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41 Cards in this Set

  • Front
  • Back
Your client has cirrosis (early phase), you would increase the client's intake of thiamin. You would approve of this menu choice --

A. Carrots
B. Pork
C. Milkshake
D. Brussel sprouts
B
You assess your patient and you suspect early cirrhosis encelopathy when your client --

A. Vomits blood
B. Ascites
C. Asterixes
D. Disorientated
C - early sign of disease
You are to assess your patient who has cirrhosis for signs of ascites. You would ask your client to --

A. Stretch arms, flex wrists
B. Flex elbows, extend wrists
C. Flex elbows flex wrists
D. Extend elbows, extend wrists
D
Your patient received lactulose. You would feel that the potency of the med worked when the serum ammonia levels hit --

A. 98
B. 72
C. 45
D. 31
C - range is 35 to 65
Your client has chronic alcoholism. Cirrhosis is suspect. There are no obvious signs or symptoms. To confirm that this might be the case, you would look at --

A. Crackles in the lung sounds
B. BP = 89/35
C. Amonia level = 43
D. Calcium level = 7
A
Your cirrhotic patient is about to receive neomyacin. You tell your patient that this will help --

A. Break down your normal bacteria in your bowels
B. Protect your bowels from ammonia by increasing normal flora
C. This will prevent ammonia-produced infection
D. This will increase lactic acid breakdown
A - Breaks down to prevent amonia production
Your patient has lactolose prescribed. You would see a --

A. Decreased protein level
B. Reduced ammonia level
C. Reduced hemoglobin level
D. Reduced saturated fat processing
B
Your patient is about to undergo a paracentisis. You wuold tell her to prepare by --

A. Avoid urinating, lay on the right side
B. Lie supine, don't eat, void before procedure
C. Void first, sit upright
D. Lay prone, right arm above head
C - this will prevent puncture of intestins
Your patient had a blakemore baloon deflate accidentally. You prepare to help the patient with --

A. Decreased LOC
B. Hemaemesis
C. Bloody stool
D. Swollen glands in stomach
B
Your patient just had a paracentesis performed. For the next few hours, you will tell your patient to lie --

A. Supine
B. On the right side
C. On the left side
D. Prone
B
You administer lactolose for two weeks on your cirrhotic patient. You can check efficacy by examining --

A. Veins
B. Sclera for fat deposits
C. Peripheral edema
D. Reduced ph in stool
D causes acid
You realize your patient has just been plagued with ascites. You would expect this upon assessment --

A. Pulse = 48
B. BP = 96/36
C. Respirations = 6
D. Temp = 35.5
BP - fluid shifts into the peritneal cavity
Yoiur patient has ascites and you would be surprised at this lab value ---

A. Albumin = 6.2
B. BP = 110/79
C. HGB = 12.2
D. Low vitamin B12 level
A - Albumin is decreased
You are about to measure your patient who has ascites. You would measure the --

A. Across the navel
B. Circumference
C> Around the largest girth
D. Neither of the above
C
YOu are about to measure the abdominal girth for your patient. You go and mark the spot after having the patient --

A. Exhale
B. Inhale
C. During fast breaths to get accurate reading of inh/exh
D. Both A and C
E. Both B and C
A
Your patient's vitals and labs come back with bp = 103/71, Pulse = 103 and Ammonia levels of 185. You would first assess --

A. Reflexes
B. Level of conciousness
C. Fluid volume excess
D. Jaundice
B - High amonia
T/F - With cirrhosis, increased gluccocortiocids come into play, raising the blood sugar --
True
You would be surprised to find this value in a patient with cirrhosis --

A. Decreased blood volume
B. Calcium = 7.1
C. Potassium = 5.9
D. Sodium = 131
C - Hypokalemia is usually a biproduct of this.
Your patient has ascites and he is weighed daily. You notice there is no sign of a coma. You allow him to eat --

A. A low carb, low protein diet with vitamin supplements.
B. A high protein diet supplemented with vitamins
C. A low fat, high protein vitamins, with water soluble vitamins only
D. Regular diet, watch the junk food
B - only turns to low protein when ascites, edema are absen
Yor patient has ascites and is resting in the bed lying flat. You hear that his brother is bringing in some high-salt lunch meat with a gallon of spring water. Your first prevention is to --

A. Tell him that he needs to watch fluids
B. Measure the girth
C. Warn him about salt in the diet
D. Raise the head of the bed
D
Your client needs to have abdominal girth measured. You would have the client positioned --

