NUR 445 Exam 2-Renal and GI questions and
answers with solutions
What is thrombocytopenia? - ANSWER Decreased platelets below
average range (150,000 - 450,000).
What is the main complication of thrombocytopenia? - ANSWER Risk for
hemorrhage.
What are two common types of thrombocytopenia? - ANSWER DIC and
HIT.
What is the bleeding phase? - ANSWER Excessive bleeding due to
inability to form clots.
What is the medical management for excessive bleeding? - ANSWER
Treatment of underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - ANSWER Nose
bleeds, bleeding at IV site, gum bleeding, SOB, hypotension, hypoxia,
bruising, blood clots, fever, metabolic acidosis.
,How is excessive bleeding treated? - ANSWER Treat the underlying
cause, replace clotting factors, volume replacement, crystalloid
solutions, anticoagulant therapy.
What are the bleeding precautions? - ANSWER Avoid rectal
thermometer, sex, nose blows, use soft toothbrush, electric razor, and
stool softeners.
What medications are contraindicated due to increased bleeding risk? -
ANSWER NSAIDs.
What is liver disease? - ANSWER Disease affecting the liver.
What is liver trauma? - ANSWER Liver injury often caused by motor
vehicle accidents.
What are the symptoms of hepatic insufficiency? - ANSWER Jaundice,
increased bilirubin, increased serum transaminase.
What supplements should be taken for liver disease? - ANSWER Iron and
vitamin supplements.
What are the labs indicating liver failure? - ANSWER Increase liver
enzymes (ALT, AST), Increased bilirubin, Increase serum ammonia,
Decreased albumin
,What are the risk factors for hepatitis? - ANSWER Risky behaviors
(sharing needles, unprotected sex with multiple partners), Recent travel
overseas, Alcohol abuse, Exposure to some hepatotoxic medications,
toxins or autoimmune disease
What is the pathophysiology of hepatitis? - ANSWER Inflammation of
liver cells due to virus, Impairs ability to detox, limits protein production
and clotting factors, alters ability to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - ANSWER Increased
liver enzymes (ALT, AST), Increased bilirubin (total and direct), Increased
serum ammonia, Decreased albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - ANSWER Recent travel outside U.S
What medications are used for hepatitis? - ANSWER Vaccination for
Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C -
related cirrhosis? - ANSWER Hepatitis C-related cirrhosis
What are the major complications after liver transplant? - ANSWER
Organ rejection and infection
What assessments are done for liver transplant patients? - ANSWER
Increased liver enzymes (ALT and AST), Signs of organ rejection (RUQ
pain, changes in bile drainage, fever, tachycardia, jaundice)
, What nursing actions should be taken for hepatitis patients? - ANSWER
Refer patient to social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? -
ANSWER Nutritional teaching (balanced diet, decreased fat and protein),
Good hand hygiene to decrease transmission from fecal -oral route, Avoid
behaviors that contribute to transmission (needle sharing, unprotected
sex), Importance of vaccinations to prevent hepatitis A and B, Safe
public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - ANSWER Chronic infection with
Hep A, B or C, Chronic alcoholism
What is the pathophysiology of cirrhosis? - ANSWER Irreversible chronic
cell destruction and fibrosis/scarring of the hepatic tissue
What is ascites? - ANSWER Accumulation of protein-rich fluid in the
abdominal cavity.
What are the signs and symptoms of cirrhosis? - ANSWER Shortness of
breath, jaundice, increased abdominal girth, large spleen, elevated liver
enzymes, increased risk of bleeding, thrombocytopenia, prolonged PT,
hemorrhoids, elevated serum ammonia, changes in LOC, changes in
motor function, hyponatremia.
answers with solutions
What is thrombocytopenia? - ANSWER Decreased platelets below
average range (150,000 - 450,000).
What is the main complication of thrombocytopenia? - ANSWER Risk for
hemorrhage.
What are two common types of thrombocytopenia? - ANSWER DIC and
HIT.
What is the bleeding phase? - ANSWER Excessive bleeding due to
inability to form clots.
What is the medical management for excessive bleeding? - ANSWER
Treatment of underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - ANSWER Nose
bleeds, bleeding at IV site, gum bleeding, SOB, hypotension, hypoxia,
bruising, blood clots, fever, metabolic acidosis.
,How is excessive bleeding treated? - ANSWER Treat the underlying
cause, replace clotting factors, volume replacement, crystalloid
solutions, anticoagulant therapy.
What are the bleeding precautions? - ANSWER Avoid rectal
thermometer, sex, nose blows, use soft toothbrush, electric razor, and
stool softeners.
What medications are contraindicated due to increased bleeding risk? -
ANSWER NSAIDs.
What is liver disease? - ANSWER Disease affecting the liver.
What is liver trauma? - ANSWER Liver injury often caused by motor
vehicle accidents.
What are the symptoms of hepatic insufficiency? - ANSWER Jaundice,
increased bilirubin, increased serum transaminase.
What supplements should be taken for liver disease? - ANSWER Iron and
vitamin supplements.
What are the labs indicating liver failure? - ANSWER Increase liver
enzymes (ALT, AST), Increased bilirubin, Increase serum ammonia,
Decreased albumin
,What are the risk factors for hepatitis? - ANSWER Risky behaviors
(sharing needles, unprotected sex with multiple partners), Recent travel
overseas, Alcohol abuse, Exposure to some hepatotoxic medications,
toxins or autoimmune disease
What is the pathophysiology of hepatitis? - ANSWER Inflammation of
liver cells due to virus, Impairs ability to detox, limits protein production
and clotting factors, alters ability to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - ANSWER Increased
liver enzymes (ALT, AST), Increased bilirubin (total and direct), Increased
serum ammonia, Decreased albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - ANSWER Recent travel outside U.S
What medications are used for hepatitis? - ANSWER Vaccination for
Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C -
related cirrhosis? - ANSWER Hepatitis C-related cirrhosis
What are the major complications after liver transplant? - ANSWER
Organ rejection and infection
What assessments are done for liver transplant patients? - ANSWER
Increased liver enzymes (ALT and AST), Signs of organ rejection (RUQ
pain, changes in bile drainage, fever, tachycardia, jaundice)
, What nursing actions should be taken for hepatitis patients? - ANSWER
Refer patient to social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? -
ANSWER Nutritional teaching (balanced diet, decreased fat and protein),
Good hand hygiene to decrease transmission from fecal -oral route, Avoid
behaviors that contribute to transmission (needle sharing, unprotected
sex), Importance of vaccinations to prevent hepatitis A and B, Safe
public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - ANSWER Chronic infection with
Hep A, B or C, Chronic alcoholism
What is the pathophysiology of cirrhosis? - ANSWER Irreversible chronic
cell destruction and fibrosis/scarring of the hepatic tissue
What is ascites? - ANSWER Accumulation of protein-rich fluid in the
abdominal cavity.
What are the signs and symptoms of cirrhosis? - ANSWER Shortness of
breath, jaundice, increased abdominal girth, large spleen, elevated liver
enzymes, increased risk of bleeding, thrombocytopenia, prolonged PT,
hemorrhoids, elevated serum ammonia, changes in LOC, changes in
motor function, hyponatremia.
