MCCN SDAP X - Med-Surg Exam 3
questions well answered passed
Diagnostic levels that increase with liver damage - correct answer ✔✔ALT, AST, GGT, Alk Phos,
PT, Serum Bilirubin, Serum Ammonia
Diagnostic levels that decrease with liver damage - correct answer ✔✔Serum albumin, serum
glucose, serum cholesterol, CBC, Electrolytes
Why is a liver biopsy dangerous? - correct answer ✔✔When liver damage is present, the PT can
be increased and therefore the patient is at risk for prolonged bleeding from the biopsy.
Angiograms and CT-scans are safer at this point.
Hepatitis A - correct answer ✔✔Oral-fecal transmission, most infectious 2 weeks before onset
of symptoms. Illness may last 4-8 weeks and feels like the flu, may have jaundice too. Treatment
is rest, eat small meals more frequently due to fatigue.
Hepatitis B - correct answer ✔✔Transmitted through blood or sexually; not by sweat, tears,
urine, feces or breast milk. Bisexual males and IV drug users are at highest risk. Infectious before
and after symptoms appear for about 4-6 months, risk of hepatocellular cancer. Treatment is
rest and possibly antivirals.
Hepatitis C - correct answer ✔✔Transmitted through blood and sexually. Can have a
percutaneous transmission with IV drugs, blood products, tattoos and piercings. Most develop
chronic hepatitis, can lead to cirrhosis. If patient would get a liver transplant, that new organ
would also become infected (blood-born pathogen). Treatment is Harbori (very expensive), take
once/day for 12 weeks.
, Hepatitis D - correct answer ✔✔Only at risk if you have Hepatitis B first, transmitted through
blood, IV drugs, and sexually. Increases risk of fulminant hepatitis.
Hepatitis E - correct answer ✔✔Transmitted through oral-fecal route typically from
contaminated drinking water in third-world countries. Symptoms are flu-like, condition is self-
limiting. Tx: rest.
Hepatitis vaccine - correct answer ✔✔Twinrix, needs 3 doses, prevents against Hepatitis A & B.
Travelers and healthcare workers should get vaccinated.
Nursing management of viral hepatitis - correct answer ✔✔Encourage rest, small meals high in
calories and protein (unless in encephalopathy, in which case you should restrict protein),
decrease Interferon dose if H&H or WBC decreases, monitor liver enzymes and CBC.
Cirrhosis - correct answer ✔✔Progressive disease with scar tissue and hypoxia. Chronic
hepatitis and alcohol abuse can accelerate cirrhosis.
Causes of cirrhosis - correct answer ✔✔Alcoholism, Cardiac (R-sided HF leads to cor pulmonale
and constrictive pericarditis), postnecrotic (viral), and chronic biliary obstruction.
Clinical manifestations of cirrhosis - correct answer ✔✔*Fever*, *fatigue*, *weight loss*, N/V,
anorexia, constipation or diarrhea, clay-colored stool, pain in RUQ, pleural effusion, difficulty
breathing (from ascites), encephalopathy (d/t buildup or ammonia), slurred speech, increased
PT (thrombocytopenia from splenomegaly, platelets are destroyed), decreased bowel motility,
anemia, esophageal varies, hemorrhoids, caput medusae (inflamed periumbilical veins).
Ascites - correct answer ✔✔BP elevates in the liver, proteins and fluid leaks out into peritoneal
cavity resulting in hypoalbuminemia, hypokalemia, dehydration, and hyperaldosteronism. Treat
with low-sodium diet, aldactone and lasix, paracentesis, shunt (dangerous with liver failure).
questions well answered passed
Diagnostic levels that increase with liver damage - correct answer ✔✔ALT, AST, GGT, Alk Phos,
PT, Serum Bilirubin, Serum Ammonia
Diagnostic levels that decrease with liver damage - correct answer ✔✔Serum albumin, serum
glucose, serum cholesterol, CBC, Electrolytes
Why is a liver biopsy dangerous? - correct answer ✔✔When liver damage is present, the PT can
be increased and therefore the patient is at risk for prolonged bleeding from the biopsy.
Angiograms and CT-scans are safer at this point.
Hepatitis A - correct answer ✔✔Oral-fecal transmission, most infectious 2 weeks before onset
of symptoms. Illness may last 4-8 weeks and feels like the flu, may have jaundice too. Treatment
is rest, eat small meals more frequently due to fatigue.
Hepatitis B - correct answer ✔✔Transmitted through blood or sexually; not by sweat, tears,
urine, feces or breast milk. Bisexual males and IV drug users are at highest risk. Infectious before
and after symptoms appear for about 4-6 months, risk of hepatocellular cancer. Treatment is
rest and possibly antivirals.
Hepatitis C - correct answer ✔✔Transmitted through blood and sexually. Can have a
percutaneous transmission with IV drugs, blood products, tattoos and piercings. Most develop
chronic hepatitis, can lead to cirrhosis. If patient would get a liver transplant, that new organ
would also become infected (blood-born pathogen). Treatment is Harbori (very expensive), take
once/day for 12 weeks.
, Hepatitis D - correct answer ✔✔Only at risk if you have Hepatitis B first, transmitted through
blood, IV drugs, and sexually. Increases risk of fulminant hepatitis.
Hepatitis E - correct answer ✔✔Transmitted through oral-fecal route typically from
contaminated drinking water in third-world countries. Symptoms are flu-like, condition is self-
limiting. Tx: rest.
Hepatitis vaccine - correct answer ✔✔Twinrix, needs 3 doses, prevents against Hepatitis A & B.
Travelers and healthcare workers should get vaccinated.
Nursing management of viral hepatitis - correct answer ✔✔Encourage rest, small meals high in
calories and protein (unless in encephalopathy, in which case you should restrict protein),
decrease Interferon dose if H&H or WBC decreases, monitor liver enzymes and CBC.
Cirrhosis - correct answer ✔✔Progressive disease with scar tissue and hypoxia. Chronic
hepatitis and alcohol abuse can accelerate cirrhosis.
Causes of cirrhosis - correct answer ✔✔Alcoholism, Cardiac (R-sided HF leads to cor pulmonale
and constrictive pericarditis), postnecrotic (viral), and chronic biliary obstruction.
Clinical manifestations of cirrhosis - correct answer ✔✔*Fever*, *fatigue*, *weight loss*, N/V,
anorexia, constipation or diarrhea, clay-colored stool, pain in RUQ, pleural effusion, difficulty
breathing (from ascites), encephalopathy (d/t buildup or ammonia), slurred speech, increased
PT (thrombocytopenia from splenomegaly, platelets are destroyed), decreased bowel motility,
anemia, esophageal varies, hemorrhoids, caput medusae (inflamed periumbilical veins).
Ascites - correct answer ✔✔BP elevates in the liver, proteins and fluid leaks out into peritoneal
cavity resulting in hypoalbuminemia, hypokalemia, dehydration, and hyperaldosteronism. Treat
with low-sodium diet, aldactone and lasix, paracentesis, shunt (dangerous with liver failure).
