Liver Functions, Assessment, and Lab Tests

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Questions and Answers

A liver transplant recipient develops hypertension in the first year post-operation. Why are ACE inhibitors and ARBs typically not the first-line treatment option?

Renin levels are often suppressed in the early post-transplant period. (correct)
They have a high risk of causing hyperkalemia in transplant patients.
They primarily address fluid overload, which is not the primary cause of hypertension in these patients.
They are contraindicated with commonly used immunosuppressants.

Which intervention is most important to include in the nursing management plan for a patient awaiting a liver transplant?

Coordinating interdisciplinary care and assessing financial resources and relocation needs. (correct)
Providing detailed instructions on surgical procedures to alleviate anxiety.
Limiting communication with family members to reduce stress and potential conflicts.
Encouraging the patient to focus solely on physical health to improve transplant outcomes.

Post-liver transplant, a patient exhibits signs of biliary obstruction. Which of the following assessment findings would be most indicative of this complication?

Improved coagulation studies and stable electrolyte levels.
Elevated liver function tests and jaundice. (correct)
Increased urine output and decreased creatinine.
Hypotension and tachycardia.

A patient who underwent a liver transplant is being discharged on a regimen of immunosuppressant medications. What is the priority nursing education point regarding these medications?

They must be taken exactly as prescribed to prevent rejection, even without symptoms. (C) Signup and view all the answers

Following a living donor liver transplant, both the recipient and the donor require close monitoring. For the living donor, what is a primary concern during the post-operative period?

Preventing infection and monitoring for any complications related to surgery. (D) Signup and view all the answers

What is the primary goal of liver transplantation before a patient's condition progresses to gastrointestinal bleeding and hepatic coma?

Total removal of the diseased liver and replacement with a healthy one. (A) Signup and view all the answers

Which factors are considered during pre-transplant screenings to determine a patient's suitability for liver transplantation?

Physical and mental health, hepatic reserve, likelihood of survival, past medical history, and degree of need. (D) Signup and view all the answers

What does the Model for End-Stage Liver Disease (MELD) classification primarily indicate?

The level of illness and prediction of 3-month mortality in patients with end-stage liver disease. (B) Signup and view all the answers

Why is it crucial for a patient on the transplant list to remain available and closely monitored?

Because their condition may deteriorate, leading to complications or death while waiting. (D) Signup and view all the answers

According to the Milan criteria, what are the size and quantity limitations for liver tumors to consider a patient for liver transplantation in cases of liver cancer?

A single tumor smaller than 5 cm OR up to 3 tumors each ≤ 3 cm. (C) Signup and view all the answers

What is a primary advantage of living donor liver transplantation?

It allows for transplantation even when the patient is likely to die while waiting for a deceased donor liver. (D) Signup and view all the answers

Which of the following is a critical role of the donor advocate team in living donor liver transplantation?

To ensure the donor's needs and safety are prioritized during the intra- and post-operative periods. (A) Signup and view all the answers

What surgical consideration is particularly important during liver transplantation due to the patient's condition?

Managing potential extensive blood loss due to portal hypertension and collateral vessels. (B) Signup and view all the answers

What is the primary purpose of administering immunosuppressive agents following a liver transplant?

To prevent the rejection of the transplanted liver by the recipient's immune system. (B) Signup and view all the answers

Which of the following is a common sign or symptom of acute rejection following liver transplantation?

Tachycardia, right upper quadrant pain, jaundice, fever, and elevated AST/ALT. (C) Signup and view all the answers

Why are liver transplant recipients at an increased risk for infections post-transplant?

Due to the immunosuppressive therapy required to prevent organ rejection. (A) Signup and view all the answers

What factors can increase the risk of complications after liver transplantation?

Previous abdominal surgeries, presence of varices, and decreased hepatic reserve. (B) Signup and view all the answers

What is a biliary anastomosis and why might a Roux-en-Y procedure be necessary during a liver transplant?

Connection of the bile duct between donor and recipient livers; Roux-en-Y may be needed if there is biliary disease. (B) Signup and view all the answers

A patient who underwent a liver transplant is experiencing hemodynamic instability with hypotension. What are the potential causes during the post-operative period?

Blood loss, loss of vasomotor tone, and vasodilation. (A) Signup and view all the answers

Why is monitoring coagulation factors and administering platelets, FFP, or blood products important during and after liver transplantation?

To correct coagulopathies resulting from ischemic injury to the donor liver, portal hypertension, or fibrinolysis. (C) Signup and view all the answers

A patient with cirrhosis is unable to metabolize aldosterone. Which of the following physiological changes is most likely to occur as a direct result?

Increased sodium and water retention. (B) Signup and view all the answers

A patient with advanced cirrhosis develops sudden, severe liver impairment. Which timeframe aligns with the definition of acute liver failure in this scenario?

Over a period of weeks. (A) Signup and view all the answers

A patient with cirrhosis has a decreased production of albumin. How will this impact the patient's physiological status?

Decreased oncotic pressure. (A) Signup and view all the answers

A patient with advanced liver disease exhibits changes in mental acuity, sleep disturbances, and a general tremor. What condition is most likely developing?

Hepatic encephalopathy. (A) Signup and view all the answers

A patient with known esophageal varices is prescribed propranolol. What is the primary rationale for this medication in this patient?

To decrease portal pressure. (A) Signup and view all the answers

A patient with a history of alcohol abuse is admitted with suspected liver dysfunction. Which laboratory marker would be most indicative of alcoholic liver disease?

Elevated GGT. (D) Signup and view all the answers

Which of the following factors poses the greatest risk for bleeding in a patient with esophageal varices?

Straining during bowel movements. (A) Signup and view all the answers

A patient with cirrhosis presents with a distended abdomen, dyspnea, and lower extremity edema. Which condition is most likely responsible for these clinical manifestations?

Ascites. (C) Signup and view all the answers

A patient with cirrhosis develops a life-threatening complication. What is the survival rate at 1 year for this complication?

40% (C) Signup and view all the answers

A patient with esophageal varices is actively bleeding. After initial stabilization, which intervention is most appropriate for preventing recurrent bleeding?

Variceal banding. (C) Signup and view all the answers

A nurse is caring for a patient with cirrhosis who exhibits asterixis. What assessment finding confirms the presence of asterixis?

Involuntary flapping tremor of the hands. (D) Signup and view all the answers

A patient with hepatic encephalopathy is prescribed lactulose. What intended therapeutic effect should the nurse monitor?

Increased mental alertness. (D) Signup and view all the answers

What type of jaundice is most closely associated with liver disease?

Hepatocellular and obstructive (D) Signup and view all the answers

A patient with liver failure has a decreased number of platelets. How will this impact the patient's physiological status?

Decreased clotting ability (C) Signup and view all the answers

A patient's lab results show an elevated level of ammonia. Which diet should the patient follow?

Low protein (A) Signup and view all the answers

Flashcards

Calcium channel blockers

Medications that induce vasodilation and lower blood pressure.

Thiazide diuretics

Medications used for hypertension, especially when multiple drugs are needed.