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NUR 300 EXAM 4 QUESTIONS WITH
DETAILED VERIFIED ANSWERS
What is cholelithiasis? Ans: gallstones
What is cholecystitis? Ans: inflammation of the gallbladder
what is the difference between cholelithiasis and cholecystitis? Ans:
cholelithiasis is gallstones and cholecystitis is inflammation of the
gallbladder
what is compensated cirrhosis? Ans: the liver has significant scarring but
performs essential functions without causing significant symptoms; may
not be able to tell the person is sick
what is DEcompensated cirrhosis? Ans: patient experiences symptoms of
cirrhosis: ascites, jaundice, palmar erythema, PORTAL HYPERTENSION,
ESOPHAGEAL VARICES
what is the simple difference between compensated and decompensated
cirrhosis? Ans: with compensated cirrhosis you do not see symptoms,
but with decompensated you do
which vessel supplies most of the blood to the liver? Ans: portal vein
How do esophageal varices develop? what is the main severe issue that
can occur? Ans: blood backs up due to increased pressure in portal vein-
---> collateral vessels formed around high-pressure vessels; BLEEDING
where is the most common bleeding point with esophageal varices? Ans:
near gastroesophageal (GE) junction
is esophageal bleeding significant? Ans: YES- medical emergency
What is portal hypertension? what are its manifestations/symptoms?
Ans: Increased pressure in the portal venous system; ascites,
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splenomegaly, esophageal varices, large collateral veins, systemic
hypertension
esophageal varices, splenomegaly, and ascites are caused by what? Ans:
portal hypertension
What is caput medusae? Ans: varices in abdominal cavity (large veins)
what is defined as "complex of tortuous veins at lower end of
esophagus"? Ans: esophageal varices
what develop in areas where collateral and systemic circulations
communicate? Ans: esophageal varices
what is the most life-threatening complication of cirrhosis? Ans:
esophageal varices
how does ascites occur with cirrhosis? Ans: increased pressure in portal
veins----> increased hydrostatic pressure----> fluid forced out of
capillaries-----> protein rich fluid leaves, and water follows protein---->
fluid accumulation in abdomen
what is often a problem with ascites with cirrhosis after drainage? Ans: it
will often reaccumulate after drainage
what color should the fluid from the abdomen be when drained? Ans:
clear, straw colored yellow
What is hepatic encephalopathy? what causes it? Ans: altered neurologic
status resulting from toxin buildup that are crossing the blood-brain
barrier, particularly ammonia
how does constipation cause hepatic encephalopathy? Ans: food is sitting
in gut longer---> bacteria has more time to breakdown protein--->
increase in ammonia levels
what is hepatorenal syndrome? what is it a complication of? Ans: kidney
failure caused by liver failure; cirrhosis
which syndrome is characterized by the following....
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* functional renal failure with
- azotemia
- oliguria
- intractable ascites
*no structural abnormality of kidney
* can be reversed with liver transplant Ans: hepatorenal syndrome
what can reverse the effects of hepatorenal syndrome? Ans: liver
transplant
is there a specific drug therapy for cirrhosis? how is it treated? Ans: no;
drugs used to treat symptoms and complications of advanced liver
disease
how is propanolol helpful with cirrhosis? Ans: reduces portal venous
pressure
how is lactulose helpful for cirrhosis? Ans: helps eliminate ammonia
through feces
which drug used with cirrhosis helps eliminate ammonia through feces?
Ans: lactulose
how is Vitamin K helpful with cirrhosis? Ans: corrects clotting
abnormalities bc the liver isnt producing as many
how are H2 receptor antagonists and proton pump inhibitors helpful with
cirrhosis? Ans: reduces gastric acidity and secretion
how are diuretics helpful with cirrhosis? Ans: treat edema and ascites
how is Rifaximin used in treatment of cirrhosis? Ans: removes bacteria
from intestinal tract
what class of drug is lactulose? Ans: hyperosmotic laxative
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which hyperosmotic laxative is used in treatment of cirrhosis? Ans:
lactulose
what is lactulose's MOA? Ans: increases osmotic activity in GI tract; pulls
fluid into GI tract to help promote bowel movements----> stops
production of ammonia from constipation
*increases amount of water in stool*
which two ways can lactulose be given? Ans: PO or rectal
how should you give lactulose PO? Ans: given every hour until stools
begin, then titrate to 2-3 loose stools per day
how should lactulose be given rectally? Ans: dilute with water, give via
rectal balloon catheter, keep in rectum for 30-60 min, repeat in 4-6 hours
if needed
when giving lactulose rectally, how long should the balloon stay in? Ans:
30-60 min
are there any major adverse effects of lactulose? Ans: no, just diarrhea
which gender and age group has the highest risk for cholelithiasis? Ans:
women, over 40
is estrogen or testosterone a risk factor for cholelithiasis? Ans: estrogen
what is the function of bile? Ans: helps digest lipids and transport waste
products
how do gallstones (cholelithiasis) form? Ans: stasis of bile---> super
saturated with cholesterol----> precipitates and forms a stone
which cholelithiasis, which quadrant is pain felt? Ans: RUQ
what problems can stones moving out of the gallbladder cause? Ans: can
move and obstruct bile duct leading to obstructive jaundice
NUR 300 EXAM 4 QUESTIONS WITH
DETAILED VERIFIED ANSWERS
What is cholelithiasis? Ans: gallstones
What is cholecystitis? Ans: inflammation of the gallbladder
what is the difference between cholelithiasis and cholecystitis? Ans:
cholelithiasis is gallstones and cholecystitis is inflammation of the
gallbladder
what is compensated cirrhosis? Ans: the liver has significant scarring but
performs essential functions without causing significant symptoms; may
not be able to tell the person is sick
what is DEcompensated cirrhosis? Ans: patient experiences symptoms of
cirrhosis: ascites, jaundice, palmar erythema, PORTAL HYPERTENSION,
ESOPHAGEAL VARICES
what is the simple difference between compensated and decompensated
cirrhosis? Ans: with compensated cirrhosis you do not see symptoms,
but with decompensated you do
which vessel supplies most of the blood to the liver? Ans: portal vein
How do esophageal varices develop? what is the main severe issue that
can occur? Ans: blood backs up due to increased pressure in portal vein-
---> collateral vessels formed around high-pressure vessels; BLEEDING
where is the most common bleeding point with esophageal varices? Ans:
near gastroesophageal (GE) junction
is esophageal bleeding significant? Ans: YES- medical emergency
What is portal hypertension? what are its manifestations/symptoms?
