If a health care worker believes that he or she may have been exposed to hepatitis A,
which immediate action will help prevent disease development?
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Request an injection of immunoglobulin.
The nurse would prioritize care for which patient?
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A patient with portal systemic encephalopathy who has become
increasingly difficulty to arouse.
Rationale
A change in the level of consciousness (LOC) of the patient with PSE is the
greatest concern; actions to improve the patient's LOC should be rapidly
implemented. Although uncomfortable, a headache in the patient with
, ascites is not likely related to liver disease and does not pose an immediate
threat or complication. A hemoglobin of 10.9 g/dL and thrombocytopenia
are expected findings in a patient with cirrhosis and do not pose an
immediate threat. Elevated ALT and AST levels are expected for the patient
with hepatitis A and do not indicate a risk for severe complications.
Which medication prescription would the nurse question for a patient with portal
hypertension and portal system encephalopathy who is receiving spironolactone?
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potassium chloride
Rationale
Spironolactone is a potassium-sparing diuretic; additional potassium may
result in potassium intoxication. Lactulose and neomycin are used to
control hepatic encephalopathy, which is part of the expected treatment
plan. Propranolol is used to prevent GI hemorrhage secondary to portal
hypertension and gastroesophageal varices, which is an expected
treatment for portal hypertension.
A positive result from hepatitis B antigen test would indicate which condition for a
patient who was previously treated for HEP B virus?
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Infectious status of the patient.
Rationale
As long as the HBsAg is present, the patient is infectious and may be in a
carrier state. It does not indicate permanent immunity, recurrence of
infection, or long-term liver damage.
,Which nutritional recommendation will the nurse make when educating the spouse of
a patient with cirrhosis about the patient's diet?
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Include a multivitamin.
Rationale
A patient who has cirrhosis should be taking a multivitamin. The nurse will
tell the patient's spouse that the patient's diet should be low sodium, not
high sodium. It should consist of small frequent meals, not large ones, and
the patient should abstain from alcohol completely.
Which medication may cause intestinal bloating and cramping for a patient who is
being treated for hepatic encephalopathy?
Give this one a try later!
lactulose
Rationale
Lactulose is a laxative prescribed to treat hepatic encephalopathy by
promoting excretion of ammonia in the stool by preventing absorption of
ammonia in the colon. Lactulose causes abdominal cramping and bloating
as side effects; therefore lactulose would be discontinued and replaced
with another medication. Rifaximin is the most effective, safe, and long-
term drug in the treatment of hepatic encephalopathy. A benzodiazepine,
such as alprazolam, is used when the patient is experiencing alcohol
withdrawal. Metronidazole is used as an antiseptic for intestinal infections
and is not associated with abdominal cramping or bloating.
, Portal hypertension related to cirrhosis can result in which complication? (select all
that apply)
Give this one a try later!
ascites
hemorrhoids
esophageal varices
Rationale
Portal hypertension results from increased resistance to or obstruction
(blockage) of the flow of blood through the portal vein and its branches.
The blood meets resistance to flow and seeks collateral (alternative)
venous channels around the high-pressure area. Veins become dilated in
the esophagus (esophageal varices), rectum (hemorrhoids), and abdomen
(ascites because of excessive abdominal [peritoneal] fluid). Hematuria may
indicate insufficient production of clotting factors in the liver and
decreased absorption of vitamin K. Fever indicates an inflammatory
process.
Which statement indicates understanding of how to observe for esophageal bleeding
in the patient with cirrhosis?
Give this one a try later!
which immediate action will help prevent disease development?
Give this one a try later!
Request an injection of immunoglobulin.
The nurse would prioritize care for which patient?
Give this one a try later!
A patient with portal systemic encephalopathy who has become
increasingly difficulty to arouse.
Rationale
A change in the level of consciousness (LOC) of the patient with PSE is the
greatest concern; actions to improve the patient's LOC should be rapidly
implemented. Although uncomfortable, a headache in the patient with
, ascites is not likely related to liver disease and does not pose an immediate
threat or complication. A hemoglobin of 10.9 g/dL and thrombocytopenia
are expected findings in a patient with cirrhosis and do not pose an
immediate threat. Elevated ALT and AST levels are expected for the patient
with hepatitis A and do not indicate a risk for severe complications.
Which medication prescription would the nurse question for a patient with portal
hypertension and portal system encephalopathy who is receiving spironolactone?
Give this one a try later!
potassium chloride
Rationale
Spironolactone is a potassium-sparing diuretic; additional potassium may
result in potassium intoxication. Lactulose and neomycin are used to
control hepatic encephalopathy, which is part of the expected treatment
plan. Propranolol is used to prevent GI hemorrhage secondary to portal
hypertension and gastroesophageal varices, which is an expected
treatment for portal hypertension.
A positive result from hepatitis B antigen test would indicate which condition for a
patient who was previously treated for HEP B virus?
Give this one a try later!
Infectious status of the patient.
Rationale
As long as the HBsAg is present, the patient is infectious and may be in a
carrier state. It does not indicate permanent immunity, recurrence of
infection, or long-term liver damage.
,Which nutritional recommendation will the nurse make when educating the spouse of
a patient with cirrhosis about the patient's diet?
Give this one a try later!
Include a multivitamin.
Rationale
A patient who has cirrhosis should be taking a multivitamin. The nurse will
tell the patient's spouse that the patient's diet should be low sodium, not
high sodium. It should consist of small frequent meals, not large ones, and
the patient should abstain from alcohol completely.
Which medication may cause intestinal bloating and cramping for a patient who is
being treated for hepatic encephalopathy?
Give this one a try later!
lactulose
Rationale
Lactulose is a laxative prescribed to treat hepatic encephalopathy by
promoting excretion of ammonia in the stool by preventing absorption of
ammonia in the colon. Lactulose causes abdominal cramping and bloating
as side effects; therefore lactulose would be discontinued and replaced
with another medication. Rifaximin is the most effective, safe, and long-
term drug in the treatment of hepatic encephalopathy. A benzodiazepine,
such as alprazolam, is used when the patient is experiencing alcohol
withdrawal. Metronidazole is used as an antiseptic for intestinal infections
and is not associated with abdominal cramping or bloating.
, Portal hypertension related to cirrhosis can result in which complication? (select all
that apply)
Give this one a try later!
ascites
hemorrhoids
esophageal varices
Rationale
Portal hypertension results from increased resistance to or obstruction
(blockage) of the flow of blood through the portal vein and its branches.
The blood meets resistance to flow and seeks collateral (alternative)
venous channels around the high-pressure area. Veins become dilated in
the esophagus (esophageal varices), rectum (hemorrhoids), and abdomen
(ascites because of excessive abdominal [peritoneal] fluid). Hematuria may
indicate insufficient production of clotting factors in the liver and
decreased absorption of vitamin K. Fever indicates an inflammatory
process.
Which statement indicates understanding of how to observe for esophageal bleeding
in the patient with cirrhosis?
Give this one a try later!
