Your Hostess, Cirrhosis
The nurse knows that a therapeutic procedure to relieve ascites is:
Paracentesis
True or False:
Clients with Cholecystitis should be placed in Fowler's position
Fowler's position can be used to decrease pressure on the abdomen and decrease pain
True or False? *2 questions
A high fat and low calorie diet is recommended for patients with hepatitis.
A patient with hepatitis is encouraged to increase their daily exercise
FALSE
FALSE
True or False?
High fat foods can decrease symptoms
FALSE
True or false?
All clients with Diverticulosis will develop Diverticulitis
FALSE
When using a liver biopsy to help diagnose Cirrhosis, the nurse should monitor which of the following labs before the procedure?
A. Amylase
B. coagulation tests
C. ALT/AST
D. Bilirubin
B. Coagulation studies
*concerned for risk of bleeding
Name 2 procedures that can be used to treat gall stones
-extracorporeal shock wave lithotripsy
-Cholecystectomy (usually *laparoscopic)
Name 2 pancreatic enzymes that are elevated in clients with pancreatitis
Name the two areas that can be affected by ecchymoses or bluish gray discoloration
Amylase
Lipase
&
Flanks
Periumbilical area (Cullen's sign)
We should instruct client's with GERD to keep the head of the bed:
A. Less than 5 inches
B. 6 to 8 inches
C. 25 degrees
D. Lying flat can help relieve symptoms.
B. 6 to 8 inches
When telling the client foods to avoid that may block diverticulum, we know that this might include:
-Nuts
-Seeds
-Popcorn
What are 3 common physical findings that can be seen in clients with Cirrhosis?
ATI p. 321 (11th edition):
-Gastroesophageal bleeding
-Ascites
-Jaundice
-dark urine (d/t elevated bilirubin)
-Spider Angiomas
-Petechiae
-Cognitive changes
-Splenomegaly
Name 3 labs that may become elevated if the common bile duct is obstructed
AST
ALT
Bilirubin
Name 3 ways someone can become infected with Hepatitis B
-during birth (maternal to child transmission)
-sexual contact
-contaminated needles (medical/dental equipment)
-contaminated blood introduced through skin or mucous membranes
Name 3 foods that relax the lower esophageal sphincter
chocolate
caffeinated beverages
spicy foods
alcohol
citrus fruits
A client with Diverticulitis develops a rigid abdomen, tachycardia, and a fever. The nurse should be concerned for:
A. Obstruction
B. Ulcer
C. Constipation
D. Perforation
D. Perforation
For each lab value, would an expected finding be a decreased or elevated level in a client initially diagnosed with Cirrhosis:
ALT-decreased or elevated?
AST-decreased or elevated?
Bilirubin-decreased or elevated?
Albumin-decreased or increased?
In Cirrhosis: (ATI p. 322)
ALT-elevated
AST-elevated
Bilirubin-elevated
Albumin-decreased
Name 4 physical findings that can be seen in Cholecystitis caused by Cholelithiasis
-Sharp pain in right upper quadrant-often radiates to shoulder
-Jaundice
-Clay colored stools
-Steatorrhea (fatty stools)
-Dyspepsia
-Fever
-Nausea and vomiting
For a patient with hepatitis C that has developed chronic infection, what are they at risk of developing? Select all that apply.
A. Hepatitis E
B. Liver Cancer
C. Cirrhosis
D. Hepatitis D
B. Liver Cancer
C. Cirrhosis
The nurse should instruct the client to take antacids:
A. When acid secretions are highest (1-3 hours after meals, at bedtime
B. Separate from other medications by 20 minutes
C. without water
D. Separate from other medications by 30 min
A. When acid secretions are highest
When teaching about risk factors for developing Diverticulosis, the nurse knows the client understands the teaching when they state:
A. "I make sure to follow a low fiber diet"
B. "I will ensure adequate intake of fiber"
C. I will increase my fat intake above 30% of daily caloric intake
D. I will increase my consumption of nuts
B. "I will ensure adequate intake of fiber"
If encephalopathy develops, the following dietary guideline may be implemented to prevent further elevating ammonia levels:
A. low sodium diet
B. low protein diet
C. Fluid intake increase
D. 3 moderate sized meals a day
B. low protein diet
Which of the following should be included in client education for Cholecystitis? Select all that apply.
A. adhere to a low fat diet
B. Increase intake of beans, cauliflower, broccoli
C. Work toward weight reduction
D. increase intake of HDL fat sources
A-low fat diet
C-work toward weight loss
D-increase HDL
Which of the following patients is infected with a type of hepatitis that is considered curable? Select all that apply.
A. A patient infected with hepatitis A
B. A patient infected with hepatitis B
C. A patient infected with hepatitis C
D. A patient infected with hepatitis G
A. Hepatitis A
C. Hepatitis C
What are complications of Peptic Ulcer Disease that can be considered life threatening?
-Perforation
-Hemorrhage
Diverticula can perforate and cause (Select all that apply):
A. Severe bleeding
B. Peritonitis
C. Chrohn's Disease
A. Severe bleeding
B. Perforation