A 54-year-old reports vomiting blood. Tests reveal portal hypertension. Which of the following is the most likely cause of this condition?

Choice A reason:
Amphotericin B is known to cause infusion reactions, including fever, chills, and rigors. These reactions are common and expected when administering this medication. Therefore, the statement that there is an infusion reaction to Amphotericin B is correct and does not indicate a need for further teaching.
Choice B reason:
This choice is incorrect because infusions of Amphotericin B should not be administered rapidly. Rapid infusion can increase the risk of severe side effects and adverse reactions. The drug should be administered slowly to minimize these risks. Thus, this statement indicates a need for further teaching.
Choice C reason:
Rotating the IV site frequently or using a larger vein, such as a central line, is a standard practice to reduce the risk of phlebitis, a common complication of Amphotericin B treatment. This statement is correct and does not indicate a need for further teaching.
Choice D reason:
Amphotericin B is indeed used for the treatment of systemic fungal infections. This statement is factually accurate and does not suggest any misunderstanding on the part of the nursing student. Therefore, it does not indicate a need for further teaching.

Choice A reason:
While decreased cerebral blood flow can contribute to various neurological conditions, it is not the primary cause of hepatic encephalopathy. Hepatic encephalopathy is primarily associated with liver dysfunction rather than cerebrovascular issues. Thus, this choice is incorrect.
Choice B reason:
Impaired ammonia metabolism is the primary cause of hepatic encephalopathy. When the liver is unable to adequately convert ammonia to urea due to chronic liver disease, ammonia accumulates in the bloodstream. This leads to toxic effects on the brain, resulting in the symptoms of hepatic encephalopathy. Therefore, this choice accurately reflects the underlying pathophysiology of the condition.
Choice C reason:
Hyperbilirubinemia and jaundice are common in liver disease but are not the primary causes of hepatic encephalopathy. These conditions result from impaired bilirubin metabolism and do not directly lead to the neurological manifestations seen in hepatic encephalopathy. Therefore, this choice is incorrect.
Choice D reason:
Fluid and electrolyte imbalances can occur with chronic liver disease but are not the primary cause of hepatic encephalopathy. While they may exacerbate the condition, the main issue is the accumulation of ammonia due to impaired liver function. Hence, this choice is incorrect.