Ans: Increased pressure in the portal venous system; ascites,
, Page | 2
splenomegaly, esophageal varices, large collateral veins, systemic
hypertension
esophageal varices, splenomegaly, and ascites are caused by what? Ans:
portal hypertension
What is caput medusae? Ans: varices in abdominal cavity (large veins)
what is defined as "complex of tortuous veins at lower end of
esophagus"? Ans: esophageal varices
what develop in areas where collateral and systemic circulations
communicate? Ans: esophageal varices
what is the most life-threatening complication of cirrhosis? Ans:
esophageal varices
how does ascites occur with cirrhosis? Ans: increased pressure in portal
veins----> increased hydrostatic pressure----> fluid forced out of
capillaries-----> protein rich fluid leaves, and water follows protein---->
fluid accumulation in abdomen
what is often a problem with ascites with cirrhosis after drainage? Ans: it
will often reaccumulate after drainage
what color should the fluid from the abdomen be when drained? Ans:
clear, straw colored yellow
What is hepatic encephalopathy? what causes it? Ans: altered neurologic
status resulting from toxin buildup that are crossing the blood-brain
barrier, particularly ammonia
how does constipation cause hepatic encephalopathy? Ans: food is sitting
in gut longer---> bacteria has more time to breakdown protein--->
increase in ammonia levels
what is hepatorenal syndrome? what is it a complication of? Ans: kidney
failure caused by liver failure; cirrhosis
which syndrome is characterized by the following....
, Page | 3
* functional renal failure with
- azotemia
- oliguria
- intractable ascites
*no structural abnormality of kidney
* can be reversed with liver transplant Ans: hepatorenal syndrome
what can reverse the effects of hepatorenal syndrome? Ans: liver
transplant
is there a specific drug therapy for cirrhosis? how is it treated? Ans: no;
drugs used to treat symptoms and complications of advanced liver
disease
how is propanolol helpful with cirrhosis? Ans: reduces portal venous
pressure
how is lactulose helpful for cirrhosis? Ans: helps eliminate ammonia
through feces
which drug used with cirrhosis helps eliminate ammonia through feces?
Ans: lactulose
how is Vitamin K helpful with cirrhosis? Ans: corrects clotting
abnormalities bc the liver isnt producing as many
how are H2 receptor antagonists and proton pump inhibitors helpful with
cirrhosis? Ans: reduces gastric acidity and secretion
how are diuretics helpful with cirrhosis? Ans: treat edema and ascites
how is Rifaximin used in treatment of cirrhosis? Ans: removes bacteria
from intestinal tract
what class of drug is lactulose? Ans: hyperosmotic laxative
, Page | 4
which hyperosmotic laxative is used in treatment of cirrhosis? Ans:
lactulose
what is lactulose's MOA? Ans: increases osmotic activity in GI tract; pulls
fluid into GI tract to help promote bowel movements----> stops
production of ammonia from constipation
*increases amount of water in stool*
which two ways can lactulose be given? Ans: PO or rectal
how should you give lactulose PO? Ans: given every hour until stools
begin, then titrate to 2-3 loose stools per day
how should lactulose be given rectally? Ans: dilute with water, give via
rectal balloon catheter, keep in rectum for 30-60 min, repeat in 4-6 hours
if needed
when giving lactulose rectally, how long should the balloon stay in? Ans:
30-60 min
are there any major adverse effects of lactulose? Ans: no, just diarrhea
which gender and age group has the highest risk for cholelithiasis? Ans:
women, over 40
is estrogen or testosterone a risk factor for cholelithiasis? Ans: estrogen
what is the function of bile? Ans: helps digest lipids and transport waste
products
how do gallstones (cholelithiasis) form? Ans: stasis of bile---> super
saturated with cholesterol----> precipitates and forms a stone
which cholelithiasis, which quadrant is pain felt? Ans: RUQ
what problems can stones moving out of the gallbladder cause? Ans: can
move and obstruct bile duct leading to obstructive jaundice
