A nurse is caring for a client who has advanced liver disease. Which of the following laboratory results should the nurse monitor when assessing this client?
Serum ammonia
Phosphate level
Serum troponin
Glucose level
The Correct Answer is A
Rationale:
A. Serum ammonia: In advanced liver disease, the liver's ability to detoxify ammonia is impaired. Ammonia can accumulate in the bloodstream, leading to hepatic encephalopathy, which can cause confusion, lethargy, or even coma. Monitoring serum ammonia levels is essential.
B. Phosphate level: Phosphate levels are not a primary concern in advanced liver disease. Although abnormalities in electrolyte balance can occur, phosphate levels are not directly impacted by liver function in the same way as ammonia or other liver-related markers.
C. Serum troponin: Serum troponin is primarily used to assess for myocardial injury, such as in the case of a heart attack. It is not a relevant marker for liver disease. While cardiac complications can occur in liver disease, troponin levels are not a priority.
D. Glucose level: While glucose metabolism can be affected by liver disease due to impaired glycogen storage and gluconeogenesis, monitoring serum ammonia is more critical in advanced liver disease for assessing hepatic encephalopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["3300"]
Explanation
Calculation:
- Calculate the total volume from the continuous IV infusion over 24 hours.
Continuous infusion rate = 125 mL/hr
Time = 24 hr
Volume from continuous infusion = 125 mL/hr × 24 hr
= 3000 mL.
- Calculate the total volume from the cefazolin IV bolus over 24 hours.
Cefazolin bolus volume per dose = 50 mL
Frequency = every 4 hr
Number of doses in 24 hr = 24 hr / 4 hr/dose
= 6 doses.
Volume from cefazolin bolus = 50 mL/dose × 6 doses
= 300 mL.
- Calculate the total IV fluid intake over 24 hours.
Total IV fluid intake = Volume from continuous infusion + Volume from cefazolin bolus
= 3000 mL + 300 mL
= 3300 mL.
Correct Answer is A
Explanation
Rationale:
A. Provide the client with high-protein meals: High-protein meals are important for tissue repair and healing, especially in clients at risk for pressure ulcers. Adequate nutrition, including protein, is essential to promote skin integrity and prevent further skin breakdown.
B. Gently massage the reddened areas: Massaging reddened areas can increase tissue damage and worsen skin breakdown. Instead of massaging, the nurse should relieve pressure on those areas to prevent further injury.
C. Place the client in a supine position: The supine position might increase pressure on the client's scapulae. It is better to reposition the client to relieve pressure from affected areas, ideally by turning them to their side or using pillows to offload pressure.
D. Use hot water when cleaning the client's skin: Hot water can dry and irritate the skin, worsening the condition. The nurse should use lukewarm water and gentle, non-irritating products to clean the skin and prevent further damage.
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