NURS 406 TEST 4 EXAM QUESTIONS AND ANSWERS
key points - CORRECT ANSWER✅✅
hepatic - CORRECT ANSWER✅✅when caring for patients with cirrhosis, collaborate with the hcp,
dietician, pharmacist, social worker, and spiritual leader of the pt's choice to provide comprehensive
interprofessional care
refer pts' with liver disorders to the American Liver Foundation; refer dying pts to hospice and other
community resources as needed
follow guidelines (chart 58-3) to prevent viral hepatitis in the workplace
teach pts to take precautions to prevent viral hepatitis in the community as described in chart 58-4
for pts with viral hepatitis, instruct them to follow the guidelines listed in chart 58-5
teach pts to avoid alcohol and illicit street drugs to prevent or slow the progression of alcohol induced
cirrhosis; remind them to not take any medication (including otc drugs) without first checking with their
hcp
recognize that pts with cirrhosis have mental and emotional changes due to hepatic encephalopathy
be aware that pts with cirrhosis and/or chronic hepatitis may feel guilty abt their disease because of
past habits such as drug and alcohol use. allow pts to express feelings openly.
be aware that family members and friends may fear getting hepatitis from pt
be aware that pts having liver transplantation have major concerns about the possibility of
complications, such as organ rejection
be aware that cirrhosis has many causes other than alcohol use (table 58=1)
,observe for clinical signs and symptoms of hepatic encephalopathy (PSE) as listed in table 58-2
monitor lab values of pts suspected of or diagnosed with cirrhosis of the liver as listed in table 58-3
monitor pt with cirrhosis for bleeding and neurologic changes
provide care for pt having a paracentesis as described in chart 58-1
administer drug therapy to decrease ammonia levels (that cause pse) in pts with cirrhosis, such as
lactulose and nonabsorbable an
burn points - CORRECT ANSWER✅✅use strict aseptic technique when caring for patients who have
open burn wounds to prevent infection
monitor vital signs at least every 8 hours and assess wounds at least daily for signs of wound infection or
sepsis (for pts with greater than 25% TBSA burn, monitor vital signs more frequently)
administer prescribed opioid analgesics intravenously during the resuscitation phase of burn recovery
encourage adults to have and maintain home smoke and carbon monoxide detectors
teach pts to not smoke in bed or in rooms where home oxygen is in use and to not smoke when taking
substances that induce sedation (drugs, alcohol)
teach pts who have reduced sensation in hands or feet to use a bath thermometer to check water
temperature before bathing
teach pts to avoid exposing burned skin to the sun or to temp extremes
,instruct adults to set hot water tank temperatures to manufacturer recommendations
allow pts time to grieve over a change in body image and other fire-related loss
reassure pts that pain will be managed effectively and comfort will be promoted
explain procedures to the pt and family
assess the pt's and family's use of coping strategies related to burn injury, treatment, possible role
changes, and possible outcomes
support the pt and family in coping with permanent changes in appearance and function
encourage the patient with wounds and scars related to burn injury to participate in self care
*always prioritize the airway and adequacy of breathing*
*keep an endotracheal or tracheostomy kit at the bedside of any pt with facial burns, burns inside the
mouth, singed nasal hairs, or a "smoky" smell to the breath*
*notify the rapid response team immediately if the pt with an inhalation injury becomes more
breathless or audible wheezes disappear*
*administer analgesics, sedatives, and antianxiety drugs to pt
respiratory points - CORRECT ANSWER✅✅
------- - CORRECT ANSWER✅✅-------
action alerts - CORRECT ANSWER✅✅
, hepatic system - CORRECT ANSWER✅✅-pt centered care (gender health considerations)
the amt of alcohol necessary to cause cirrhosis varies widely from individual to individual, and there are
gender differences
in women, it may take as few as 2 or 3 drinks per day over a minimum of 10 years
in men, perhaps 6 drinks per day over 10 years or more may be needed to cause disease
however, a small amount of alcohol over a long period of time can increase memory loss from alcohol
toxicity of the cerebral cortex
binge drinking can increase risk for hepatitis and fatty liver
-for skin irritation and pruritus associated with jaundice, teach pt to use cool rather than warm water on
the skin and to use a small amount of soap.
