Common: Hepatic

Question 1

Hep: Explain why a patient with ascites who has undergone a paracentesis, is at risk for shock.

Answer 1

The rapid removal of fluid from the abdominal cavity during a paracentesis leads to decreased abdominal pressure, which can cause vasodilation and resultant shock.

Question 2

Hep: Daily weights, intake and output, and abdominal girth are assessments of a patient with what disease process?

Answer 2

Liver cirrhosis and ascites

Question 3

Hep: Describe why patients with liver disease should avoid high protein foods in their diet.

Answer 3

Elevated ammonia level is caused by the diseased liver. Most of the body’s ammonia, a byproduct of protein broken down by the liver, is found in the GI tract. Therefore, foods high in protein should be avoided to prevent further elevation of ammonia levels.

Question 4

Hep: How is hepatitis C transmitted?

Answer 4

Blood-to-blood transmission

Question 5

Hep: Why would a pressure-relief mattress be recommended for a patient with cirrhosis and accompanying edema?

Answer 5

They are at risk for skin breakdown, especially in vulnerable areas. A pressure-relief mattress will better distribute pressure and reduce the risk for skin injury.

Question 6

Hep: Asterixis and lethargy are serious symptoms of what complication of liver failure?

Answer 6

Hepatic encephalopathy

Question 7

Hep: People with end-stage liver disease are at risk for developing encephalopathy. Describe the relationship of dietary protein to this risk

Answer 7

Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting dietary protein intake can assist with decreasing the client’s ammonia level. Protein is necessary for healing, so strict limitation of dietary protein is not recommended.

Question 8

Hep: The best defense against hepatitis A transmission

Answer 8

Good hand hygiene. Hepatitis A is spread through fecal-oral transmission

Question 9

Hep: Ascites is a common complication of liver disease. Describe interventions that may be used for this complication

Answer 9

Use of diuretics to decrease the fluid accumulation

Limit sodium intake

Monitor abdominal girth

Question 10

Hep: What is petechia and how it is related to liver disease?

Answer 10

A dysfunctional liver causes disruption in the blood coagulation so patients with advanced cirrhosis often have petechiae, tiny purplish spots caused by ruptures in blood vessels.

Question 11

<p>Hep: Several disease processes may cause jaundice. What causes jaundice?</p>

Answer 11

<p>Jaundice is caused by the elevation of bilirubin level associated with red blood cell hemolysis.</p>

Question 12

<p>Hep: What is the best way to critically think through patient assignments and room pairings on a unit with varying levels of acute liver problems?</p>

Answer 12

<p>Infection and exposure risk</p>