A nurse is caring for a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

Only use a soft-bristle toothbrush

Apply an ice pack over a bleeding wound

Use a Boss pick instead of the four string to floss in between the teeth

Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues

Answer and Explanation

The Correct Answer is A

A. Only use a soft-bristle toothbrush: Clients with thrombocytopenia are at risk for bleeding, including gum bleeding. Using a soft-bristle toothbrush minimizes trauma to the gums and reduces the risk of bleeding.

B. Apply an ice pack over a bleeding wound: While ice can help constrict blood vessels and reduce minor bleeding, it is not the primary preventative measure for thrombocytopenia-related bleeding.

C. Use a floss pick instead of the floss string to clean between teeth: A floss pick may still cause gum trauma. It is recommended to use a soft flossing technique or avoid flossing if platelet counts are extremely low.

D. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues: While monitoring for petechiae or bruising is important, it does not actively prevent bleeding complications.

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Correct Answer is A

Explanation

A. Obstruction of the bile duct: Biliary cirrhosis (now called primary or secondary biliary cholangitis) can occur due to prolonged bile duct obstruction, leading to liver damage and cirrhosis.

B. Hepatitis C: Hepatitis C can cause cirrhosis, but it is not a direct cause of biliary cirrhosis. Instead, it leads to post-viral cirrhosis.

C. Hepatotoxic medications: Certain medications (e.g., acetaminophen overdose) can cause liver damage, but they do not specifically cause biliary cirrhosis.

D. Excessive alcohol consumption: Alcohol abuse can cause alcoholic cirrhosis, but not biliary cirrhosis.

A. Rifaximin daily B. Low sodium diet C. Low protein diet D. Lactulose 30gm/30 ml PO

Correct Answer is ["A","D"]

Explanation

A. Rifaximin daily: Rifaximin is an antibiotic that helps lower intestinal bacteria, which produce ammonia. It is used to prevent hepatic encephalopathy.

B. Low sodium diet: A low sodium diet helps manage ascites and fluid retention but does not lower ammonia levels.

C. Low protein diet: Though historically used to reduce ammonia production, current practices focus on optimizing protein intake rather than strictly limiting it to prevent malnutrition..

D. Lactulose 30 gm/30 mL PO: Lactulose traps ammonia in the gut and excretes it through the stool, reducing blood ammonia levels and preventing hepatic encephalopathy.

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A nurse is caring for a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

Nursing Test Bank

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