A. Supine, arms raised
B. Right side lying, right arm raised
C. Sitting upright, arms spread out horizontally
D. Prone, place tape under and wrap around
A
Your chart indicates the doctor's orders are to check for fetor hepaticus. To carry out this order, you would assess the patient's --

A. Liver positioning
B. Sclera for jaundice
C. Stool for blood
D. Mouth odor
D
Your patient has some internal bleeding, hgb is 10.8, hct is 31. You secure the airway and raise the head of the bed. You administer oxygen. Your next move is to --

A. Assess for edema on extremities
B. Administer vitamin K as ordered
C. Administer heparin as ordered
D. Assess for asterixis
B
You would expect this intestinal PH level when giving a patient lactulose --

A. PH = 7.88
B. PH = 7.41
C. PH = 7.35
D. PH = 7.32
D
T/F - Administering flagyl or neomycin helps protect the normal flora in the stomach from invading bacterial due to the low wbc count from spleen failure --
F - It's used to desrupt protein synthesis in normal flora, so normal flora will die. This will decrease amonia.
Your patient's mar shows up. This patient is showing signs of ascites, esophageal bleeding from portal hypertension. You would hold this medication --

A. Flagyl 25 mL
B. Ativan 100 mg
C. Spirodactone 25 mg
D. Lassix 150 mg
B - no sedatives, opioids or barbituates
Your patient with cirrhosis has a prolonged clotting time. You would urge the patient to do all but --

A. Use a soft bristle toothbrush
B. Tighten restraints to prevent falling
C. Cancel colonoscopy appointment.
D. Replace lysterine with baking soda solution
B, don't make them too tight.
Your patient has end stage liver disease thanks to oliguric failure. You would question this development listed on the chart --

A. Hyponatremia
B. Output of 10 mL /hr
C. Hypocalcemia
D. Hypophosphoremia
A - since so much urine is going, the body will try to conserve that to save water
You administer 32 mg of lactulose and you know it's meeting expectations when you see --

A. Watery amonia-filled stools exiting for two hours straight followed by juandice reduction
B. Four soft stools a day without diarrhea
C. INduced vomiting filled with ammonia
D. Pain reduction in the formerly filled amonia blood stream
B
Your patient's amonia levels are increasing at an outrageous rate. You would best give lactulose at this time via --

A. PO
B. IV
C. Enema
D. SQ
C - quicker absorption
Your patient is develping potential encelopathy. Your BEST choice for his carb intake --

A. Multigrain baguette
B. Sweet potato
C. White flour bisquit
D. Milk
C
Your patient just had a paracentises. You would monitor for --

A. BP
B. Hemoglobin
C. WBC
D. Blood Glucose
A
Your patient has GGT values that are elevated. YOu assess for --

A. Hx of herpes
B. Hx of alcoholism
C. Hx of diabetes
D. Hx of family liver disorders
B
Your patient is scheduled for a liver biopsy and shows up. You position the patient supine, extend right arm above head. You also make sure that --

A. Patient on right side of the bed, head looking straight up
B. Patient turns head left, moves over to left side of bed
C. Right hand over head, right side of bed, head turned to the left
D. None of these are true
D
Your patient has elevated ALP levels. The patient nursing dx that would be most indicative and appropriate would be --

A. Fluid volume excess
B. Safety, risk for
C. Ineffective tissue perfusion
D. Complicated grieving
B - bones
You don't want your patient to develop PSE. You would make sure to raise --

A. Sodium
B. Potassium
C. Magnesium
D. Ferous sulfate
B
Your patient has ascites and is jaundiced. You would tell the patient to _____ when it comes to skin and itching --

A. Do not use soap
B. Avoid lotion
C. Scratch if skin feels itchy
D. Use cool water instead of warm water
D
Your child patient has developed ascites from cirrhosis. Your first intervention --

A. Use a hand puppet to explain what the disorder is
B. Weigh the kid on what you call "The Magic scale."
C. Remove water pitcher from the room
D. Give the kid some pickles to use as a distraction
C
Patient is vomiting blood. You should do the steps in what order?

A. Raise bed, turn head
B. Give O2
C. Take vitals
D. Call for help
E. Call Doctor
F. Wear PPE equipment
D
F
A
C
E
Your patient has received lactulose. Monitor the patient for --

A. Bloating
B. Constipation
C. Redened urine
D. Satiety
A
Your patient is receiving flagyl. You urge the patient that flagyl should --

A. Be d'cd when patient feels better
B. Uase it for short period of time
C. Never used with cirrohsis
D. Both A and B
D