Liver

Question 1

_________ and ________ are initial indications of hepatic dysfucntion

Answer 1

fatigue and dark urine

Question 2

___________ and __________ indicates the possibility of internal bleeding (a life threatening problem)

Answer 2

distended abdomen and splenomegaly

Question 3

3 things to know about cholecystitis:

Answer 3

1. can cause nausea
2. frequent belching
3. right upper abdominal pain

Question 4

2 things a T-Tube is used for:

Answer 4

1. to allow drainage of bile

2. to allow the introduction of media

Question 5

2 things to avoid when having a T-Tube:

Answer 5

1. strenuous exercise

2. do not immerse T-Tube in water

Question 6

What is the expected drainage of a T-Tube?

Answer 6

500 - 1000 mL/day initially, will gradually decrease

Question 7

What do you do following a cholecystectomy?

Answer 7

ensure the pt has help at home the first 24 - 48 hours

Question 8

What should the pt do prior to an abdominal cholecystectomy?

Answer 8

place a pillow against the abdomen, take 3 deep breaths, hold the breath and the cough 2 - 3 times; this should be done every 2 hrs to prevent respiratory complications

Question 9

_________can prevent abdominal jarring.

Answer 9

splinting

Question 10

If a pt complains of severe abdominal pain in the right upper quadrant, it could indicate…

Answer 10

peritonitis or wound infection

Question 11

Sources of Vitamin K:

Answer 11

1. Green salad (most green vegetables), pork

Question 12

If a pt has vitamin K deficiency, it means that ____________

Answer 12

they can bleed easily, check arm after BP for any bruising

Question 13

What position should a pt be in after a liver biopsy?

Answer 13

lying on the right side for several hours to promote hemostasis and prevent hemorrhage and bile leakage

Question 14

How should the nurse position the pt in preparation of a liver biopsy?

Answer 14

supine with the arms raised above the head to allow access to the liver.

Question 15

Where is the needle inserted when doing a liver biopsy?

Answer 15

between two of the lower ribs or below the right rib cage

Question 16

In Asians, signs of early jaundice are best observed on __________

Answer 16

the posterior hard palate; involved with taking Isoniazid

Question 17

Jaundice may signal ____________

Answer 17

metastatic disease

Question 18

Jaundice may also indicate a possible ___________

Answer 18

stone in the bile duct causing obstruction

Question 19

8 signs of alcohol withdrawal symptoms:

Answer 19

1. increase in pulse
2. anxiety
3. tremors
4. insomnia
5. hallucinations
6. restless
7. agitated
8. irritable

Question 20

3 early symptoms of alcohol withdrawal:

Answer 20

1. hyperalert
2. easily startled
3. anorexia

Question 21

When does alcohol withdrawal peak?

Answer 21

24 - 48 hours after the last drink

Question 22

What is a good indicator of the pt’s progress through alcohol withdrawal?

Answer 22

an elevated pulse rate

Question 23

How do you know if a pt in alcohol withdrawal is approaching delirium tremens (the most severe expression of alcohol withdrawal syndrome?

Answer 23

a steady increase in vital signs

Question 24

How can delirium tremens be avoided in pt’s with alcohol withdrawal?

Answer 24

with additional sedation

Question 25

Chronic alcohol use is the most common cause of _____________

Answer 25

hypomagnesium (less than 1.5)

Question 26

4 Clinical manifestations of hypo magnesium include:

Answer 26

increase neuromuscular irritability
tremors
tetany
seizures

Question 27

The best way to identify possible physical of alcohol dependency is through ___________

Answer 27

a complete physical assessment

Question 28

What is hepatic toxicity?

Answer 28

a serious complication resulting from an acute Tylenol overdose that manifests 1 to 3 days after initial ingestion. ALT and AST will be increased.

Question 29

3 symptoms of hepatitis A:

Answer 29

1. Fatigue
2. Anorexia
3. intolerance to odors

Question 30

3 recommendations for pts with hepatitis A:

Answer 30

1. eat small meals and snacks
2. eat protein from milk, meat and eggs
3. increase calories 2000 - 3000 per day to meet energy needs

Question 31

When is hepatitis A not infectious?

Answer 31

within a week or so after the onset of jaundice

Question 32

What kind of precaution is needed for hepatitis A?

Answer 32

Standard precaution

Question 33

What supplements do pts with chronic alcoholism need?

Answer 33

all B vitamins, especially thiamine (vitamin B1)

Question 34

___________ is the primary cause of alcohol related changes such as _________ and ___________

Answer 34

Thiamine deficiency

Wernicke’s encephalopathy and Korsakoff’s syndrome

Question 35

Side effects of Disulfiram (Antabuse):

Answer 35

1. helps to minimize complications from the sedative effects of the drug
2. the longer the pt takes the drug, the more sensitive they will be to alcohol.
3. ANY contact with alcohol will cause alcohol-disulfiram reaction which may lead to shock and cardiac dysrhythmias

Question 36

In the event of ascites, ___________ is given to _____________

Answer 36

albumin; pull fluid back into the blood vessel; then a diuretic is given to remove the excess fluids

Question 37

In cirrhosis, a __________ is need to relieve portal hypertension.

Answer 37

a shunt

Question 38

What kind of diet would a pt need in the early stages of cirrhosis?

Answer 38

High protein, high carbohydrate diet

Question 39

Later in the disease process a pt with cirrhosis needs what kind of diet?

Answer 39

low fiber, protein, fat and sodium

Question 40

What is an early symptom of chronic cirrhosis?

Answer 40

impaired thought process

Question 41

3 Nursing interventions for a pt with cirrhosis:

Answer 41

1. monitor for bleeding; administer blood
2. measure abdominal girth; weight pt daily
3. assess for respiratory difficulties