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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Rationale:

A. "Remove the needle from the syringe before you place it in the trash." Needles should not be removed from syringes before disposal. This can increase the risk of needle-stick injuries. The entire syringe and needle should be disposed of intact in a proper sharps container.

B. "Secure the cap tightly over the needle before you discard it" Securing the cap over the needle increases the risk of needle-stick injuries. The needle should be placed directly in a sharps container without recapping.

C. "Place your storage container in a recycle bin when it is full." Sharps containers should never be placed in a recycle bin due to the risk of injury. Once full, the sharps container should be disposed of in a designated waste disposal service.

D. "You can discard needles in an empty bleach bottle with a lid.” The nurse should instruct the client to dispose of used needles in a rigid, puncture-proof container, such as an empty bleach bottle with a secure lid, until a proper sharps container is available. This helps prevent injury to others.

A. "I can't seem to get reading materials far enough away to see the words." B. "I'm having more difficulty telling the difference between blues and greens." C. "I've noticed that there is a gray ring around the colored part of my eye." D. "In the last day, I have had a severe headache and pain around my right eye."

Correct Answer is D

Explanation

Rationale:

A. "I can't seem to get reading materials far enough away to see the words." This statement may indicate presbyopia, which is a common age-related change in vision. It does not require immediate intervention, though corrective lenses may help.

B. "I'm having more difficulty telling the difference between blues and greens." This could indicate age-related changes in color vision or cataracts, which is common but not immediately concerning. It does not represent an urgent need for intervention.

C. "I've noticed that there is a gray ring around the colored part of my eye." This could suggest a cataract, which is common in older adults. However, it is a chronic condition that progresses slowly and is not an emergency.

D. "In the last day, I have had a severe headache and pain around my right eye." This is a priority, as it could indicate acute angle-closure glaucoma, a medical emergency that requires immediate attention to prevent permanent vision loss. Symptoms include severe headache, eye pain, nausea, and blurred vision, all of which need urgent assessment and intervention.

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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?

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