Podcast
Questions and Answers
Viral hepatitis is caused by several different viruses. Which of the following hepatitis viruses does not have a vaccine available for prevention?
Viral hepatitis is caused by several different viruses. Which of the following hepatitis viruses does not have a vaccine available for prevention?
- Hepatitis A virus (HAV)
- Hepatitis C virus (HCV) (correct)
- Hepatitis D virus (HDV)
- Hepatitis B virus (HBV)
A patient is diagnosed with Hepatitis B. Which of the following is a potential route of transmission that the nurse should educate the patient about?
A patient is diagnosed with Hepatitis B. Which of the following is a potential route of transmission that the nurse should educate the patient about?
- Close contact, such as shaking hands
- Sharing contaminated needles (correct)
- Airborne droplets from coughing or sneezing
- Ingestion of contaminated food or water
A patient presents with symptoms of jaundice, fatigue, and abdominal pain. The doctor suspects a liver disorder. Which diagnostic test would be most helpful in determining the type and extent of liver damage?
A patient presents with symptoms of jaundice, fatigue, and abdominal pain. The doctor suspects a liver disorder. Which diagnostic test would be most helpful in determining the type and extent of liver damage?
- Urinalysis
- Liver biopsy (correct)
- Complete blood count (CBC)
- Basic metabolic panel (BMP)
Which of the following hepatitis viruses can lead to chronic infection and increase the risk of cirrhosis and liver cancer?
Which of the following hepatitis viruses can lead to chronic infection and increase the risk of cirrhosis and liver cancer?
A patient with Hepatitis B is being discharged. Which statement indicates a need for further teaching regarding infection control?
A patient with Hepatitis B is being discharged. Which statement indicates a need for further teaching regarding infection control?
In which of the following scenarios is Hepatitis E virus (HEV) infection most likely to be a significant concern?
In which of the following scenarios is Hepatitis E virus (HEV) infection most likely to be a significant concern?
A patient with Hepatitis D is being assessed. Which of the following conditions must also be present for Hepatitis D to exist?
A patient with Hepatitis D is being assessed. Which of the following conditions must also be present for Hepatitis D to exist?
A public health nurse is planning a community education program about preventing hepatitis. Which of the following topics should be emphasized to reduce the risk of hepatitis A?
A public health nurse is planning a community education program about preventing hepatitis. Which of the following topics should be emphasized to reduce the risk of hepatitis A?
A patient presents with jaundice, dark urine, and right upper quadrant pain. Initial blood tests reveal the presence of anti-HAV IgM. Which of the following is the most likely diagnosis?
A patient presents with jaundice, dark urine, and right upper quadrant pain. Initial blood tests reveal the presence of anti-HAV IgM. Which of the following is the most likely diagnosis?
A healthcare worker experiences a needlestick injury while drawing blood from a patient known to have Hepatitis B. Which of the following is the MOST appropriate immediate action for postexposure prophylaxis, assuming the healthcare worker is not already immune?
A healthcare worker experiences a needlestick injury while drawing blood from a patient known to have Hepatitis B. Which of the following is the MOST appropriate immediate action for postexposure prophylaxis, assuming the healthcare worker is not already immune?
A patient is diagnosed with Hepatitis C and undergoes treatment. Which diagnostic test is MOST useful for monitoring the effectiveness of antiviral therapy?
A patient is diagnosed with Hepatitis C and undergoes treatment. Which diagnostic test is MOST useful for monitoring the effectiveness of antiviral therapy?
Which of the following is the MOST common mode of transmission for Hepatitis C (HCV) in the United States?
Which of the following is the MOST common mode of transmission for Hepatitis C (HCV) in the United States?
A patient tests positive for HBsAg. What does this result indicate?
A patient tests positive for HBsAg. What does this result indicate?
A patient with chronic Hepatitis B is diagnosed with Hepatitis D. How does Hepatitis D affect the Hepatitis B infection?
A patient with chronic Hepatitis B is diagnosed with Hepatitis D. How does Hepatitis D affect the Hepatitis B infection?
A traveler returning from an endemic area reports symptoms of anorexia, nausea, and jaundice. Which type of viral hepatitis is MOST likely given the prevalence and transmission route?
A traveler returning from an endemic area reports symptoms of anorexia, nausea, and jaundice. Which type of viral hepatitis is MOST likely given the prevalence and transmission route?
Which of the following is the MOST important preventative measure against Hepatitis A in areas with poor sanitation?
Which of the following is the MOST important preventative measure against Hepatitis A in areas with poor sanitation?
A patient who has recovered from a Hepatitis A infection is tested for anti-HAV IgG. What does a positive result MOST likely indicate?
A patient who has recovered from a Hepatitis A infection is tested for anti-HAV IgG. What does a positive result MOST likely indicate?
Which of the following Hepatitis viruses has a vaccine currently only available in China?
Which of the following Hepatitis viruses has a vaccine currently only available in China?
What is the significance of detecting HBeAg in a patient with Hepatitis B?
What is the significance of detecting HBeAg in a patient with Hepatitis B?
A patient with known HBV is found to have anti-HBe. This result suggests which of the following?
A patient with known HBV is found to have anti-HBe. This result suggests which of the following?
Which of the following groups is at highest risk of developing chronic hepatitis after being infected?
Which of the following groups is at highest risk of developing chronic hepatitis after being infected?
A patient is suspected of having a hepatitis infection. Which set of tests would be MOST appropriate as an initial screening to determine the type of hepatitis?
A patient is suspected of having a hepatitis infection. Which set of tests would be MOST appropriate as an initial screening to determine the type of hepatitis?
A patient is diagnosed with HCV. What key information does the HCV genotype provide for treatment planning?
A patient is diagnosed with HCV. What key information does the HCV genotype provide for treatment planning?
Which of the following statements best describes the role of immunoglobulin (IG) in preventing hepatitis?
Which of the following statements best describes the role of immunoglobulin (IG) in preventing hepatitis?
A patient is diagnosed with hepatitis and is in the icteric stage. Which set of symptoms would the nurse expect to observe?
A patient is diagnosed with hepatitis and is in the icteric stage. Which set of symptoms would the nurse expect to observe?
Which of the following is the least effective method for preventing the transmission of hepatitis viruses in a healthcare setting?
Which of the following is the least effective method for preventing the transmission of hepatitis viruses in a healthcare setting?
What is the primary goal of therapeutic measures for a patient diagnosed with hepatitis?
What is the primary goal of therapeutic measures for a patient diagnosed with hepatitis?
A patient with hepatitis reports taking several over-the-counter medications. Which of the following medications should the nurse be most concerned about regarding potential hepatotoxicity?
A patient with hepatitis reports taking several over-the-counter medications. Which of the following medications should the nurse be most concerned about regarding potential hepatotoxicity?
A patient with hepatitis C virus (HCV) is prescribed a direct-acting antiviral (DAA). What is the most significant advantage of using DAAs compared to older treatments like interferon?
A patient with hepatitis C virus (HCV) is prescribed a direct-acting antiviral (DAA). What is the most significant advantage of using DAAs compared to older treatments like interferon?
Which of the following statements accurately describes the implications of being an asymptomatic carrier of Hepatitis B virus (HBV) or Hepatitis C virus (HCV)?
Which of the following statements accurately describes the implications of being an asymptomatic carrier of Hepatitis B virus (HBV) or Hepatitis C virus (HCV)?
A patient with suspected liver dysfunction is undergoing diagnostic testing. Which laboratory test result would be most specific in indicating liver damage?
A patient with suspected liver dysfunction is undergoing diagnostic testing. Which laboratory test result would be most specific in indicating liver damage?
During a community health fair, a participant asks about preventing hepatitis A. What is the MOST important advice for the nurse to provide?
During a community health fair, a participant asks about preventing hepatitis A. What is the MOST important advice for the nurse to provide?
A patient with cirrhosis develops ascites. Which laboratory finding best explains the pathophysiology behind ascites?
A patient with cirrhosis develops ascites. Which laboratory finding best explains the pathophysiology behind ascites?
A patient with hepatitis is experiencing pruritus. Which nursing intervention is most appropriate to provide relief?
A patient with hepatitis is experiencing pruritus. Which nursing intervention is most appropriate to provide relief?
A patient's serological test results indicate the presence of viral antigens but absence of antibodies. Which stage of hepatitis infection is this patient most likely in?
A patient's serological test results indicate the presence of viral antigens but absence of antibodies. Which stage of hepatitis infection is this patient most likely in?
In the context of hepatitis infection, what distinguishes the convalescent stage from the icteric stage?
In the context of hepatitis infection, what distinguishes the convalescent stage from the icteric stage?
A patient is diagnosed with hepatic encephalopathy. Which lab value is the priority to monitor?
A patient is diagnosed with hepatic encephalopathy. Which lab value is the priority to monitor?
A patient with a history of alcohol abuse is admitted with signs of liver failure. The nurse anticipates which of the following metabolic disorders may also be present?
A patient with a history of alcohol abuse is admitted with signs of liver failure. The nurse anticipates which of the following metabolic disorders may also be present?
For which types of hepatitis are there currently vaccines available that provide permanent, active immunity in the United States?
For which types of hepatitis are there currently vaccines available that provide permanent, active immunity in the United States?
Which of the following viruses is least likely to cause hepatitis?
Which of the following viruses is least likely to cause hepatitis?
Which of the following statements best describes the Healthy People 2030 goals related to viral hepatitis?
Which of the following statements best describes the Healthy People 2030 goals related to viral hepatitis?
