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NUR303 Evolve Unit 4 WithComplete Solution
A patient is admitted with diabetes mellitus, malnutrition, osteomyelitis, and
alcohol abuse. His laboratory studies reveal an ALT of 198 IU/L and an AST of
224 IU/L. To which diagnosis can the nurse attribute these findings? -
ANSWER Alcohol abuse
Alcohol abuse can be a complication for the patient and may cause liver
disease. The liver function tests would increase above the normal levels in
case of alcohol abuse. The normal ALT range is 7 to 56 IU/L, while the normal
AST is 5 to 40 IU/L. Diabetes would cause an increase in blood sugar levels.
Malnutrition would lead to low levels of protein. Osteomyelitis is an infection
of the bone that would raise the white blood cell count.
A client is to be discharged from the hospital with the diagnosis of hepatitis
A infection. What is the most important instruction the nurse should include
in the discharge teaching? - ANSWER Wash hands carefully after bowel
movements.
The mode of transmission of hepatitis A infection is the fecal-oral route.
Hence, personal and environmental hygiene is very important. The nurse
should teach the patient and the family members to practice careful hand
washing immediately after bowel movements and before taking food to
avoid outbreaks of hepatitis A viral infection. The non-sharing of
toothbrushes and razors are of concern regarding the prevention of hepatitis
,B and C because they are transferred through blood contact. Isolation of the
patient with hepatitis A is not necessary, except if the patient is incontinent
or has poor personal hygiene. Acetaminophen is potentially hepatotoxic and
must be avoided in hepatic viral infection.
The client is to receive lactulose 30 grams orally q12h. An oral solution of
lactulose is available that contains 5 g/10 mL. How many milliliters of the
solution should be poured into the medication cup to administer the dose
ordered? - ANSWER 60mL
The teaching regarding acute hepatitis C (HCV) infection to the male patient
is understood by the patient when he makes which statement? - ANSWER "I
will have to be tested for chronic HCV and other liver diseases.". Most
individuals who become infected with HCV typically progress to chronic
disease that can result in cirrhosis or liver cancer. HCV is not spread through
saliva, but through percutaneous and high-risk sexual activity exposure.
Acute Viral Hepatitis The treatment for acute viral hepatitis is directed at
resting the body and providing adequate nutrition to promote liver
regeneration. Severe hepatitis B with liver failure is treated with Adofevir.
Pegylated interferon with ribavirin is used to treat Chronic HCV. Unlike
hepatitis A virus and HBV, immunity does not occur with HCV so the patient
can be reinfected with another type of HCV.
What are the precautions that must be taken by nurses and hospital staff
while treating patients with hepatitis infections? - ANSWER Discard the
, needles and syringes used on the patient judiciously.
Wear gloves while handling articles contaminated by urine or feces.
Follow infection control precautions while injecting the patient and avoid
getting pricked by the used needle.
R: Hepatitis A spreads via the fecal-oral route and hepatitis B via blood.
Hence, the virus can spread through needles and syringes used by the
patient. Also, the virus can spread while the nurse is handling the urine or
fecal material of the patient; hence it is necessary to wear gloves. Hepatitis
does not spread through the air; hence a mask is not required. A private
room is required in respiratory diseases, not in hepatitis.
The client with cirrhosis is receiving instructions related to self-care. Which
statement by the patient identifies that the patient requires further teaching?
ANSWER "If I notice a fast heart rate or irregular beats, it is normal for
cirrhosis."
If the cirrhotic patient develops a rapid or irregular pulse, this may indicate
hypokalemia and should be reported to the health care provider because this
is not a usual occurrence in cirrhosis. Edematous tissue is at risk for
breakdown and requires careful skin care. Scrotal edema is more comfortable
if a scrotal support is used. Pillows and a semi-Fowler's or Fowler's position
enhance respiratory effort.
A patient has an elevated level of ammonia related to hepatic
encephalopathy. What assessment finding does the nurse expect? - ANSWER
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