teach unlicensed assistive personnel to use lotion to soothe the skin
assess for open skin areas from scratching, which could become infected
-for the pt with hepatopulmonary syndrome, monitor his or her oxygen saturation with pulse oximetry
if needed, apply oxygen therapy to ease breathing
elevate the head of the bed to at least 30degrees or as high as the pt wants to improve breathing
key points - CORRECT ANSWER✅✅
hepatic - CORRECT ANSWER✅✅when caring for patients with cirrhosis, collaborate with the hcp,
dietician, pharmacist, social worker, and spiritual leader of the pt's choice to provide comprehensive
interprofessional care
refer pts' with liver disorders to the American Liver Foundation; refer dying pts to hospice and other
community resources as needed
follow guidelines (chart 58-3) to prevent viral hepatitis in the workplace
teach pts to take precautions to prevent viral hepatitis in the community as described in chart 58-4
for pts with viral hepatitis, instruct them to follow the guidelines listed in chart 58-5
teach pts to avoid alcohol and illicit street drugs to prevent or slow the progression of alcohol induced
cirrhosis; remind them to not take any medication (including otc drugs) without first checking with their
hcp
recognize that pts with cirrhosis have mental and emotional changes due to hepatic encephalopathy
be aware that pts with cirrhosis and/or chronic hepatitis may feel guilty abt their disease because of
past habits such as drug and alcohol use. allow pts to express feelings openly.
be aware that family members and friends may fear getting hepatitis from pt
be aware that pts having liver transplantation have major concerns about the possibility of
complications, such as organ rejection
be aware that cirrhosis has many causes other than alcohol use (table 58=1)
,observe for clinical signs and symptoms of hepatic encephalopathy (PSE) as listed in table 58-2
monitor lab values of pts suspected of or diagnosed with cirrhosis of the liver as listed in table 58-3
monitor pt with cirrhosis for bleeding and neurologic changes
provide care for pt having a paracentesis as described in chart 58-1
administer drug therapy to decrease ammonia levels (that cause pse) in pts with cirrhosis, such as
lactulose and nonabsorbable an
burn points - CORRECT ANSWER✅✅use strict aseptic technique when caring for patients who have
open burn wounds to prevent infection
monitor vital signs at least every 8 hours and assess wounds at least daily for signs of wound infection or
sepsis (for pts with greater than 25% TBSA burn, monitor vital signs more frequently)
administer prescribed opioid analgesics intravenously during the resuscitation phase of burn recovery
encourage adults to have and maintain home smoke and carbon monoxide detectors
teach pts to not smoke in bed or in rooms where home oxygen is in use and to not smoke when taking
substances that induce sedation (drugs, alcohol)
teach pts who have reduced sensation in hands or feet to use a bath thermometer to check water
temperature before bathing
teach pts to avoid exposing burned skin to the sun or to temp extremes
,instruct adults to set hot water tank temperatures to manufacturer recommendations
allow pts time to grieve over a change in body image and other fire-related loss
reassure pts that pain will be managed effectively and comfort will be promoted
explain procedures to the pt and family
assess the pt's and family's use of coping strategies related to burn injury, treatment, possible role
changes, and possible outcomes
support the pt and family in coping with permanent changes in appearance and function
encourage the patient with wounds and scars related to burn injury to participate in self care
*always prioritize the airway and adequacy of breathing*
*keep an endotracheal or tracheostomy kit at the bedside of any pt with facial burns, burns inside the
mouth, singed nasal hairs, or a "smoky" smell to the breath*
*notify the rapid response team immediately if the pt with an inhalation injury becomes more
breathless or audible wheezes disappear*
*administer analgesics, sedatives, and antianxiety drugs to pt
respiratory points - CORRECT ANSWER✅✅
------- - CORRECT ANSWER✅✅-------
action alerts - CORRECT ANSWER✅✅
, hepatic system - CORRECT ANSWER✅✅-pt centered care (gender health considerations)
the amt of alcohol necessary to cause cirrhosis varies widely from individual to individual, and there are
gender differences
in women, it may take as few as 2 or 3 drinks per day over a minimum of 10 years
in men, perhaps 6 drinks per day over 10 years or more may be needed to cause disease
however, a small amount of alcohol over a long period of time can increase memory loss from alcohol
toxicity of the cerebral cortex
binge drinking can increase risk for hepatitis and fatty liver
-for skin irritation and pruritus associated with jaundice, teach pt to use cool rather than warm water on
the skin and to use a small amount of soap.
teach unlicensed assistive personnel to use lotion to soothe the skin
assess for open skin areas from scratching, which could become infected
-for the pt with hepatopulmonary syndrome, monitor his or her oxygen saturation with pulse oximetry
if needed, apply oxygen therapy to ease breathing
elevate the head of the bed to at least 30degrees or as high as the pt wants to improve breathing