A patient with a known history of chronic hepatitis B (HBV) is being considered for treatment. Which factor would be most important for the healthcare provider to consider when selecting an antiviral medication?
A patient with a known history of chronic hepatitis B (HBV) is being considered for treatment. Which factor would be most important for the healthcare provider to consider when selecting an antiviral medication?
A patient newly diagnosed with hepatitis asks the nurse about preventing the spread of the disease. Which of the following instructions is most important?
A patient newly diagnosed with hepatitis asks the nurse about preventing the spread of the disease. Which of the following instructions is most important?
What is the primary reason for the implementation of widespread blood supply screening in the United States since 1992?
What is the primary reason for the implementation of widespread blood supply screening in the United States since 1992?
A patient with hepatitis has prolonged prothrombin time (PT). This indicates the liver is no longer able to produce which substance?
A patient with hepatitis has prolonged prothrombin time (PT). This indicates the liver is no longer able to produce which substance?
A nurse is caring for a patient with hepatitis and notes the patient's stools are pale. What is the most likely cause of this finding?
A nurse is caring for a patient with hepatitis and notes the patient's stools are pale. What is the most likely cause of this finding?
A patient has been diagnosed with Hepatitis D (HDV) and is also positive for Hepatitis B (HBV). What does the co-infection of HBV and HDV mean for this patient's treatment?
A patient has been diagnosed with Hepatitis D (HDV) and is also positive for Hepatitis B (HBV). What does the co-infection of HBV and HDV mean for this patient's treatment?
A patient with Hepatitis B is prescribed interferon alpha. Which of the following statements should the nurse include in the teaching plan?
A patient with Hepatitis B is prescribed interferon alpha. Which of the following statements should the nurse include in the teaching plan?
Which of the following liver conditions is a potential long-term complication specifically associated with chronic hepatitis B (HBV) and hepatitis C (HCV) infections?
Which of the following liver conditions is a potential long-term complication specifically associated with chronic hepatitis B (HBV) and hepatitis C (HCV) infections?
A patient is suspected of having toxic hepatitis due to occupational exposure. Based on the listed possible causes, which of the following substances in their workplace is the most likely cause?
A patient is suspected of having toxic hepatitis due to occupational exposure. Based on the listed possible causes, which of the following substances in their workplace is the most likely cause?
A patient with hepatitis reports right upper quadrant (RUQ) abdominal pain. Which of the following is the most likely cause of this pain?
A patient with hepatitis reports right upper quadrant (RUQ) abdominal pain. Which of the following is the most likely cause of this pain?
A patient is diagnosed with Wilson's disease. The nurse understands that this condition primarily leads to an accumulation of which substance in the liver?
A patient is diagnosed with Wilson's disease. The nurse understands that this condition primarily leads to an accumulation of which substance in the liver?
A patient with hepatitis reports taking Kava-containing herbal supplements. The nurse should counsel the patient regarding the risk of:
A patient with hepatitis reports taking Kava-containing herbal supplements. The nurse should counsel the patient regarding the risk of:
In acute liver failure, what is the immediate nursing priority if hepatic encephalopathy (HE) develops?
In acute liver failure, what is the immediate nursing priority if hepatic encephalopathy (HE) develops?
Which of the following lab value patterns would be MOST indicative of acute liver failure?
Which of the following lab value patterns would be MOST indicative of acute liver failure?
A patient with acute liver failure is at risk for bleeding. Which intervention is MOST appropriate to prevent GI bleeding?
A patient with acute liver failure is at risk for bleeding. Which intervention is MOST appropriate to prevent GI bleeding?
Why is it important to avoid stimulation and promote bed rest for a patient with acute liver failure?
Why is it important to avoid stimulation and promote bed rest for a patient with acute liver failure?
A patient with cirrhosis develops ascites. Which pathophysiological mechanism contributes to this condition?
A patient with cirrhosis develops ascites. Which pathophysiological mechanism contributes to this condition?
Which of the following is an INITIAL symptom commonly associated with cirrhosis?
Which of the following is an INITIAL symptom commonly associated with cirrhosis?
A patient with cirrhosis has developed portal hypertension. Which of the following findings would MOST likely be associated with this condition?
A patient with cirrhosis has developed portal hypertension. Which of the following findings would MOST likely be associated with this condition?
Why does cirrhosis lead to impaired blood clotting?
Why does cirrhosis lead to impaired blood clotting?
Which of the following is a common cause of cirrhosis?
Which of the following is a common cause of cirrhosis?
Which nursing diagnosis is MOST appropriate for a patient with cirrhosis experiencing confusion and disorientation?
Which nursing diagnosis is MOST appropriate for a patient with cirrhosis experiencing confusion and disorientation?
Which of the following describes the pathophysiology of liver damage in cirrhosis?
Which of the following describes the pathophysiology of liver damage in cirrhosis?
Which teaching point is MOST crucial for a young adult regarding alcohol consumption to prevent acute alcohol toxicity?
Which teaching point is MOST crucial for a young adult regarding alcohol consumption to prevent acute alcohol toxicity?
A patient with bleeding esophageal varices is at significant risk. What is the MOST immediate nursing intervention?
A patient with bleeding esophageal varices is at significant risk. What is the MOST immediate nursing intervention?
What is the primary goal of therapeutic measures for acute liver failure?
What is the primary goal of therapeutic measures for acute liver failure?
Which of these conditions is most commonly associated with nonalcoholic steatohepatitis (NASH)?
Which of these conditions is most commonly associated with nonalcoholic steatohepatitis (NASH)?
A patient with hepatitis is being discharged. Which instruction is MOST important to emphasize to the patient and their family to prevent the spread of the virus?
A patient with hepatitis is being discharged. Which instruction is MOST important to emphasize to the patient and their family to prevent the spread of the virus?
A nurse is teaching a caregiver how to handle the laundry of a patient with hepatitis at home. Which of the following instructions is MOST appropriate?
A nurse is teaching a caregiver how to handle the laundry of a patient with hepatitis at home. Which of the following instructions is MOST appropriate?
A patient with ascites is being cared for at home. Which intervention is MOST important for the home health nurse to implement?
A patient with ascites is being cared for at home. Which intervention is MOST important for the home health nurse to implement?
A patient with a history of heavy alcohol use reports taking acetaminophen (Tylenol) for pain relief. What is the MOST important instruction to give this patient regarding acetaminophen use?
A patient with a history of heavy alcohol use reports taking acetaminophen (Tylenol) for pain relief. What is the MOST important instruction to give this patient regarding acetaminophen use?
A patient is admitted to the emergency department with a suspected acetaminophen overdose. What is the MOST important initial intervention the nurse should prepare for if the overdose occurred within 4 hours?
A patient is admitted to the emergency department with a suspected acetaminophen overdose. What is the MOST important initial intervention the nurse should prepare for if the overdose occurred within 4 hours?
What is the primary physiological mechanism by which the kidneys respond to decreased circulating blood volume in a patient with cirrhosis?
What is the primary physiological mechanism by which the kidneys respond to decreased circulating blood volume in a patient with cirrhosis?
Which statement BEST describes how to accurately monitor a patient's acetaminophen intake in a 24-hour period?
Which statement BEST describes how to accurately monitor a patient's acetaminophen intake in a 24-hour period?
A patient is diagnosed with acute liver failure. What is the MOST critical immediate concern regarding the potential outcomes of this condition?
A patient is diagnosed with acute liver failure. What is the MOST critical immediate concern regarding the potential outcomes of this condition?
A patient with cirrhosis develops a markedly enlarged abdomen due to ascites. Which of the following is the most immediate respiratory complication that can arise from this condition?
A patient with cirrhosis develops a markedly enlarged abdomen due to ascites. Which of the following is the most immediate respiratory complication that can arise from this condition?
Which of the following best describes the pathophysiology of hepatic encephalopathy (HE) in a patient with cirrhosis?
Which of the following best describes the pathophysiology of hepatic encephalopathy (HE) in a patient with cirrhosis?
What symptoms are commonly associated with the initial stages of liver failure, making early detection challenging?
What symptoms are commonly associated with the initial stages of liver failure, making early detection challenging?
A patient with cirrhosis is exhibiting progressive confusion, asterixis, and fetor hepaticus. Which stage of hepatic encephalopathy (HE) is the patient most likely experiencing?
A patient with cirrhosis is exhibiting progressive confusion, asterixis, and fetor hepaticus. Which stage of hepatic encephalopathy (HE) is the patient most likely experiencing?
A patient is being educated on ways to prevent liver failure. Which of the following statements indicates a NEED for further teaching?
A patient is being educated on ways to prevent liver failure. Which of the following statements indicates a NEED for further teaching?
When caring for a patient with abdominal ascites at home, which instruction is MOST important for the nurse to provide regarding daily weight monitoring?
When caring for a patient with abdominal ascites at home, which instruction is MOST important for the nurse to provide regarding daily weight monitoring?
A patient in Grade 3 hepatic encephalopathy is somnolent but arousable. Besides disorientation, what other neurological symptom is most indicative of this stage?
A patient in Grade 3 hepatic encephalopathy is somnolent but arousable. Besides disorientation, what other neurological symptom is most indicative of this stage?
A patient with hepatitis reports using herbal supplements to boost their immune system. What is the MOST appropriate nursing intervention?
A patient with hepatitis reports using herbal supplements to boost their immune system. What is the MOST appropriate nursing intervention?
Which of the following best describes the primary cause of hepatorenal syndrome in a patient with cirrhosis?
Which of the following best describes the primary cause of hepatorenal syndrome in a patient with cirrhosis?
