. The procedure will be canceled until the laboratory results are within
normal parameters.
c. The paracentesis will be performed at the bedside.
d. The nurse will administer packed red blood cells (RBCs) prior to the
paracentesis.
a. An ultrasound-guided paracentesis will be performed.
The nurse is caring for a patient with ascites. Which intervention will the
nurse perform to correct the decrease in effective arterial blood volume
that will lead to sodium retention?
a. Administer diuretic therapy.
b. Assist with a therapeutic paracentesis.
c. Infuse platelets.
d. Infuse albumin.
d. Infuse albumin.
The nurse provides care to a patient with gross ascites who is
maintaining a position of comfort in the high semi-Fowler position.
Which is the nurse’s priority assessment of this patient?
a. Respiratory assessment related to increased thoracic pressure
b. Urinary output related to increased sodium retention
c. Peripheral vascular assessment related to immobility
d. Skin assessment related to increase in bile salts
a. Respiratory assessment related to increased thoracic pressure
A patient with suspected esophageal varices is scheduled for an upper
endoscopy with moderate sedation. After the procedure is performed,
how long will the nurse withhold food and fluids?
a. For 2 hours after the last dose of medication is given
b. Until the gag reflex returns
c. Until the patient expresses thirst
d. For 6 hours after the procedure
b. Until the gag reflex returns
A patient who had a recent myocardial infarction was brought to the
emergency department with bleeding esophageal varices and is presently
receiving fluid resuscitation. Which first-line pharmacologic therapy will
the nurse prepare to administer to control the bleeding from the varices?
a. Vasopressin
b. Epinephrine
c. Octreotide
d. Glucagon
c. Octreotide
A patient with bleeding esophageal varices has had pharmacologic
therapy with octreotide and endoscopic therapy with esophageal varices
banding but continues to bleed. Which procedure will the nurse prepare
for that will lower portal pressure?
a. Transjugular intrahepatic portosystemic shunting (TIPS)
b. Administration of vasopressin
c. Sclerotherapy
d. Balloon tamponade
a. Transjugular intrahepatic portosystemic shunting (TIPS)
The nurse is educating a patient being treated for hepatic encephalopathy
about dietary restrictions to prevent ammonia accumulation. Which
statement made by the patient indicates that the patient understands the
education?
a. “I will decrease the amount of fats in my diet.”
b. “I need to eat foods that are high in potassium.”
c. “I need to decrease the amount of protein in my diet.”
d. “It is necessary to increase the amount of magnesium in my diet.”
c. “I need to decrease the amount of protein in my diet.”
The nurse is caring for a patient with cirrhosis of the liver and observes
that the patient is having hand-flapping tremors. How will the nurse
document this finding?
a. Constructional apraxia
b. Fetor hepaticus
c. Ataxia
d. Asterixis
d. Asterixis
The nurse is administering lactulose to decrease the ammonia level in a
patient who has hepatic encephalopathy. Which will the nurse carefully
monitor for that may indicate a medication overdose?
a. Watery diarrhea
b. Vomiting
c. Ringing in the ears
d. The presence of asterixis
a. Watery diarrhea
A patient with severe chronic liver dysfunction comes to the clinic with
bleeding of the gums and blood in the stool. Which vitamin deficiency
does the nurse identify the patient may be experiencing?
a. Riboflavin deficiency
b. Folic acid deficiency
c. Vitamin A deficiency
d. Vitamin K deficiency
d. Vitamin K deficiency
A patient must begin receiving the hepatitis B series of injections. The
patient asks when the next two injections should be administered. Which
is the best response by the nurse?
a. “You must have the second one in 2 weeks and the third in 1 month.”
b. “You must have the second one in 1 month and the third in 6
months.”
c. “You must have the second one in 6 months and the third in 1 year.”
d. “You must have the second one in 1 year and the third the following
year.”
b. “You must have the second one in 1 month and the third in 6
months.”
