Pathophysiology
Ascites in cirrhosis primarily occurs due to increased hydrostatic pressure within this vascular system.
What is portal hypertension?
A musty or sweet breath odor seen in hepatic encephalopathy is called this.
What is fetor hepaticus?
This medication is administered to reduce ammonia levels in patients with hepatic encephalopathy.
What is lactulose?
This procedure removes fluid from the peritoneal cavity to relieve ascites.
What is paracentesis?
The most appropriate diet for a stable patient with cirrhosis without complications.
What is a high-calorie, high-carbohydrate, moderate-fat diet?
A patient with cirrhosis develops confusion and asterixis because the liver cannot convert this toxic substance into urea.
What is ammonia?
A flapping tremor of the hands that indicates worsening hepatic encephalopathy.
What is asterixis?
This nonabsorbable antibiotic is commonly used with lactulose to reduce ammonia-producing bacteria.
What is rifaximin?
This minimally invasive procedure decreases portal pressure by creating a shunt between the portal and hepatic veins.
What is TIPS (transjugular intrahepatic portosystemic shunt)?
The dietary restriction most important for patients with ascites.
What is low sodium intake?
A cirrhosis patient with ascites suddenly becomes febrile and reports abdominal pain. The priority complication the nurse should suspect.
What is spontaneous bacterial peritonitis?
A patient with cirrhosis who presents with hematemesis and melena is most likely experiencing bleeding from these fragile collateral vessels.
What are esophageal varices?
These medications reduce portal pressure and help prevent bleeding from esophageal varices.
What are nonselective beta blockers (propranolol or nadolol)?
The nurse should immediately report this assessment finding in a patient with cirrhosis and esophageal varices.
What is hematemesis or melena?
This diet modification may be required for severe hepatic encephalopathy to decrease ammonia production.
What is a low-protein diet?
Functional renal failure that occurs in advanced cirrhosis due to decreased renal perfusion is known as this syndrome.
What is hepatorenal syndrome?
Generalized edema and ascites in cirrhosis are worsened by low levels of this protein responsible for maintaining oncotic pressure.
What is albumin?
This medication is given to correct prolonged clotting times in cirrhosis.
What is vitamin K (phytonadione)?
A cirrhosis patient with ascites suddenly develops hypotension and tachycardia after paracentesis. The nurse should suspect this complication.
What is hypovolemia?
This medication may be administered to control acute variceal bleeding by reducing portal blood flow.
Hint: Not a beta blocker
What is octreotide?
A cirrhosis patient receiving lactulose therapy should have dosing adjusted to maintain this clinical outcome.
What are two to three soft bowel movements per day?
A patient with cirrhosis becomes increasingly confused and lethargic. The nurse should suspect worsening of this complication.
What is hepatic encephalopathy?
These medications are used to treat ascites by promoting sodium and water excretion. List 2 medications.
What are diuretics such as spironolactone and furosemide?
This emergency device may be inserted to temporarily control massive variceal bleeding by applying pressure within the esophagus and stomach.
What is a Sengstaken-Blakemore tube (balloon tamponade)?
A patient with cirrhosis develops sudden hematemesis, tachycardia, and hypotension. The nurse recognizes the priority problem is compromise of this physiologic function.
What is airway protection due to massive upper GI bleeding?