A nurse is reviewing a patient's medication list and notes that the patient is taking multiple medications containing acetaminophen. What is the MOST important action for the nurse to take?
A nurse is reviewing a patient's medication list and notes that the patient is taking multiple medications containing acetaminophen. What is the MOST important action for the nurse to take?
A patient with hepatorenal syndrome exhibits oliguria. What other finding is most consistent with this condition?
A patient with hepatorenal syndrome exhibits oliguria. What other finding is most consistent with this condition?
A patient with acute liver failure develops hepatic encephalopathy. Which of the following nursing interventions is MOST important to implement?
A patient with acute liver failure develops hepatic encephalopathy. Which of the following nursing interventions is MOST important to implement?
Which treatment would directly address the reduced intravascular volume and blood flow associated with hepatorenal syndrome?
Which treatment would directly address the reduced intravascular volume and blood flow associated with hepatorenal syndrome?
Which of the following is the underlying cause of Wernicke–Korsakoff syndrome?
Which of the following is the underlying cause of Wernicke–Korsakoff syndrome?
A patient with a history of IV drug use is being screened for hepatitis. Which type of hepatitis is MOST likely to be associated with this risk factor?
A patient with a history of IV drug use is being screened for hepatitis. Which type of hepatitis is MOST likely to be associated with this risk factor?
A patient is diagnosed with Wernicke encephalopathy secondary to chronic alcohol abuse. Which neurological symptoms are most indicative of this acute condition?
A patient is diagnosed with Wernicke encephalopathy secondary to chronic alcohol abuse. Which neurological symptoms are most indicative of this acute condition?
A patient with acute liver failure is at risk for bleeding. Which of the following nursing interventions is MOST important to implement to prevent bleeding complications?
A patient with acute liver failure is at risk for bleeding. Which of the following nursing interventions is MOST important to implement to prevent bleeding complications?
A patient with a history of chronic alcohol abuse is diagnosed with Korsakoff psychosis. What is the expected outcome of administering thiamine in this patient?
A patient with a history of chronic alcohol abuse is diagnosed with Korsakoff psychosis. What is the expected outcome of administering thiamine in this patient?
During an esophagogastroduodenoscopy (EGD) on a patient with cirrhosis, what specific complication is the healthcare provider primarily assessing?
During an esophagogastroduodenoscopy (EGD) on a patient with cirrhosis, what specific complication is the healthcare provider primarily assessing?
A patient with cirrhosis is undergoing a liver biopsy. What is the most critical post-procedure nursing intervention?
A patient with cirrhosis is undergoing a liver biopsy. What is the most critical post-procedure nursing intervention?
A patient with ascites is prescribed spironolactone and furosemide. What primary electrolyte imbalance should the nurse monitor for in this patient?
A patient with ascites is prescribed spironolactone and furosemide. What primary electrolyte imbalance should the nurse monitor for in this patient?
A patient with cirrhosis and refractory ascites undergoes a transjugular intrahepatic portosystemic shunt (TIPS) procedure. What is the intended outcome of this intervention?
A patient with cirrhosis and refractory ascites undergoes a transjugular intrahepatic portosystemic shunt (TIPS) procedure. What is the intended outcome of this intervention?
A patient with cirrhosis is experiencing anorexia. Which nursing intervention is most appropriate to promote adequate nutrition?
A patient with cirrhosis is experiencing anorexia. Which nursing intervention is most appropriate to promote adequate nutrition?
A patient with elevated ammonia levels is at risk for acute confusion. Which nursing intervention is a priority?
A patient with elevated ammonia levels is at risk for acute confusion. Which nursing intervention is a priority?
A patient with hepatic encephalopathy is receiving lactulose. Which assessment finding indicates that the medication is having the desired effect?
A patient with hepatic encephalopathy is receiving lactulose. Which assessment finding indicates that the medication is having the desired effect?
A patient with ascites is experiencing ineffective breathing patterns. What nursing intervention will best promote effective respiration?
A patient with ascites is experiencing ineffective breathing patterns. What nursing intervention will best promote effective respiration?
A patient with esophageal varices is at risk for deficient fluid volume. Which nursing intervention is most important to prevent bleeding?
A patient with esophageal varices is at risk for deficient fluid volume. Which nursing intervention is most important to prevent bleeding?
Which laboratory finding should the nurse prioritize when assessing a patient at risk for bleeding related to liver dysfunction?
Which laboratory finding should the nurse prioritize when assessing a patient at risk for bleeding related to liver dysfunction?
What should the nurse teach a patient with cirrhosis to avoid due to the risk of increasing pressure on esophageal varices?
What should the nurse teach a patient with cirrhosis to avoid due to the risk of increasing pressure on esophageal varices?
Which medication should be questioned for a patient with hepatic encephalopathy due to the risk of precipitating further neurological decline?
Which medication should be questioned for a patient with hepatic encephalopathy due to the risk of precipitating further neurological decline?
Following a liver transplant, what is the most important aspect of patient care that the nurse should emphasize during patient teaching?
Following a liver transplant, what is the most important aspect of patient care that the nurse should emphasize during patient teaching?
A patient with cirrhosis develops new onset confusion and asterixis. Which lab value is most important for the nurse to review?
A patient with cirrhosis develops new onset confusion and asterixis. Which lab value is most important for the nurse to review?
A patient with cirrhosis and ascites is prescribed spironolactone. Which electrolyte imbalance is the nurse's priority to monitor for?
A patient with cirrhosis and ascites is prescribed spironolactone. Which electrolyte imbalance is the nurse's priority to monitor for?
What dietary modification is most appropriate for a patient with cirrhosis to manage both ascites and hepatic encephalopathy?
What dietary modification is most appropriate for a patient with cirrhosis to manage both ascites and hepatic encephalopathy?
A patient with cirrhosis is prescribed a paracentesis. Which nursing action is most important following the procedure?
A patient with cirrhosis is prescribed a paracentesis. Which nursing action is most important following the procedure?
Which statement by a patient with cirrhosis indicates a need for further teaching regarding the management of their condition?
Which statement by a patient with cirrhosis indicates a need for further teaching regarding the management of their condition?
A patient with cirrhosis is being discharged. Which of the following symptoms should the nurse instruct the patient to report immediately to their healthcare provider?
A patient with cirrhosis is being discharged. Which of the following symptoms should the nurse instruct the patient to report immediately to their healthcare provider?
A patient with esophageal varices is actively bleeding. After initiating standard interventions, which of the following medications would the nurse anticipate administering first?
A patient with esophageal varices is actively bleeding. After initiating standard interventions, which of the following medications would the nurse anticipate administering first?
Which assessment finding in a patient with cirrhosis would indicate the highest risk for hepatic encephalopathy?
Which assessment finding in a patient with cirrhosis would indicate the highest risk for hepatic encephalopathy?
A patient with cirrhosis is prescribed lactulose. Which of the following indicates the medication is having the desired therapeutic effect?
A patient with cirrhosis is prescribed lactulose. Which of the following indicates the medication is having the desired therapeutic effect?
The nurse is caring for a patient with cirrhosis who has developed ascites. Which dietary modification is most important for managing this condition?
The nurse is caring for a patient with cirrhosis who has developed ascites. Which dietary modification is most important for managing this condition?
A patient with cirrhosis is scheduled for a paracentesis to relieve ascites. What nursing intervention is most important immediately after the procedure?
A patient with cirrhosis is scheduled for a paracentesis to relieve ascites. What nursing intervention is most important immediately after the procedure?
Which intervention is most appropriate to prevent rebleeding in a patient who had a recent episode of esophageal variceal bleeding?
Which intervention is most appropriate to prevent rebleeding in a patient who had a recent episode of esophageal variceal bleeding?
A patient with cirrhosis develops hepatic encephalopathy. The family asks why the patient is confused and disoriented. Which explanation by the nurse is most accurate?
A patient with cirrhosis develops hepatic encephalopathy. The family asks why the patient is confused and disoriented. Which explanation by the nurse is most accurate?
A patient with cirrhosis is being discharged. Which of the following instructions is most important regarding medication use?
A patient with cirrhosis is being discharged. Which of the following instructions is most important regarding medication use?
A patient with cirrhosis and ascites is on spironolactone and furosemide. What electrolyte imbalance should the nurse most closely monitor for?
A patient with cirrhosis and ascites is on spironolactone and furosemide. What electrolyte imbalance should the nurse most closely monitor for?
A patient with a history of cirrhosis presents with increased abdominal girth, dyspnea, and peripheral edema. Which nursing diagnosis takes priority?
A patient with a history of cirrhosis presents with increased abdominal girth, dyspnea, and peripheral edema. Which nursing diagnosis takes priority?
A patient with cirrhosis is prescribed rifaximin. What is the primary purpose of this medication in managing the patient's condition?
A patient with cirrhosis is prescribed rifaximin. What is the primary purpose of this medication in managing the patient's condition?
The nurse is teaching a patient with cirrhosis about nutrition. Which of the following statements indicates a need for further teaching?
The nurse is teaching a patient with cirrhosis about nutrition. Which of the following statements indicates a need for further teaching?
A patient with cirrhosis is undergoing a transjugular intrahepatic portosystemic shunt (TIPS) procedure. What is the main goal of this procedure?
A patient with cirrhosis is undergoing a transjugular intrahepatic portosystemic shunt (TIPS) procedure. What is the main goal of this procedure?
The nurse is caring for a patient with cirrhosis who is at risk for bleeding. Which nursing intervention is most important to implement?
The nurse is caring for a patient with cirrhosis who is at risk for bleeding. Which nursing intervention is most important to implement?
