Chapter 35: Nursing Care of Patients with Liver, Pancreatic and Gallbladder Disorders

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A patient reports that a family member is diagnosed with hepatitis and asks the nurse the best way to prevent becoming infected. Which is the best information for the nurse to provide?

a. Expose fabric or unwashable items to ultraviolet light.
b. Thoroughly scrub hard surfaces with a strong bleach solution.
c. Perform frequent hand washing and do not share personal items.
d. Immediately start and complete a prophylactic antibiotic regimen.
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Terms in this set (20)
A patient reports that a family member is diagnosed with hepatitis and asks the nurse the best way to prevent becoming infected. Which is the best information for the nurse to provide?

a. Expose fabric or unwashable items to ultraviolet light.
b. Thoroughly scrub hard surfaces with a strong bleach solution.
c. Perform frequent hand washing and do not share personal items.
d. Immediately start and complete a prophylactic antibiotic regimen.
c. Perform frequent hand washing and do not share personal items.
The nurse is providing care for a patient admitted with acute liver failure related to an acetaminophen overdose. Which goal is associated with care for the patient?

a. Maintain functional ability of the liver.
b. Keep the patient on complete bed rest.
c. Monitor for the need to initiate intubation.
d. Provide a diet high in vitamins and protein.
a. Maintain functional ability of the liver.
A patient with liver failure and esophageal varices is prescribed to receive vasopressin. For which purpose does the nurse recognize the need for this medication?
a. To promote portal circulation
b. To reduce ammonia buildup and encephalopathy
c. To constrict vessel dilation to the esophageal varices
d. To maintain hypotension related to bleeding varices
c. To constrict vessel dilation to the esophageal varices
The nurse is obtaining information from a patient who is obese and has diabetes mellitus (DM). Upon physical examination, the nurse notes generalized ecchymosis, an enlarged and tender liver with palpation, and evidence of ascites with percussion. Which possible disease condition does the nurse identify from the findings?

a. Diabetic complications
b. Liver dysfunction
c. Acute kidney disorder
d. Deficient blood clotting
b. Liver dysfunction
The nurse is reinforcing teaching provided to a patient with esophageal varices. Which suggestion is the least important?

a. Avoid lifting heavy objects.
b. Bleeding is a reason to call 911.
c. Keep appointments with the health care provider (HCP).
d. Maintain low physical activity.
d. Maintain low physical activity.
The nurse is collecting data from a patient with liver failure to detect hepatic encephalopathy. Which instruction does the nurse give to the patient to collect the data?

a. "Stand with your eyes closed."
b. "Hold out your arms and hands."
c. "Kneel on your hands and knees."
d. "Perform a Valsalva's maneuver."
b. "Hold out your arms and hands."
The nurse is collecting data from a patient with acute pancreatitis. Which symptoms should the nurse anticipate?

a. Low abdominal pain, bradycardia, and confusion
b. Shortness of breath, hypotension, and restlessness
c. Fever, tachycardia, right upper quadrant pain, and jaundice
d. Abdominal distention, respiratory distress, and midepigastric pain
d. Abdominal distention, respiratory distress, and midepigastric pain
The nurse is providing care for a patient diagnosed with chronic pancreatitis. The patient's vital signs are blood pressure 130/78 mm Hg, respirations 28 breaths/min and labored with O2 saturation rate of 90%, pulse 102 beats/min, and pain level of 7 on a 0-to-10 scale. Which immediate nursing action is appropriate?

a. Observe for use of accessory or intercostal muscles.
b. Validate when the last pain medication was administered.
c. Place in an upright or slightly leaning forward position.
d. Seek approval to begin or increase delivery of oxygen therapy.
c. Place in an upright or slightly leaning forward position.
A patient just receives a diagnosis of pancreatic cancer with metastasis to the liver, gallbladder, and stomach. The nurse is informed that the patient has agreed to palliative care. Which intervention seems unexpected to the nurse?

a. Performance of a Whipple procedure
b. Surgery to bypass a blocked bile duct
c. Chemotherapy and radiation therapy
d. Surgical placement of a bile duct stent
a. Performance of a Whipple procedure
The nurse is assisting with the care of a patient following a liver transplant for cirrhosis. Which finding will the nurse report immediately to the RN or HCP?

