NURS 221 Final Exam (New Material) With Certified Solutions

NURS 221 Final Exam (New Material) With Certified Solutions NB: Answers appear at the top of the questions cirrhosis Typically a person with ____ shows no signs or symptoms initially until the disease is advanced. When symptoms present, they include: hepatomegaly, splenomegaly (associated anemia and leukopenia), bleeding, weight loss, weakness, anorexia. pruritis In a patient with cirrhosis (end-stage liver disease), bile salts in the blood are excreted onto the skin resulting in ____. Treat with Cholestyramine (Questran). gynecomastia Male patients with cirrhosis of the liver may present with enlarged breasts due to hormone imbalance known as ____. spider angiomas The scientific name for "drinker's nose" referring to a symptom of liver disease is ____ (two words). bilirubin (conjugated) The nurse knows that patients with liver disease who have jaundice have an abnormally high level of ____ in their blood. thrombocytopenia Low production of clotting factors in a damaged or diseased liver results in ____, which places patients at risk of VTE/DVT. portal hypertension Enlarged vessels, ascites (d/t drop in albumin level), collateral shunting like caput medusi (enlarged umbilical veins), esophageal varices (enlarged esophageal vessels) and hemorrhoids are all signs of ____ (two words). ammonia Lactulose (Cephulac) PO, binds with ____ in the colon for excretion in the stools. S/E is increased number of stools (3-5/day). This med may be prescribed for patients with liver cirrhosis/hepatic encephalopathy. bacteria Neomycin Sulfate (Mycifrudin), PO, kills ammonia producing ____ in the stomach. This med may be prescribed for patients with liver cirrhosis. hepatic encephalopathy With liver cirrhosis AMMONIA which is a byproduct of protein and bacterial breakdown does not get metabolized into UREA. Ammonia builds up in the blood resulting in cognitive (confusion) and motor changes known as ____ (two words). I NORMAL LOC, periods of lethargy and euphoria, reversal of DAY/NIGHT SLEEP patterns, impaired WRITING and DRAWING with a normal EEG. This is stage [ I, II, III, IV ] of hepatic encephalopathy. II Declining LOC with increased drowsiness, increased disorientation, INAPPROPRIATE BEHAVIOR, mood swings, ASTERIXIS (hand flapping), fetor hepaticus (d/t portal hypertension, thiols entering the lungs, sweet, fecal smelling breath), ABNORMAL EEG. This is stage [ I, II, III, IV ] of hepatic encephalopathy.