The nurse is reviewing the lab results of a patient with cirrhosis. Which of the following findings would the nurse expect to see?
The nurse is reviewing the lab results of a patient with cirrhosis. Which of the following findings would the nurse expect to see?
In Jewish law, under which of the following circumstances is organ transplantation generally considered permissible?
In Jewish law, under which of the following circumstances is organ transplantation generally considered permissible?
A liver transplant recipient is being monitored for organ rejection. Which of the following assessment findings is an early indicator of potential rejection?
A liver transplant recipient is being monitored for organ rejection. Which of the following assessment findings is an early indicator of potential rejection?
A patient who underwent liver transplantation is being discharged. Which instruction is most important to emphasize to the patient regarding long-term care?
A patient who underwent liver transplantation is being discharged. Which instruction is most important to emphasize to the patient regarding long-term care?
A patient is diagnosed with liver cancer. The physician explains that the cancer likely originated elsewhere in the body. From which of the following primary sites is liver metastasis most common?
A patient is diagnosed with liver cancer. The physician explains that the cancer likely originated elsewhere in the body. From which of the following primary sites is liver metastasis most common?
Which of the following factors poses the greatest risk for the development of liver cancer?
Which of the following factors poses the greatest risk for the development of liver cancer?
A patient with suspected liver cancer undergoes diagnostic testing. Which elevated laboratory value is most indicative of liver cancer?
A patient with suspected liver cancer undergoes diagnostic testing. Which elevated laboratory value is most indicative of liver cancer?
A patient post-operative from liver cancer resection is being cared for. Which of the following nursing interventions would be most appropriate?
A patient post-operative from liver cancer resection is being cared for. Which of the following nursing interventions would be most appropriate?
A patient is admitted with acute pancreatitis. Which pathophysiological process is primarily responsible for the severe abdominal pain associated with this condition?
A patient is admitted with acute pancreatitis. Which pathophysiological process is primarily responsible for the severe abdominal pain associated with this condition?
Which of the following is a leading cause of acute pancreatitis?
Which of the following is a leading cause of acute pancreatitis?
A patient with acute pancreatitis develops signs of shock. Which pathophysiologic mechanism best explains this development?
A patient with acute pancreatitis develops signs of shock. Which pathophysiologic mechanism best explains this development?
Which of the following assessment findings is most indicative of acute pancreatitis?
Which of the following assessment findings is most indicative of acute pancreatitis?
During the assessment of a patient with acute pancreatitis, the nurse notes shallow respirations and abdominal splinting. What is the most likely cause of these findings?
During the assessment of a patient with acute pancreatitis, the nurse notes shallow respirations and abdominal splinting. What is the most likely cause of these findings?
A patient with a history of heavy alcohol use is admitted with acute pancreatitis. What preventative measure should the nurse emphasize during discharge teaching to reduce the patient's risk of future episodes?
A patient with a history of heavy alcohol use is admitted with acute pancreatitis. What preventative measure should the nurse emphasize during discharge teaching to reduce the patient's risk of future episodes?
A patient being evaluated for acute pancreatitis reports nausea, vomiting, and jaundice. Which etiology of pancreatitis should the nurse suspect based on these signs and symptoms?
A patient being evaluated for acute pancreatitis reports nausea, vomiting, and jaundice. Which etiology of pancreatitis should the nurse suspect based on these signs and symptoms?
A patient with acute pancreatitis is being treated for pain and fluid imbalances. What additional intervention is most important to include in the patient's plan of care to prevent complications?
A patient with acute pancreatitis is being treated for pain and fluid imbalances. What additional intervention is most important to include in the patient's plan of care to prevent complications?
Which of the following best describes the typical pain associated with chronic pancreatitis (CP)?
Which of the following best describes the typical pain associated with chronic pancreatitis (CP)?
A patient with chronic pancreatitis reports frequent, greasy, foul-smelling stools. Which complication is MOST likely causing this symptom?
A patient with chronic pancreatitis reports frequent, greasy, foul-smelling stools. Which complication is MOST likely causing this symptom?
Which diagnostic test is typically preferred as the initial radiologic test for chronic pancreatitis?
Which diagnostic test is typically preferred as the initial radiologic test for chronic pancreatitis?
Which of the following therapeutic measures is MOST important in managing pain and preventing further damage in chronic pancreatitis?
Which of the following therapeutic measures is MOST important in managing pain and preventing further damage in chronic pancreatitis?
A patient with chronic pancreatitis is prescribed pancrelipase. What key teaching point should the nurse emphasize regarding the administration of this medication?
A patient with chronic pancreatitis is prescribed pancrelipase. What key teaching point should the nurse emphasize regarding the administration of this medication?
Which of the following assessment findings would be MOST indicative of a risk for injury related to hemorrhage in a patient with pancreatitis?
Which of the following assessment findings would be MOST indicative of a risk for injury related to hemorrhage in a patient with pancreatitis?
A patient with chronic pancreatitis is experiencing persistent itching. Which medication class might be prescribed to relieve this symptom?
A patient with chronic pancreatitis is experiencing persistent itching. Which medication class might be prescribed to relieve this symptom?
In a patient with chronic pancreatitis, what is the significance of monitoring the patient's weight every other day?
In a patient with chronic pancreatitis, what is the significance of monitoring the patient's weight every other day?
What is the rationale for advising patients with chronic pancreatitis to stop smoking?
What is the rationale for advising patients with chronic pancreatitis to stop smoking?
Which of the following electrolyte imbalances is MOST likely to occur in a patient with pancreatitis?
Which of the following electrolyte imbalances is MOST likely to occur in a patient with pancreatitis?
Which of the following best explains why serum amylase and lipase levels might be normal or low in a patient with chronic pancreatitis?
Which of the following best explains why serum amylase and lipase levels might be normal or low in a patient with chronic pancreatitis?
A patient with chronic pancreatitis develops diabetes mellitus. What is the MOST likely cause of this complication?
A patient with chronic pancreatitis develops diabetes mellitus. What is the MOST likely cause of this complication?
A patient with chronic pancreatitis is scheduled for extracorporeal shock-wave lithotripsy. What is the purpose of this procedure?
A patient with chronic pancreatitis is scheduled for extracorporeal shock-wave lithotripsy. What is the purpose of this procedure?
A patient with acute pancreatitis has a nasogastric tube in place for enteral feeding. Which nursing intervention is the priority when administering the feeding?
A patient with acute pancreatitis has a nasogastric tube in place for enteral feeding. Which nursing intervention is the priority when administering the feeding?
A patient with chronic pancreatitis is being discharged. Which of the following instructions should the nurse emphasize to promote long-term health?
A patient with chronic pancreatitis is being discharged. Which of the following instructions should the nurse emphasize to promote long-term health?
A nurse is teaching a patient with chronic pancreatitis about self-monitoring for malabsorption syndrome. Which symptom should the nurse emphasize as MOST indicative of this condition?
A nurse is teaching a patient with chronic pancreatitis about self-monitoring for malabsorption syndrome. Which symptom should the nurse emphasize as MOST indicative of this condition?
A patient with acute pancreatitis develops a purplish discoloration around the umbilicus. Which of the following complications is MOST likely indicated by this clinical sign?
A patient with acute pancreatitis develops a purplish discoloration around the umbilicus. Which of the following complications is MOST likely indicated by this clinical sign?
A patient taking bile acid dissolution agents should be taught to avoid which type of antacid?
A patient taking bile acid dissolution agents should be taught to avoid which type of antacid?
Which electrolyte imbalance is MOST likely to occur in a patient with acute pancreatitis due to autodigestion and fat necrosis?
Which electrolyte imbalance is MOST likely to occur in a patient with acute pancreatitis due to autodigestion and fat necrosis?
A patient with chronic pancreatitis reports persistent abdominal pain despite taking pain medications. Which intervention is MOST appropriate for the nurse to suggest?
A patient with chronic pancreatitis reports persistent abdominal pain despite taking pain medications. Which intervention is MOST appropriate for the nurse to suggest?
A patient with acute pancreatitis is at risk for developing Systemic Inflammatory Response Syndrome (SIRS). Which assessment finding is an EARLY indicator of SIRS?
A patient with acute pancreatitis is at risk for developing Systemic Inflammatory Response Syndrome (SIRS). Which assessment finding is an EARLY indicator of SIRS?
A patient with chronic pancreatitis has significant exocrine insufficiency. What nutritional deficiency is MOST likely to develop as a result?
A patient with chronic pancreatitis has significant exocrine insufficiency. What nutritional deficiency is MOST likely to develop as a result?
A patient with cirrhosis is experiencing ascites. Which dietary modification is MOST appropriate to manage this condition?
A patient with cirrhosis is experiencing ascites. Which dietary modification is MOST appropriate to manage this condition?
A patient is admitted with acute pancreatitis. Which of the following interventions is MOST important in the initial management of pain?
A patient is admitted with acute pancreatitis. Which of the following interventions is MOST important in the initial management of pain?
What is the MOST important teaching point for a patient being discharged after hospitalization for acute pancreatitis related to gallstones?
What is the MOST important teaching point for a patient being discharged after hospitalization for acute pancreatitis related to gallstones?
Following an ERCP, a patient reports new onset of severe abdominal pain. What is the nurse's MOST appropriate initial action?
Following an ERCP, a patient reports new onset of severe abdominal pain. What is the nurse's MOST appropriate initial action?
A patient with chronic cirrhosis presents with esophageal varices. What is the MOST critical concern related to this condition?
A patient with chronic cirrhosis presents with esophageal varices. What is the MOST critical concern related to this condition?