a. Surgical pain greater than 4 on a 0-to-10 scale
b. Decrease in the amount of bile in the T-tube
c. Difficulty with taking deep breaths or coughing
d. A regular apical pulse rate of 98 beats/min
b. Decrease in the amount of bile in the T-tube
The nurse is reinforcing patient teaching regarding the causes of gallbladder disorders. Which condition does the nurse present as being a common cause? a. Metastasis of cancer from the liver b. Obesity and high dietary intake of fats c. Gallstones and inflammations d. History of excessive alcohol intakec. Gallstones and inflammationsA patient presents at the HCP's office with epigastric pain. The patient's temperature and pulse and respiration rates are all elevated. Which additional symptom will the nurse associate as a possible sign of cholelithiasis? a. Jaundice b. Vomiting c. Heartburn d. Flatulencea. JaundiceA patient is being treated for acute cholecystitis. The patient is instructed on dietary measures to reduce the possibility of recurrent episodes. Which patient comment indicates a need to reinforce teaching? a. "I will need to limit the amount of fat in my diet." b. "I can increase my intake of nuts and avocados." c. "While I am having an attack, I may need to be NPO." d. "I need to get my extra weight off as quick as possible."d. "I need to get my extra weight off as quick as possible."A patient with biliary colic is prescribed an anticholinergic medication to help treat the condition. For which medical diagnosis should the nurse question the administration of this medication? a. Asthma b. Psoriasis c. DM d. Prostatic hypertrophyd. Prostatic hypertrophyThe nurse is providing care for a client following an open cholecystectomy involving the removal of large gallstones and placement of a T-tube. Which third day postsurgical manifestation will cause the nurse to report the finding? a. Deep breathing and coughing improves with incisional splinting. b. Pain level remains between 3 and 5 depending on patient activity. c. T-tube drainage is 600 mL over the past 24-hour period. d. Patient complains about receiving a soft, low-fat diet.c. T-tube drainage is 600 mL over the past 24-hour period.The nurse is providing care for an older adult patient with a diagnosis of small noncalcified gallstones. The HCP prefers to avoid surgery on the patient due to age and a medical history of cardiac disorders. Which medical treatment does the nurse most likely expect the HCP to prescribe? a. Dietary alterations and limitations b. Management of cholecystitis flare-ups c. Routine anti-inflammatory medications d. Long-term treatment with a dissolution drugd. Long-term treatment with a dissolution drugThe nurse is gathering information about a new patient in an adult clinic. The patient states, "I have severe arthritis, but I control the pain with two 650-mg acetaminophen tablets four times a day." Which condition does the nurse associate with the patient's medication regimen? a. Urinary retention b. Gastric bleeding c. Liver failure d. Kidney diseasec. Liver failureThe nurse is providing care for a patient admitted with serious acute pancreatitis. The patient is in guarded condition and exhibits multiple manifestations of pancreatitis complications. The nurse is aware that which body system is unlikely to lead to patient death? a. Neurologic b. Cardiovascular c. Respiratory d. Renal/kidneya. NeurologicA patient recovering from hepatitis is concerned about liver damage from the infection. Which instructions does the nurse provide the patient to prevent long-term liver damage? (Select all that apply.) a. Get adequate rest. b. Ingest nutritious foods. c. Abstain from all alcohol. d. Restrict physical activity. e. Limit the intake of dairy products.a. Get adequate rest. b. Ingest nutritious foods. c. Abstain from all alcohol.The nurse is preparing to reinforce discharge teaching for a patient who underwent a cholecystectomy. Which information does the nurse plan to cover? (Select all that apply.) a. Increase high-quality protein to promote healing. b. Avoid dietary fats to prevent postoperative nausea or pain. c. Call the HCP if fever, redness, or drainage indicates infection. d. Increase fluid intake to flush excess bilirubin from the system. e. Reintroduce fats slowly back into the diet to prevent rebound effects.a. Increase high-quality protein to promote healing. b. Avoid dietary fats to prevent postoperative nausea or pain. c. Call the HCP if fever, redness, or drainage indicates infection. e. Reintroduce fats slowly back into the diet to prevent rebound effects.