A client with liver cirrhosis complains of difficulty sleeping at night due to frequent awakenings caused by shortness of breath. Which complication should the nurse suspect as the most likely cause of the client's symptom?
Hepatocellular carcinoma
Portal hypertension
Hepatic encephalopathy
Hepatopulmonary syndrome
The Correct Answer is D
A) Hepatocellular carcinoma is a type of liver cancer and can be a complication of liver cirrhosis. However, it is not typically associated with difficulty sleeping or shortness of breath.
B) Portal hypertension, a common complication of liver cirrhosis, can lead to the development of ascites and esophageal varices, among other manifestations. It is not the likely cause of the client's difficulty sleeping and shortness of breath.
C) Hepatic encephalopathy is a neuropsychiatric complication of advanced liver disease and is not associated with difficulty sleeping or shortness of breath.
D) Hepatopulmonary syndrome is a complication of liver cirrhosis characterized by the development of pulmonary vascular dilation and arteriovenous shunting. This results in impaired oxygenation of blood, leading to difficulty breathing (dyspnea), especially while lying down (orthopnea). Clients with hepatopulmonary syndrome often experience frequent awakenings due to shortness of breath during sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Iron supplements are not indicated in the care of a client with liver cirrhosis and esophageal varices. The client's condition is related to portal hypertension and the risk of variceal bleeding, not blood clotting.
B) Monitoring fluid balance and daily weights is important in managing clients with liver cirrhosis, especially those with ascites. However, it is not the essential intervention specific to clients at risk of developing esophageal varices.
C) Elevating the head of the bed is a standard intervention to prevent aspiration in clients with various medical conditions. However, it is not the essential intervention specific to clients at risk of esophageal varices.
D) Encouraging the client to avoid straining during bowel movements is essential in the care of a client at risk of developing esophageal varices. Straining during bowel movements can increase intra-abdominal pressure, which may lead to increased pressure in the portal vein, potentially exacerbating portal hypertension and increasing the risk of variceal bleeding.
Correct Answer is A
Explanation
B) Furosemide is a diuretic used to treat fluid retention in clients with cirrhosis but is not effective in reducing ammonia levels or managing hepatic encephalopathy.
C) Propranolol is a beta-blocker often prescribed to reduce portal hypertension and prevent variceal bleeding in clients with liver cirrhosis. It is not used to treat hepatic encephalopathy.
D) Spironolactone is a diuretic used to manage fluid retention and ascites in clients with liver cirrhosis. Like furosemide, it is not effective in reducing ammonia levels or treating hepatic encephalopathy.
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