Which diagnostic result is the MOST specific indicator of acute pancreatitis?
Which diagnostic result is the MOST specific indicator of acute pancreatitis?
Following a laparoscopic cholecystectomy, a patient should receive education about which dietary change?
Following a laparoscopic cholecystectomy, a patient should receive education about which dietary change?
A patient with chronic pancreatitis is at risk for developing diabetes mellitus. Which pathophysiological change leads to this endocrine insufficiency?
A patient with chronic pancreatitis is at risk for developing diabetes mellitus. Which pathophysiological change leads to this endocrine insufficiency?
What is the rationale for using semi-Fowler's position in patients with acute pancreatitis?
What is the rationale for using semi-Fowler's position in patients with acute pancreatitis?
A patient with acute pancreatitis is being treated with aggressive intravenous fluid hydration. Which assessment finding indicates effective fluid resuscitation?
A patient with acute pancreatitis is being treated with aggressive intravenous fluid hydration. Which assessment finding indicates effective fluid resuscitation?
Which laboratory finding is MOST indicative of acute pancreatitis?
Which laboratory finding is MOST indicative of acute pancreatitis?
What is the MOST common cause of chronic pancreatitis?
What is the MOST common cause of chronic pancreatitis?
A patient with cirrhosis develops hepatic encephalopathy. Which dietary modification would be MOST appropriate?
A patient with cirrhosis develops hepatic encephalopathy. Which dietary modification would be MOST appropriate?
What is the BEST strategy to prevent hepatitis A infection when preparing food for others?
What is the BEST strategy to prevent hepatitis A infection when preparing food for others?
A patient with chronic pancreatitis is experiencing significant steatorrhea. What dietary modification is MOST appropriate to manage this symptom?
A patient with chronic pancreatitis is experiencing significant steatorrhea. What dietary modification is MOST appropriate to manage this symptom?
A patient with cirrhosis is prescribed diuretics. What electrolyte imbalance is the patient MOST at risk for?
A patient with cirrhosis is prescribed diuretics. What electrolyte imbalance is the patient MOST at risk for?
A patient with acute pancreatitis suddenly develops muscle twitching and complains of numbness around the mouth. Which electrolyte imbalance is suspected?
A patient with acute pancreatitis suddenly develops muscle twitching and complains of numbness around the mouth. Which electrolyte imbalance is suspected?
A patient with gallstones is experiencing right upper quadrant pain after eating a high-fat meal. What is the MOST likely cause of this pain?
A patient with gallstones is experiencing right upper quadrant pain after eating a high-fat meal. What is the MOST likely cause of this pain?
Which of the following factors contributes to the formation of cholesterol gallstones?
Which of the following factors contributes to the formation of cholesterol gallstones?
A patient with cholelithiasis also has sickle cell disease. How does sickle cell disease contribute to the formation of gallstones?
A patient with cholelithiasis also has sickle cell disease. How does sickle cell disease contribute to the formation of gallstones?
Following a cholecystectomy, an older adult patient is at higher risk for complications due to:
Following a cholecystectomy, an older adult patient is at higher risk for complications due to:
Mrs. Garcia is post-operative following an open cholecystectomy. She has shallow respirations. After ensuring airway patency, what is the most appropriate initial nursing intervention?
Mrs. Garcia is post-operative following an open cholecystectomy. She has shallow respirations. After ensuring airway patency, what is the most appropriate initial nursing intervention?
A patient post-cholecystectomy has a T-tube. Kinking of the T-tube is a concern because it can lead to:
A patient post-cholecystectomy has a T-tube. Kinking of the T-tube is a concern because it can lead to:
A patient with acute cholecystitis is experiencing severe abdominal pain. Which of the following medications would the nurse most likely administer?
A patient with acute cholecystitis is experiencing severe abdominal pain. Which of the following medications would the nurse most likely administer?
A patient with cholecystitis is at risk for deficient fluid volume. Which assessment finding is the best indicator of dehydration?
A patient with cholecystitis is at risk for deficient fluid volume. Which assessment finding is the best indicator of dehydration?
Which of the following nursing interventions is most important for a patient at risk for ineffective breathing pattern following a cholecystectomy?
Which of the following nursing interventions is most important for a patient at risk for ineffective breathing pattern following a cholecystectomy?
A patient's stool is clay-colored. This finding is most likely related to:
A patient's stool is clay-colored. This finding is most likely related to:
A patient with a history of chronic cholecystitis is admitted. Which dietary instruction is most appropriate for this patient?
A patient with a history of chronic cholecystitis is admitted. Which dietary instruction is most appropriate for this patient?
What is the primary difference between acute and chronic cholecystitis?
What is the primary difference between acute and chronic cholecystitis?
A nurse is reviewing the laboratory results for a patient suspected of having a gallbladder disorder. Which lab value is most indicative of a bile duct obstruction?
A nurse is reviewing the laboratory results for a patient suspected of having a gallbladder disorder. Which lab value is most indicative of a bile duct obstruction?
A patient with choledocholithiasis is likely to experience:
A patient with choledocholithiasis is likely to experience:
Which of the following conditions is most likely to cause stasis of bile in the gallbladder?
Which of the following conditions is most likely to cause stasis of bile in the gallbladder?
When teaching a patient about preventing gallstones, which of the following recommendations is most appropriate?
When teaching a patient about preventing gallstones, which of the following recommendations is most appropriate?
Following a Whipple procedure, a patient exhibits signs of peritonitis. Which of the following complications is the MOST likely cause?
Following a Whipple procedure, a patient exhibits signs of peritonitis. Which of the following complications is the MOST likely cause?
A patient with pancreatic cancer experiences significant weight loss, fatigue, and generalized weakness. Which nursing intervention is the MOST appropriate initial approach to address these symptoms?
A patient with pancreatic cancer experiences significant weight loss, fatigue, and generalized weakness. Which nursing intervention is the MOST appropriate initial approach to address these symptoms?
A patient is scheduled for a distal pancreatectomy. What other organ will MOST likely be removed during the procedure?
A patient is scheduled for a distal pancreatectomy. What other organ will MOST likely be removed during the procedure?
A patient with advanced pancreatic cancer is experiencing severe, intractable pain. Which intervention should the nurse anticipate as a means to provide longer-term pain relief when pharmacological interventions are insufficient?
A patient with advanced pancreatic cancer is experiencing severe, intractable pain. Which intervention should the nurse anticipate as a means to provide longer-term pain relief when pharmacological interventions are insufficient?
What dietary modification is most appropriate for a patient immediately following a cholecystectomy?
What dietary modification is most appropriate for a patient immediately following a cholecystectomy?
A patient with cholecystitis is experiencing significant pain. Besides medication, what non-pharmacological intervention can the nurse implement to provide additional comfort?
A patient with cholecystitis is experiencing significant pain. Besides medication, what non-pharmacological intervention can the nurse implement to provide additional comfort?
A patient with pancreatic cancer develops jaundice and pruritus. Which nursing intervention is MOST appropriate to manage the pruritus?
A patient with pancreatic cancer develops jaundice and pruritus. Which nursing intervention is MOST appropriate to manage the pruritus?
A patient who had an open cholecystectomy, which nursing intervention is most important to prevent pulmonary complications?
A patient who had an open cholecystectomy, which nursing intervention is most important to prevent pulmonary complications?
A patient is diagnosed with pancreatic cancer and presents with steatorrhea. Which intervention should the nurse prioritize to address this issue?
A patient is diagnosed with pancreatic cancer and presents with steatorrhea. Which intervention should the nurse prioritize to address this issue?
A patient with pancreatic cancer is being discharged with drains post-operatively. Which statement indicates a need for further teaching?
A patient with pancreatic cancer is being discharged with drains post-operatively. Which statement indicates a need for further teaching?
Which assessment finding would indicate that the treatment plan for a patient with cholecystitis is effective?
Which assessment finding would indicate that the treatment plan for a patient with cholecystitis is effective?
A patient post Whipple reports new onset of anxiety, which intervention should the nurse implement FIRST?
A patient post Whipple reports new onset of anxiety, which intervention should the nurse implement FIRST?
A patient is suspected of having acute cholecystitis. Which diagnostic test would be most useful in confirming this diagnosis quickly and non-invasively?
A patient is suspected of having acute cholecystitis. Which diagnostic test would be most useful in confirming this diagnosis quickly and non-invasively?
Which of the following findings suggests a potential complication of cirrhosis related to impaired liver function?
Which of the following findings suggests a potential complication of cirrhosis related to impaired liver function?
A patient with pancreatic cancer is on palliative care. Which of the following outcomes should be prioritized by the nurse for the patient's plan of care:
A patient with pancreatic cancer is on palliative care. Which of the following outcomes should be prioritized by the nurse for the patient's plan of care:
What is the primary purpose of CA 19-9 testing in a patient diagnosed with pancreatic cancer?
What is the primary purpose of CA 19-9 testing in a patient diagnosed with pancreatic cancer?
Which condition is most commonly associated with acute pancreatitis?
Which condition is most commonly associated with acute pancreatitis?
A patient reports epigastric pain, especially after eating fatty meals. Which condition is this patient most likely experiencing?
A patient reports epigastric pain, especially after eating fatty meals. Which condition is this patient most likely experiencing?
A patient with known pancreatic cancer reports significant abdominal distention and increased shortness of breath. Which complication should the nurse suspect?
A patient with known pancreatic cancer reports significant abdominal distention and increased shortness of breath. Which complication should the nurse suspect?
A patient with pancreatic cancer is receiving chemotherapy. Which of the following nursing interventions is MOST important to prevent infection?
