1. As you continue your assessment of Bell, you recall the pathophysiology of cirrhosis of the liver. Which statement best describes cirrhosis?
Cirrhosis
... [Show More] is an irreversible loss of liver cells with scarring
2. Which situation about Bell's history increased her risk for cirrhosis of the liver?
Chronic alcohol ingestion
3. Characteristic of advanced cirrhosis, Bell's abdomen is enlarged due to accumulation of fluid in the peritoneal cavity. This is called:
Ascites
4. How does the HCP confirm that Bell has abdominal ascites?
Percussion of dullness in dependent areas of the abdomen
5. In cirrhosis, which factors contribute to ascites? (Select 3)
-Portal hypertension
-Accumulation of antidiuretic hormone (ADH)
-Hypoproteinemia
6. You and the HCP talk with Bell and examine her, checking for clinical signs of cirrhosis. What are the clinical signs of cirrhosis? (Select 5)
-Nausea
-Jaundice
-Weight change
-Ecchymosis
-Peripheral edema
7. Bell has been hospitalized for less than a day. Assuming she was drinking heavily prior to admission, at this time she might exhibit signs and symptoms of early alcohol withdrawal. What are signs and symptoms of early alcohol withdrawal? (Select 5)
-Anxiety
-Agitation
-Tremors
-Irritability
-Diaphoresis
8. The medical procedure that removes excess fluid from the peritoneal cavity is called:
Paracentesis
9. How should you prepare Bell for the paracentesis?
Ask her to void
10. After the HCP completes the paracentesis procedure, which nursing actions are indicated for Bell's care? (Select 2)
-Monitor Bell's pulse and blood pressure frequently
-Assess the procedure site and dressing
11. You work on Bell's plan of care. At this time, what is the major goal of nursing care for Bell?
Improve Bell's nutritional status
12. The HCP's prescriptions reflect the need to carefully monitor Bell's fluid balance. Which of the following provides the most useful data for monitoring fluid loss or gain?
Daily weights
13. You remind the HCP that she needs to prescribe a diet for Bell. Which diet is she likely to prescribe?
High-carbohydrate, low-salt
14. When determining the extent of Bell's liver dysfunction, which blood tests are monitored? (Select 6)
-Aspartate aminotransferase (AST)
-Alanine aminotransferase (ALT)
-Creatinine
-Albumin
-Ammonia
-Prothrombin time (PT)
15. Bell's HCP is called away, but tells you she will return shortly to write more prescriptions. You anticipate that she will prescribe which medications?
Propranolol or nadolol
16. Albumin is expected to alleviate Bell's ascites by which mechanism?
Albumin will make the vascular compartment hypertonic, causing a fluid shift from the peritoneal cavity into the bloodstream
17. Until Bell's ascites is resolved, which position do you encourage her to take while she is in bed?
Fowler's
18. Bell's skin and hair are dirty, and her skin is itchy from jaundice. Which action should the nurse take when bathing Bell and caring for her skin?
Apply lotion to dry skin areas
19. After Bell is bathed, she uses a bedpan. Which of the following, if observed, should be reported?
Melena
20. When a person with severe cirrhosis has esophageal or any other gastrointestinal (GI) bleeding, lactulose may be given. Which of the following are expected with administration of lactulose? (Select 2)
-Onset of soft stools
-Reduction of serum ammonia level
21. Bleeding from esophageal varices can be abrupt and massive. If a client at risk for varices started vomiting blood, which actions are important for the nurse to take? (Select 6)
-Assess vital signs
-Turn the client on her side
-Prepare to administer oxygen
-Prepare suctioning equipment
-Insure an IV access
-Prepare for insertion of a nasogastric tube [Show Less]