nur 445 exam 5 UPDATED Questions and
CORRECT Answers
what are the clinical manifestations of cirrhosis of the liver? - CORRECT ANSWER -
Shortness of breath
• Decreased blood pressure
• Petechiae, bruising, and bleeding
• Altered mental status
• Asterixis
• Elevated liver enzymes
• Jaundice
• Dark amber urine
• Increased abdominal girth and bloating
• Decreased serum albumin levels
• Spider angiomas
• Palmar erythema
• Pruritus (secondary to accumulation of bile salts)
how is cirrhosis of the liver treated? - CORRECT ANSWER - sodium rstrictions
fluid restrictions
ativan diazepam
lactulose- waste excess ammonia
diuretics to help wast fluid ascites
parecentesis to drain ascites
vitamins a, b, c, k and folate to help vitamin b12 deficiencies
liver biopsy- removing damaged part of liver
Administer vitamin K, blood products, and fresh frozen plasma as ordered (Corrects coagulation
disorders)
small, frequent meals to prevent protein loading
,transjugular intrahepatic portosystemic shunt -reduces fluid accumulation
why is promoting rest important for cirrhosis clients? - CORRECT ANSWER - Promote
rest periods between activities; sit down while bathing, dressing
Decreases metabolic demand on liver, decreases oxygen demand, and prevents fatigue
what medications that are contraindicated in cirrhosis? - CORRECT ANSWER - fluids-
reduce risk of ascites
protein restrictions- prevents uremia and ammonia build up
No ASPIRIN /tylenol due to decreased ability to metabolize
warfarin/ anticoagulants
antidepressants
What is asterixis? - CORRECT ANSWER - (flapping tremor of the hand when wrist
extended)
Cirrohsis labs - CORRECT ANSWER - ALT elevated: > 40 males
> 36 females
AST elevated: > 40 males
> 35 females
Alkaline phosphate elevated
Males > 142
Females > 125
Alkaline phosphate liver faction elevated
>93
Bilirubin total: >1
Bilirubin direct: > 0.3
Albumin decreased: <5.1
Ammonia elevated platelets decrease:
, Less than 150,000
Aptt prolonged longer than 35 seconds
Prothombrine ( ptt) time longer than 13 seconds
what are the expected increased labs in cirrhosis? - CORRECT ANSWER - Bilirubin,
ALT, AST, alkaline phosphate liver faction, ammonia, INR prolonged aptt greater then 35 secs.
what is the appropriate diet for cirrhosis of the liver patient? - CORRECT ANSWER -
Sodium and fluid restrictions, low protein
when do you know ammonia levels are built up? - CORRECT ANSWER - Confusion
delirium
what labs decreases in cirrhosis of liver? - CORRECT ANSWER - albumin
Platelets less than 150,000
patient teaching for cirrhosis - CORRECT ANSWER - rest, avoid infections, turn q2hr,
ROM, soft bristled tooth brush, electric razor, caution when blowing nose, avoid valsalva, avoid
soap, avoid perfumed lotion, avoid rubbing alcohol, benedryl for dry skin and pruritis, explain
relationship of therapeutic diet low protein diet to avoid ammonia build up.
What is lactulose used for? - CORRECT ANSWER - Lactulose works by stimulating the
production of excess stools to rid the body of excess ammonia.
liver cancer clinical manifestations early stage - CORRECT ANSWER - assymptomatic
liver cancer clinical manifestations late stage - CORRECT ANSWER - abdominal pain,
weight loss, anorexia, weakness, fatigue, jaundice, and ascites
how is liver cancer diagnosed? - CORRECT ANSWER - LIVER BIOPSY / ct/ mri
CORRECT Answers
what are the clinical manifestations of cirrhosis of the liver? - CORRECT ANSWER -
Shortness of breath
• Decreased blood pressure
• Petechiae, bruising, and bleeding
• Altered mental status
• Asterixis
• Elevated liver enzymes
• Jaundice
• Dark amber urine
• Increased abdominal girth and bloating
• Decreased serum albumin levels
• Spider angiomas
• Palmar erythema
• Pruritus (secondary to accumulation of bile salts)
how is cirrhosis of the liver treated? - CORRECT ANSWER - sodium rstrictions
fluid restrictions
ativan diazepam
lactulose- waste excess ammonia
diuretics to help wast fluid ascites
parecentesis to drain ascites
vitamins a, b, c, k and folate to help vitamin b12 deficiencies
liver biopsy- removing damaged part of liver
Administer vitamin K, blood products, and fresh frozen plasma as ordered (Corrects coagulation
disorders)
small, frequent meals to prevent protein loading
,transjugular intrahepatic portosystemic shunt -reduces fluid accumulation
why is promoting rest important for cirrhosis clients? - CORRECT ANSWER - Promote
rest periods between activities; sit down while bathing, dressing
Decreases metabolic demand on liver, decreases oxygen demand, and prevents fatigue
what medications that are contraindicated in cirrhosis? - CORRECT ANSWER - fluids-
reduce risk of ascites
protein restrictions- prevents uremia and ammonia build up
No ASPIRIN /tylenol due to decreased ability to metabolize
warfarin/ anticoagulants
antidepressants
What is asterixis? - CORRECT ANSWER - (flapping tremor of the hand when wrist
extended)
Cirrohsis labs - CORRECT ANSWER - ALT elevated: > 40 males
> 36 females
AST elevated: > 40 males
> 35 females
Alkaline phosphate elevated
Males > 142
Females > 125
Alkaline phosphate liver faction elevated
>93
Bilirubin total: >1
Bilirubin direct: > 0.3
Albumin decreased: <5.1
Ammonia elevated platelets decrease:
, Less than 150,000
Aptt prolonged longer than 35 seconds
Prothombrine ( ptt) time longer than 13 seconds
what are the expected increased labs in cirrhosis? - CORRECT ANSWER - Bilirubin,
ALT, AST, alkaline phosphate liver faction, ammonia, INR prolonged aptt greater then 35 secs.
what is the appropriate diet for cirrhosis of the liver patient? - CORRECT ANSWER -
Sodium and fluid restrictions, low protein
when do you know ammonia levels are built up? - CORRECT ANSWER - Confusion
delirium
what labs decreases in cirrhosis of liver? - CORRECT ANSWER - albumin
Platelets less than 150,000
patient teaching for cirrhosis - CORRECT ANSWER - rest, avoid infections, turn q2hr,
ROM, soft bristled tooth brush, electric razor, caution when blowing nose, avoid valsalva, avoid
soap, avoid perfumed lotion, avoid rubbing alcohol, benedryl for dry skin and pruritis, explain
relationship of therapeutic diet low protein diet to avoid ammonia build up.
What is lactulose used for? - CORRECT ANSWER - Lactulose works by stimulating the
production of excess stools to rid the body of excess ammonia.
liver cancer clinical manifestations early stage - CORRECT ANSWER - assymptomatic
liver cancer clinical manifestations late stage - CORRECT ANSWER - abdominal pain,
weight loss, anorexia, weakness, fatigue, jaundice, and ascites
how is liver cancer diagnosed? - CORRECT ANSWER - LIVER BIOPSY / ct/ mri