A patient with pancreatic cancer is receiving chemotherapy. Which of the following nursing interventions is MOST important to prevent infection?
A patient with cirrhosis develops ascites that is unresponsive to diuretics. What is the next appropriate step?
A patient with cirrhosis develops ascites that is unresponsive to diuretics. What is the next appropriate step?
What is the rationale for performing a laparoscopy with biopsy in a patient diagnosed with pancreatic cancer?
What is the rationale for performing a laparoscopy with biopsy in a patient diagnosed with pancreatic cancer?
What is a major long-term complication of cirrhosis that requires ongoing monitoring?
What is a major long-term complication of cirrhosis that requires ongoing monitoring?
A patient with pancreatic cancer presents with a new onset of confusion. The patient's family reports increased sleepiness and forgetfulness over the past few days. Which lab value should the nurse assess first?
A patient with pancreatic cancer presents with a new onset of confusion. The patient's family reports increased sleepiness and forgetfulness over the past few days. Which lab value should the nurse assess first?
How does chronic cholecystitis typically develop?
How does chronic cholecystitis typically develop?
A patient with chronic pancreatitis is experiencing malabsorption and steatorrhea. What intervention will best address these issues?
A patient with chronic pancreatitis is experiencing malabsorption and steatorrhea. What intervention will best address these issues?
A patient with pancreatic cancer is having difficulty managing their blood sugar levels. They report that their blood sugars are high after meals. Which education should the nurse provide?
A patient with pancreatic cancer is having difficulty managing their blood sugar levels. They report that their blood sugars are high after meals. Which education should the nurse provide?
Which finding in a patient with end-stage liver disease indicates the most immediate need for possible liver transplant evaluation?
Which finding in a patient with end-stage liver disease indicates the most immediate need for possible liver transplant evaluation?
A patient with cirrhosis is at risk for esophageal varices. What dietary modification is most important to minimize this risk?
A patient with cirrhosis is at risk for esophageal varices. What dietary modification is most important to minimize this risk?
Which nursing intervention is MOST important for a patient experiencing breakthrough pain despite receiving regular analgesics for acute pancreatitis?
Which nursing intervention is MOST important for a patient experiencing breakthrough pain despite receiving regular analgesics for acute pancreatitis?
A patient with pancreatic cancer is undergoing palliative care. What is the primary goal of this approach?
A patient with pancreatic cancer is undergoing palliative care. What is the primary goal of this approach?
A patient with acute pancreatitis develops a persistent, nonproductive cough and decreased oxygen saturation. Which complication should the nurse suspect?
A patient with acute pancreatitis develops a persistent, nonproductive cough and decreased oxygen saturation. Which complication should the nurse suspect?
A patient with chronic pancreatitis is being discharged. Which dietary instruction is MOST appropriate to minimize pancreatic stimulation?
A patient with chronic pancreatitis is being discharged. Which dietary instruction is MOST appropriate to minimize pancreatic stimulation?
What is the primary rationale for advising a patient with pancreatic cancer to avoid cigarette smoking?
What is the primary rationale for advising a patient with pancreatic cancer to avoid cigarette smoking?
A patient with pancreatic cancer reports that pain is worse at night and radiates to the back. Which position should the nurse suggest to potentially alleviate this discomfort?
A patient with pancreatic cancer reports that pain is worse at night and radiates to the back. Which position should the nurse suggest to potentially alleviate this discomfort?
Which assessment finding in a pancreatic cancer patient requires the MOST immediate intervention by the nurse?
Which assessment finding in a pancreatic cancer patient requires the MOST immediate intervention by the nurse?
Following a Whipple procedure for pancreatic cancer, a patient develops paralytic ileus. Which nursing intervention is MOST appropriate?
Following a Whipple procedure for pancreatic cancer, a patient develops paralytic ileus. Which nursing intervention is MOST appropriate?
A patient with pancreatic cancer develops thrombophlebitis. Which intervention is MOST important for the nurse to implement?
A patient with pancreatic cancer develops thrombophlebitis. Which intervention is MOST important for the nurse to implement?
After a pancreaticoduodenectomy (Whipple procedure), a patient exhibits signs of hyperglycemia. Which intervention should the nurse prioritize?
After a pancreaticoduodenectomy (Whipple procedure), a patient exhibits signs of hyperglycemia. Which intervention should the nurse prioritize?
Which statement BEST describes the significance of CA 19-9 in the management of pancreatic cancer?
Which statement BEST describes the significance of CA 19-9 in the management of pancreatic cancer?
Which of the following is the MOST critical assessment for a patient with acute pancreatitis concerning potential respiratory complications?
Which of the following is the MOST critical assessment for a patient with acute pancreatitis concerning potential respiratory complications?
A patient with chronic pancreatitis reports persistent steatorrhea despite enzyme replacement therapy. What dietary modification should the nurse recommend FIRST?
A patient with chronic pancreatitis reports persistent steatorrhea despite enzyme replacement therapy. What dietary modification should the nurse recommend FIRST?
A patient with pancreatic cancer is undergoing palliative care. Which nursing intervention is MOST appropriate for managing anorexia and cachexia?
A patient with pancreatic cancer is undergoing palliative care. Which nursing intervention is MOST appropriate for managing anorexia and cachexia?
A patient with chronic pancreatitis and diabetes mellitus is prescribed both pancreatic enzyme supplements and insulin. What is the MOST important instruction for the nurse to provide regarding medication administration?
A patient with chronic pancreatitis and diabetes mellitus is prescribed both pancreatic enzyme supplements and insulin. What is the MOST important instruction for the nurse to provide regarding medication administration?
A patient with pancreatic cancer who is receiving chemotherapy reports increased fatigue and malaise. Apart from rest, which intervention is MOST appropriate for the nurse to recommend?
A patient with pancreatic cancer who is receiving chemotherapy reports increased fatigue and malaise. Apart from rest, which intervention is MOST appropriate for the nurse to recommend?
Flashcards
Hepatitis
Hepatitis
Inflammation of the liver; can result from infection, toxins, or disorders.
HAV
HAV
Hepatitis A virus; typically transmitted through contaminated food or water.
HBV
HBV
Hepatitis B virus; transmitted through blood and body fluids.
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Examples of DAA Combinations
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Hepatic Inflammation
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Subjective Data in Hepatitis
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Objective Data in Hepatitis
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Acute Pain (Hepatitis)
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Imbalanced Nutrition (Hepatitis)
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Risk for Impaired Liver Function
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Aldosterone's Role in Kidneys
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Ascites Definition
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Hepatic Encephalopathy Grade 0
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Hepatic Encephalopathy Grade 1
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Asterixis (Liver Flap)
Asterixis (Liver Flap)
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Ineffective Breathing Pattern
Ineffective Breathing Pattern
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Risk for Deficient Fluid Volume
Risk for Deficient Fluid Volume
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Esophageal Varices
Esophageal Varices
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Patient Education
Patient Education
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Liver Transplantation
Liver Transplantation
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Organ Matching
Organ Matching
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Prolonged PT
Prolonged PT
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Low Albumin
Low Albumin
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Hepatic Encephalopathy
Hepatic Encephalopathy
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Chronic Pancreatitis (CP)
Chronic Pancreatitis (CP)
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CP Signs/Symptoms
CP Signs/Symptoms
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CP Complications
CP Complications
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CP Diagnosis
CP Diagnosis
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Amylase/Lipase Levels in CP
Amylase/Lipase Levels in CP
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Fecal Fat Analysis in CP
Fecal Fat Analysis in CP
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CP Treatment Goals
CP Treatment Goals
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CP Pain Management
CP Pain Management
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Extracorporeal shock-wave lithotripsy
Extracorporeal shock-wave lithotripsy
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Antiemetics
Antiemetics
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Bile Acid Sequestrants
Bile Acid Sequestrants
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Bile Acid Dissolution Agents
Bile Acid Dissolution Agents
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Pancreatic Supplements
Pancreatic Supplements
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Monitoring Weight
Monitoring Weight
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Injury Monitoring
Injury Monitoring
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Acute Pancreatitis (AP)
Acute Pancreatitis (AP)
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Symptoms of Pancreatitis
Symptoms of Pancreatitis
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Diagnosing Acute Pancreatitis
Diagnosing Acute Pancreatitis
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Treating Acute Pancreatitis
Treating Acute Pancreatitis
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Complications of Acute Pancreatitis
Complications of Acute Pancreatitis
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Turner/Cullen Sign
Turner/Cullen Sign
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Nutrition in Severe Acute Pancreatitis
Nutrition in Severe Acute Pancreatitis
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Causes of Chronic Pancreatitis
Causes of Chronic Pancreatitis
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Outcomes of Chronic Pancreatitis
Outcomes of Chronic Pancreatitis
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Nutritional Deficiencies in CP
Nutritional Deficiencies in CP
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Chronic Pancreatitis interventions
Chronic Pancreatitis interventions
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Decreased Calcium Levels
Decreased Calcium Levels
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Pain Management in Acute Pancreatitis
Pain Management in Acute Pancreatitis
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Systemic Inflammatory Response Syndrome (SIRS)
