What is D?
Activation of the complement system by antigen-antibody complexes
What causes the systemic effects of viral Hepatitis?
b. Impaired portal circulation
c. Toxins produced by the infected liver
d. Activation of the complement system by antigen-antibody complexes
What is C?
Development of collateral channels of circulation in inelastic, fragile esophageal veins as result of portal HTN
Which manifestations may be seen in the pt w/ cirrhosis r/t esophageal varies?
a. jaundice, peripheral edema, & ascites from increased intrahepatic pressure & dysfunction
b. loss of small bile ducts & cholestasis in its w/ other autoimmune disorders
c. development of collateral channels of circulation in inelastic, fragile esophageal veins as result of portal HTN
d. scarring & nodular changes in liver lead to compression of veins & sinusoids, causing resistance of blood flow through liver from portal vein
What is B?
What is a risk factor associated w/ cancer of the pancreas?
a. alcohol intake
b. cigarette smoking
c. exposure to asbestos
d. increased dietary intake of spoiled milk products
What is A? NPO w/ NG suction
What tx for acute cholecystitis will prevent further stimulation of the gallbladder?
a. NPO w/ NG suction
b. incisional cholecystectomy
c. administration od antiemetics
d. administration of anticholinergics
What is D? Use of acetaminophen
The occurrence of acute liver failure is most common in which situation?
a. individual w/ Hepatitis A
b. individual w/ Hepatitis C
c. Antihypertensive medication use
d. Use of acetaminophen
What is B?
"I must avoid all physical contact w/ my family until the jaundice is gone."
The nurse identifies a need for further teaching when the pt w/ Hepatitis B makes which statement?
a. "I should avoid alcohol completely for as long as a year."
b. "I must avoid all physical contact w/ my family until the jaundice is gone."
c. "I should use a condom to prevent spread of the disease to my sexual partner."
d. "I will need to rest several times a day, gradually increasing my activity as. tolerate it."
What is A?
Oral hygiene before meals & snacks
Malnutrition can be a big problem for its w/ cirrhosis. Which nursing intervention can help to improve nutrient intake?
a. oral hygiene before meals & snacks
b. provide all foods the pt likes to eat
c. improve oral intake by feeding the pt
d. limit snack offers to when the pt is hungry
What is D?
severe midepigastric or LUQ pain
When assessing a pt w/ acute pancreatitis, the nurse would expect to find a. hyperactive bowel sounds
b. hypertension & tachycardia
c. temperature > 102 F (38.9C)
d. severe midepigastric or LUQ pain
What is C?
report any bile-colored or purulent drainage from the incisions
During discharge instructions for a pt following a laparoscopic cholecystectomy, what should the nurse include in teaching?
a. keep incision areas clean & dry for at least 1 week
b. report the need to take pain medication for shoulder pain
c. report any bile-colored or purulent drainage from the incisions
d. expect some post N/V for a few days
What is D?
primary sclerosing cholangitis
The pt presents w/ jaundice & itching, steatorrhea, & liver enlargement. This pt has also had ulcerative colitis for several years. What dx should the nurse expect for this pt?
b. acute liver failure
c. hepatorenal syndrome
d. primary sclerosing cholangitis
What is A?
providing adequate nutritional intake
What is one of the most challenging nursing interventions to promote healing in the patient w/ viral Hepatitis?
a. providing adequate nutritional intake
b. promoting strict bed rest during the icteric phase
c. providing pain relief w/o using liver-metabolizing drugs
d. providing quiet diversional activities during periods of fatigue
What is B?
Fresh tomato sandwich w/ salt-free butter
A pt w/ advanced cirrhosis has a nursing dx of imbalanced nutrition: less than body requirements r/t anorexia & inadequate food intake. What would be an appropriate midday snack for pt?
a. peanut butter & salt-free crackers
b. fresh tomato sandwich w/ salt-free butter
c. popcorn w/ salt-free butter & herbal seasoning
d. canned chicken noodle soup w/ low-protein bread
What is C? malabsorption & diabetes mellitus
What is the pt w/ chronic pancreatitis more likely to have the nthe pt w/ a cute pancreatitis?
a. need to abstain for alcohol
b. experience acute abdominal pain
c. malabsorption & diabetes mellitus
d. require high-carb, high-protein, low-fat diet
What is A, B, C, E, F?
