Nokea
A client with cirrhosis is complaining of severe pruritus related to the accumulation of bile salts. What can be prescribed for the client to relieve the itching?
- A. Cholestyaramine
- B. Kanamyycin
- C. Lactulose
- D. Cyclosporine
Correct Answer: A
Rationale: Cholestyramine may be prescribed to bind bile salts and relieve pruritus. Kanamycin is prescribed to reduce the bacterial count in the intestine. Lactulose is used to decrease the amount of ammonia level in the blood. Cyclosporine is used to prevent rejection of a transplanted organ.
You may also like to solve these questions
A client with cirrhosis is complaining to the nurse of itching. The client asks the nurse if the itching is from taking warm baths. What is the best response by the nurse?
- A. The itching is caused by the accumulation of bile salts.
- B. The itching is related to dry skin from the warm baths.
- C. The itching is most likely a side effect from some of the medications used in treatment.
- D. The itching is related to a psychological response from the illness.
Correct Answer: A
Rationale: Skin may itch (pruritus) from accumulated bile salts related to the diseased liver. It is not related to the baths or a psychological response from the illness. Medication side effect may cause itching, but the most likely cause is the accumulation of bile salts.
The nurse is caring for a client suspected of having stones that have collected in the common bile duct. What test should the nurse prepare the client for that will locate these stones?
- A. Colonoscopy
- B. Abdominal x-ray
- C. Cholecystectomy
- D. Endoscopic retrograde cholangiopancreatography (ERCP)
Correct Answer: D
Rationale: ERCP locates stones that have collected in the common bile duct. A colonoscopy will not locate gallstones but only allows visualization of the large intestine. Abdominal x-ray is not a reliable locator of gallstones. A cholecystectomy is the surgical removal of the gallbladder.
A client comes to the clinic to see the health care provider for right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder do these symptoms correlate with?
- A. Hepatitis
- B. Biliary colic
- C. Cholelithiasis
- D. Cholecystitis
Correct Answer: C
Rationale: With cholelithiasis, initially, clients experience belching, nausea, and right upper quadrant discomfort, with pain or cramps after high-fat meal. Symptoms become acute when a stone blocks bile flow from the gallbladder. With acute cholecystitis, clients usually are very sick with fever, vomiting, tenderness over the liver, and severe pain called biliary colic. The symptoms do not correlate with hepatitis.
The nurse is caring for a client with severe acute pancreatitis with a glucose level of 750 mg/dL. What does the nurse understand is the cause of this level of hyperglycemia?
- A. Severe acute pancreatitis causes an increase in circulating calcium.
- B. The client has not been taking the insulin and eating simple carbohydrates.
- C. The client has diabetes as well as pancreatitis.
- D. Severe acute pancreatitis causes an imbalance of glucagon, insulin, and somatostatin.
Correct Answer: D
Rationale: Complications from severe acute pancreatitis are serious and sometimes fatal. Hyperglycemia results from an imbalance of glucagon, insulin, and somatostatin. Increase in circulating calcium does not result in an increase in glucose levels. The nurse cannot assume that the client has diabetes and is noncompliant.
The nurse is administering furosemide to promote urinary excretion of excess fluids for a client with cirrhosis. When administering furosemide to this client, what should the nurse closely monitor?
- A. Sodium level
- B. Calcium level
- C. Magnesium level
- D. AST levels
Correct Answer: A
Rationale: Diuretics such as furosemide must be administered with caution because long-term use can cause sodium depletion. The other levels do not relate to the administration of furosemide.