Systemic Inflammatory Response Syndrome (SIRS)
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Effective Pancreatitis Care
Effective Pancreatitis Care
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Pancreatitis: Avoid Alcohol
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Pancreatitis: Adequate Nutrition
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Pancreatitis: Avoid Smoking
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Pancreatitis: Expected Pain Outcome
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Pancreatitis: Acute Pain Cause
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Pancreatitis: Effective Breathing
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Pancreatitis: Breathing Difficulty Cause
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Pancreatic Cancer: Rank
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Pancreatic Cancer: Type
Pancreatic Cancer: Type
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Pancreatic Cancer: Risk Factors
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Pancreatic Cancer: Symptoms
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Pancreatic Cancer: Pre-Op Complications
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Pancreatic Cancer: Post-Op Complications
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Pancreatic Cancer: Diagnostic Findings
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Cholecystitis
Cholecystitis
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Cholelithiasis
Cholelithiasis
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Biliary Colic
Biliary Colic
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Post-Cholecystectomy Diet
Post-Cholecystectomy Diet
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Post-Surgical Breathing Exercises
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Cholecystitis Pain Location
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Ultrasound
Ultrasound
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Cholecystectomy Types
Cholecystectomy Types
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Acute Pancreatitis
Acute Pancreatitis
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Obstruction of the common bile duct by a stone
Obstruction of the common bile duct by a stone
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Common Causes of Cirrhosis
Common Causes of Cirrhosis
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Discharge Education
Discharge Education
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Gallbladder Rupture Prevention
Gallbladder Rupture Prevention
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Esophageal Varices & Ascites
Esophageal Varices & Ascites
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Cirrhosis and Albumin
Cirrhosis and Albumin
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Serum Lipase
Serum Lipase
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Causes of Acute Pancreatitis
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Gallstone Pain
Gallstone Pain
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Semi-Fowler's Position
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Opioids for Pancreatitis
Opioids for Pancreatitis
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Liver Health Teaching
Liver Health Teaching
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Choledocholithiasis
Choledocholithiasis
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Cholesterol Gallstones
Cholesterol Gallstones
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Supersaturation of Bile
Supersaturation of Bile
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Clay-Colored Stools
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Tea-Colored Urine
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Cholecystectomy
Cholecystectomy
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T-Tube
T-Tube
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Temperature Monitoring
Temperature Monitoring
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Intake and Output (I&O)
Intake and Output (I&O)
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Elevated Serum Bilirubin
Elevated Serum Bilirubin
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Coughing and Deep Breathing
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Post-Cholecystectomy Complications
Post-Cholecystectomy Complications
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CA 19-9
CA 19-9
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CT, MRI, PET, and Ultrasound
CT, MRI, PET, and Ultrasound
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ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP (Endoscopic Retrograde Cholangiopancreatography)
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Pancreatic Biopsy
Pancreatic Biopsy
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Laparoscopy and Biopsy
Laparoscopy and Biopsy
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Whipple Procedure (Pancreatoduodenectomy)
Whipple Procedure (Pancreatoduodenectomy)
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Distal Pancreatectomy
Distal Pancreatectomy
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Total Pancreatectomy
Total Pancreatectomy
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Stent Placement
Stent Placement
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Celiac Plexus Block
Celiac Plexus Block
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Palliative Surgery
Palliative Surgery
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Malnutrition Signs
Malnutrition Signs
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Signs of Fluid Volume Deficit
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Skin Care for Itching
Skin Care for Itching
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Diabetes Education
Diabetes Education
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Study Notes
- These notes cover the nursing care of patients with liver, pancreatic, and gallbladder disorders.
Key Terms:
- Ascites: Accumulation of fluid in the peritoneal cavity.
- Asterixis: Flapping tremor of the hands due to metabolic disorders.
- Cholecystitis: Inflammation of the gallbladder.
- Choledocholithiasis: Gallstones in the common bile duct.
- Cholelithiasis: Formation of gallstones in the gallbladder.
- Cirrhosis: Progressive replacement of healthy liver tissue with scar tissue.
- Colic: Severe abdominal pain caused by muscle spasms or obstruction in a hollow organ like the bile duct.
- Fetor Hepaticus: Distinctive breath odor in liver disease caused by volatile substances.
- Hepatic Encephalopathy: Brain dysfunction due to liver failure and toxin accumulation.
- Hepatitis: Inflammation of the liver.
- Hepatorenal Syndrome: Kidney failure caused by liver disease.
- Laparoscopy: Surgical procedure using a small incision and camera.
- Pancreatectomy: Surgical removal of the pancreas.
- Pancreatitis: Inflammation of the pancreas.
- Portal Hypertension: Elevated blood pressure in the portal vein system.
- Transjugular Intrahepatic Portosystemic Shunt (TIPS): Artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein.
- Varices: Abnormally enlarged and twisted veins.
Concepts:
- Cognition
- Infection
- Inflammation
- Nutrition
Disorders of the Liver
Hepatitis
- Hepatitis is liver inflammation caused by viral/bacterial infections, medications, alcohol/chemicals, or metabolic/vascular disorders.
- Symptoms range from none to life-threatening.
Viral Hepatitis Etiology
- Hepatitis A (HAV)
- Hepatitis B (HBV)
- Hepatitis C (HCV)
- Hepatitis D (HDV)
- Hepatitis E (HEV)
- Viral agents vary by transmission mode, incubation, symptoms, tests, vaccines, and prophylaxis.
- Inflammation damages liver cells, impairing function and causing jaundice if bile canaliculi are affected.
Viral Hepatitis Infections: Key Differences Table 35.1
- Hepatitis A (HAV):
- Transmitted via the fecal-oral route.
- Incubation period is 15–50 days.
- Symptoms include anorexia, fatigue, nausea, jaundice, pale stools, pruritus, dark urine, and RUQ pain.
- Diagnosed using Anti-HAV IgM and Anti-HAV IgG.
- Vaccine available.
- Postexposure prophylaxis includes hepatitis A vaccine or IG.
- Prognosis is acute onset with a short illness and rarely fatal.
- Hepatitis B (HBV):
- Transmitted via blood or body fluids.
- Incubation period is 60–150 days.
- Symptoms range from asymptomatic to fatigue, malaise, anorexia, fever, nausea, headache, RUQ pain, myalgia, jaundice, and rashes.
- Diagnosed using HBsAg, Anti-HBs IgM, Anti-HBc IgM, HBeAg, and Anti-HBe.
- Vaccine available.
- Postexposure prophylaxis includes Hepatitis B IG (HBIG) and vaccination.
- Prognosis can be acute (asymptomatic or ill for weeks) or chronic (leading to cirrhosis, liver failure, or hepatocellular carcinoma).
- Hepatitis C (HCV):
- Transmitted via blood or body fluids.
- Incubation period is 2 weeks to 6 months.
- Most patients are asymptomatic.
- Diagnosed using Anti-HCV, HCV-RNA, HCV Viral Load, and HCV genotype.
- No vaccine available.
- Postexposure prophylaxis involves follow-up testing for HCV infection.
- Prognosis has a high cure rate with medication, but chronic infection can develop cirrhosis.
- Hepatitis D (HDV):
- Transmitted via blood or body fluids, requiring HBV co-infection.
- Incubation period is 3–7 weeks.
- Symptoms are the same as HBV but usually less severe.
- Diagnosed using HDV-RNA and HDAg.
- Hepatitis B vaccine provides protection.
- No specific postexposure prophylaxis is available.
- Prognosis with HBV co-infection can range from mild to severe illness with recovery, while superinfection with chronic HBV can lead to more severe disease.
- Hepatitis E (HEV):
- Transmitted via water contaminated with human feces or raw/undercooked pork, wild boar, or venison.
- Incubation period is 15–60 days.
- Symptoms include anorexia, dehydration, myalgia, nausea, RUQ pain, vomiting, fever, jaundice, pale stools, pruritus, and dark urine.
- Diagnosed using Anti-HEV.
- Hepatitis E vaccine is available in China only.
- No postexposure prophylaxis is available in the United States.
- Prognosis is a self-limiting infection, rarely fatal but risk increases for pregnant women.
Hepatitis C Virus Details
- Many HCV-infected individuals are unaware and may remain asymptomatic for up to 20 years.
- HCV can lead to chronic infection, liver disease, cirrhosis, or liver cancer.
- Before 1992, HCV spread through blood transfusions and organ transplants.
Prevention
- Hepatitis viruses resist many anti-infective measures.
- Prevent transmission through hygiene, avoiding exposure, vaccinations, and immunoglobulin (IG).
- IGs provide short-term passive protection.
- Vaccines for HAV and HBV offer permanent, active immunity.
Signs and Symptoms of Hepatitis
- People may be asymptomatic.
- Acute infection progresses through three stages:
- Prodromal: fatigue, nausea, vomiting.
- Icteric: jaundice, continued prodromal symptoms.
- Convalescent: patient starts feeling better.
- Recovery depends on the type of hepatitis.
- Acute hepatitis leads to chronic hepatitis & complications.
Complications
- Hepatitis can cause rapid liver failure
- Chronic infections develop with HBV, HCV, and HDV and increase liver cancer risk.
Diagnostic Tests
- Serological tests identify the specific virus causing hepatitis.
- Elevated serum liver enzymes and bilirubin is observed.
- Prothrombin time (PT) may be prolonged in severe cases.
Therapeutic Measures
- Goals include identifying the cause, monitoring liver status, relieving symptoms, and preventing cirrhosis.
- Adequate fluid and nutrition intake are important.
- Avoid extreme exertion, alcohol, and liver-toxic medications (Box 35.1).
- HAV and HEV infection treatment: supportive care.
- HBV and HDV coinfection: pegylated interferon therapy plus ribavirin.
- Treatment for chronic hepatitis B: antivirals
- Management of HCV: direct-acting antiviral (DAA) oral medications.
Nursing Process
- Data Collection: Subjective (malaise, fatigue, pruritus, nausea, anorexia, RUQ pain); Objective (weight, vomiting, pale stools, dark urine, jaundice).