Age over 40
Family hx of gallbladder disease
Use of estrogen or oral contraceptives
Of the following characteristics, identify those that are most commonly associated with cholelithiasis. (select all that apply)
b. age over 40
c. multiparous female
d. hx of excessive alcohol intake
e. family hx of gallbladder disease
f. use of estrogen or oral contraceptives
What is C? maintain pt's airway & prevent aspiration of blood
Priority Decision: During tx of the pt w/bleeding esophageal varies, what is the most important thing the nurse should do?
a. prepare pt for immediate portal shunting surgery
b. perform guaiac testing on all stools to detect occult blood
c. maintain pt's airway & prevent aspiration of blood
d. monitor for cardiac effects of IV vasopressin & nitroglycerin
What is C?
Those who have had household or close contact w/pt should receive immune globulin.
The family members of a pt w/ Hepatitis A ask if there is anything that will prevent them from developing the disease. What is the best response by the nurse?
a. "No immunization is available for Hepatitis A, nor are you likely to get the disease."
b. "All family members should receive the Hepatitis A vaccine to prevent or modify the infection."
c. "Those who have had household or close contact w/pt should receive immune globulin."
d. "Only those individuals who have had sexual contact w/ pt should receive immunization."
What is B, C?
Hypokalemia & renal function
The patient being treated with diuretics for ascites from cirrhosis must be monitored for (Select all that apply)
a. GI bleeding d. body image disturbances
b. hypokalemia e. increased clotting tendencies
c. renal function
What is C? "I shouldn't eat any salty foods or foods w/high amounts of Na."
The nurse determines that further discharge instruction is needed when pt w/ acute pancreatitis makes which statement?
a. "I should observe for fat in my stools."
b. "I must not use alcohol to prevent future attacks of pancreatitis."
c. "I shouldn't eat any salty foods or foods w/high amounts of Na."
d. "I will need to continue to monitor my blood glucose levels until may pancreas is healed."
What is A? it is noninvasive & is a very reliable method of detecting gallstones
The pt w/ suspected gallbladder disease is scheduled for an ultrasound of the gallbladder. What should the nurse explain to the pt about this test?
a. it is noninvasive & is a very reliable method of detecting gallstones
b. it is used only when other tests cannot be used because of allergy to contrast media
c. it will outline the gallbladder & the ductal system to enable visualization of stones
d. it is an adjunct to liver function tests to determine whether the gallbladder is inflamed
What is A, B, D?
Ulcerative colitis dietary changes
A pt was dx w/ nonalcoholic fatty liver disease (NAFLD). What tx measures should the nurse plan to teach the pt about? (Select all that apply)
a. weight loss
b. Diabetes management
c. Ulcerative colitis dietary changes
d. Dietary management of hyperlipidemia
e. maintaining blood pressure w/ increased Na & fluid intake
What is C?
is treated w/ corticosteroids or other immunosuppressive agents
When caring for a pt w/ autoimmune Hepatitis, the nurse understands that what in this pt is different from the pt who has viral Hepatitis?
a. does not manifest hepatomegaly or jaundice
b. experiences less liver inflammation & damage
c. is treated w/ corticosteroids or other immunosuppressive agents
d. usually an older adult who has used a wide variety of prescription & OTC drugs
What is C? abstinence from alcohol is most important factor in improvement of pt's condition
In discussing long-term management w/pt w/alcoholic cirrhosis, what should the nurse advise the pt?
a. daily exercise regimen is important to increase blood flow through liver
b. cirrhosis can be reversed if pt follows regimen of proper rest & nutrition
c. abstinence from alcohol is most important factor in improvement of pt's condition
d. only OTC analgesic that should be used for minor aches & pains is acetaminophen
What is A, B, C?
eat bland foods
observe stools for steatorrhea
The nurse is instructing a pt w/ chronic pancreatitis on measures to prevent further attacks. What information should be provided? (Select all that apply)
a. avoid nicotine
b. eat bland foods
c. observe stools for steatorrhea
d. eat high-fat, low-protein, high-carb meals
e. take prescribed pancreatic enzymes immediately following meals
What is C? "A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile."
A pt w/ chronic cholecystitis asks a nurse whether she will need to continue a low-fat diet after she has a cholecystectomy. What is the best response by the nurse?
a. "A low-fat diet will prevent the development of further gallstones & should be continued."
b. "Yes; because you will not have a gallbladder to store bile, you will not be able to digest fats adequately."
c. "A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile."
d. "Removal of the gallbladder will eliminate the source of your pain associated w/ fat intake, so you may eat whatever you like."
What is C?
assist the pt to the bathroom
Priority Decision: The pt has hepatic encephalopathy. What is a priority nursing intervention to keep the pt safe?
a. turn pt every 3 hours
b. encourage increasing ambulation
c. assist the pt to the bathroom
d. prevent constipation to reduce ammonia production