- Nursing Diagnoses, Planning, Implementation:
- Acute Pain: monitor pain, give analgesics.
- Imbalanced Nutrition: dietitian referral, monitor weight/intake, antiemetics.
- Risk for Impaired Liver Function: monitor liver function, review medications.
- Risk for Impaired Skin Integrity: antihistamines, prevent scratching.
- Ineffective Health Management: teach about hepatitis, transmission, and treatment.
- Evaluation: Pain relief, improved lab values, intact skin, understanding of disease and treatment.
Home Health Hints
- Blood ammonia levels: use chilled vacutainer, place specimen on ice, deliver to lab fast.
- Abdominal Ascites: hospital bed at home; measure abdominal girth; weigh on the same scale.
- Hepatitis: caregiver wears gloves when cleaning; wash linens separately.
Acute Liver Failure
- This is a rare, serious, and rapid condition. Liver function is severely impaired.
- Possible outcomes: liver recovery, liver transplant, or death.
- Acetaminophen overdose is a common cause.
- Symptoms are vague initially but worsen to include jaundice and hepatic encephalopathy.
Therapeutic Measures
- Treatment: identify & reverse liver damage.
- Intensive supportive care to maintain airway and reduce stimulation.
- Discontinue most medications.
- Dialysis if from overdose of a hepatotoxic substance.
Nursing Process
- Care is similar to cirrhosis.
Chronic Liver Disease and Cirrhosis
- Cirrhosis is irreversible, progressive replacement of healthy liver tissue with scar tissue, usually from chronic alcohol use, hepatitis B/C, or nonalcoholic steatohepatitis (NASH).
Pathophysiology
- Liver cells become inflamed, infiltrated with fat/WBCs, and replaced by fibrotic tissue.
- Scar tissue disrupts liver lobes and creates nodules, impairing blood flow and causing portal hypertension.
Signs and Symptoms
- Initial symptoms include loss of appetite and nausea.
- Progressively loses liver function.
- Enlarged liver, fluid retention, high ammonia, and jaundice.
Complications of Cirrhosis
- Clotting Defects: Impaired prothrombin and fibrinogen production, leading to bleeding.
- Portal Hypertension: Obstructed blood flow in the portal vein, leading to esophageal varices/hemorrhoids.
- Ascites: Accumulation of fluid in the peritoneal cavity, causing abdominal distention.
- Hepatic Encephalopathy (HE): Elevated ammonia levels disrupt mental status.
- Hepatorenal Syndrome: Kidney failure secondary to cirrhosis.
- Wernicke–Korsakoff Syndrome: Brain disorder caused by thiamine deficiency.
Diagnostic Tests
- Liver function tests (Table 35.2).
- Liver biopsy can determine the extent and nature of the liver damage.
Therapeutic Measures
- Interventions for cirrhosis are to prevent advancement of the disease and treat complications.
Therapeutic Ascites management
- Diuretics, sodium/fluid restrictions, albumin infusions, paracentesis, TIPS procedure.
Therapeutic Esophageal Varices management
- Beta blockers to prevent bleeding, endoscopic variceal ligation, vasoconstrictor.
Therapeutic Hepatic Encephalopathy management
- Avoid precipitants, osmotic laxatives, and antibiotics to reduce ammonia levels.
Nursing Process
- Data Collection: Pain, anorexia, RUQ pain, jaundice, ascites, altered mental status.
- Nursing Diagnoses, Planning, and Implementation:
- Excess Fluid Volume: low-sodium diet, diuretics.
- Imbalanced Nutrition: dietitian referral, small/high-calorie meals.
- Acute Confusion: monitor LOC, give lactulose, reorientation.
- Ineffective Breathing Pattern: elevate HOB, careful analgesics.
- Risk for Deficient Fluid Volume: monitor secretions, avoid suctioning.
- Evaluation: Alertness, stable fluid balance, respiratory rate, knowledge and management.
Patient Education
- Avoid alcohol.
- Report bleeding/confusion.
Liver Transplantation
- Considered for end-stage liver failure.
- Observed closely, prevent tissue rejection with meds.
Cancer of the Liver
- Metastasis from other primary cancer sites. Chronic HBV/HCV and alcohol use increase risk.
- Symptoms: encephalopathy, bleeding, jaundice, ascites.
- Treatments: surgery, chemotherapy, radiation.
Disorders of the Pancreas
Pancreatitis
- Can be either acute or chronic.
Acute Pancreatitis (AP) Pathophysiology
- Autodigestion: pancreatic enzymes activate while in the pancreas and digest it. Can cause SIRS, electrolyte imbalance, hemorrhage, shock, and infection.
Acute Pancreatitis Etiology
- Alcohol consumption or gallstones. Smoking increases the risk.
Acute Pancreatitis Prevention
- Avoid alcohol and smoking. Treat biliary disease.
Acute Pancreatitis Signs and Symptoms
- Severe pain, guarding, hypotension/shock, respiratory distress. May report nausea and vomiting, and jaundice may be evident.
Acute Pancreatitis Complications
- May lead to systemic inflammatory response syndrome (SIRS), cardiovascular, pulmonary (including acute respiratory distress syndrome), and acute kidney injury. Presence of Chvostek/Cullen/Turner sign.
Acute Pancreatitis Diagnostic Tests
- Elevated serum amylase and lipase. CT and MRI.
Acute Pancreatitis Therapeutic Measures
- IV hydration, enteral feeding, pain relief, antibiotics.
Chronic Pancreatitis (CP) Pathophysiology
- Progressive tissue replacement with fibrotic tissue. Progressive destruction of tissue/cells that produce enzymes. May be followed by diabetes.
Chronic Pancreatitis Etiology
- Alcohol abuse, biliary disease, and hyperlipidemia, as well as idiopathic, genetic, and autoimmune related. Cigarette smoking and repeated attacks of AP are risk factors for developing CP.
Chronic Pancreatitis Signs and Symptoms
- Asymptomatic or epigastric pain, nausea/vomiting, weight loss, steatorrhea, intolerance of fatty foods. Shows pattern of exacerbations and remissions.
Chronic Pancreatitis Complications
- Abscesses, fistulas, pleural effusion, vitamin/mineral deficiencies, biliary obstruction, diabetes mellitus.
Chronic Pancreatitis Diagnostic Tests
- CT scan. Normal or low serum amylase/lipase, and Endoscopic ultrasound.
Chronic Pancreatitis Therapeutic Measures
- Pain management, pancreatic enzyme supplements, diet modifications, surgery.
Nursing Process
- Data Collection: Abdominal pain, nausea, vomiting, alcohol use.
- Nursing Diagnoses, Planning, and Implementation: - Imbalanced Nutrition: enzyme supplements, avoid alcohol. - Risk for Injury: monitor electrolytes/abdomen, antiemetics.
- Evaluation: Improved nutrition/fluid balance, no injury. Patient Education: Avoid alcohol/smoking.
Cancer of the Pancreas Pathophysiology
- Tumors spread rapidly to stomach, gallbladder, and duodenum.
Cancer of the Pancreas Etiology
- Smoking, obesity, diet, chemical exposure, diabetes, pancreatitis, and heredity.
Cancer of the Pancreas Signs and Symptoms
- Epigastric/back pain, anorexia, nausea, fatigue, weight loss. The pain becomes increasingly severe and unrelenting as the cancer grows. The classic symptom is weight loss.
Cancer of the Pancreas Complications
- Malnutrition, cancer spread, gastric/duodenal obstruction, thrombophlebitis.
Cancer of the Pancreas Diagnostic Tests
- Elevated ALP, glucose, bilirubin, CA 19-9.
Cancer of the Pancreas Therapeutic Measures
- Surgery, chemotherapy, immune therapy, radiation therapy.
Nursing Process for the Patient With Pancreatic Cancer
- DATA COLLECTION. Signs of malnutrition and fluid imbalance reviewed.
- NURSING DIAGNOSES: Fluid volume maintenance, skin care for itching.
- EVALUATION. Normal body weight, and negative symptoms listed above achieved.
PATIENT EDUCATION.
- Teach self-care measures (blood glucose monitoring and insulin administration).
- Teach S/S of hypo/hyperglycemia.
- Teach dressing changes and when to report complications.
Disorders of the Gallbladder
Cholecystitis, Cholelithiasis, and Choledocholithiasis Pathophysiology
- Acute cholecystitis: gallbladder inflammation.
- Cholelithiasis: is formation of gallstones in the gallbladder.
- Choledocholithiasis: gallstones in the common bile duct.
Cholelithiasis Etiology and Incidence
- Aging, heredity, obesity, stasis of bile, frequent fasting, diabetes mellitus, cirrhosis, pregnancy, estrogen, and other medications.
Cholecystitis/Cholelithiasis Signs And Symptoms
- Pain after fatty meal, elevated temperature, jaundice.
Cholecystitis Diagnostic Tests
- Ultrasound, CT scan, ERCP, elevated WBC.
Therapeutic Measures
- Pain control
- Laparoscopic or open cholecystectomy
- Medications
- Low-fat diet
Nursing Process for the Patient With a Gallbladder Disorder
- Data Collection: Monitor VS and temperature. Monitor for pain with WHAT'S UP questions.
- Nursing Diagnoses, Planning, and Implementation:
- Pain, fluid volume maintenance, respiratory maintenance, nutrition, skin care for pruritus.
- Evaluation: Tolerable pain, stable weight/hydration, normal respiratory status, intact skin, and normal WBC count.
Patient Education
- High-protein, low-fat diet. Lose weight. Slowly reintroduce fats.
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