An older adult client with cirrhosis of the liver and hepatic failure is placed on a low sodium diet and is receiving periodic albumin infusions. Which assessment finding indicates progress toward the desired effect of this treatment plan?

Clear, dark amber-colored urine.

Prothrombin time within normal limits.

Decreased abdominal girth.

Improved level of consciousness.

Answer and Explanation

The Correct Answer is C

A. Clear, dark amber-colored urine may indicate dehydration or concentrated urine, which does not necessarily signify improvement in liver function or treatment efficacy.

B. A prothrombin time within normal limits may indicate improved liver function; however, it is not the primary goal of the treatment plan focused on managing ascites and fluid retention in cirrhosis.

C. Decreased abdominal girth is a key indicator of progress in managing fluid retention associated with cirrhosis, as the treatment plan aims to reduce ascites through a low sodium diet and albumin infusions.

D. Improved level of consciousness is essential for overall recovery but is not the primary measure of progress related to fluid management and treatment effects in this context.

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Correct Answer is []

Explanation

Potential Condition

- Dilated Cardiomyopathy: This condition is most likely because the client presents with symptoms of heart failure (chest pain, dizziness, inspiratory crackles, systolic murmur, and ankle edema) alongside a history of hypertension, which can contribute to the development of dilated cardiomyopathy.

Actions to Take

1. Apply Oxygen: The client is showing signs of potential heart failure, and oxygen can help alleviate symptoms associated with decreased oxygenation.

2. Perform 12-lead EKG: An EKG will provide information about any potential cardiac abnormalities, especially in the presence of chest pain and systolic murmur.

Parameters to Monitor

1. Blood Pressure: It is essential to monitor blood pressure due to the client's hypertension and heart failure symptoms, which may be exacerbated by elevated blood pressure.

2. Urine Output: Monitoring urine output helps assess kidney perfusion and fluid status, which can be affected by heart failure and hypertension, particularly in cases of cardiomyopathy.

A. Wear braces on both wrists during the night. B. Notify the healthcare provider as soon as possible. C. Elevate the hands on two pillows at night. D. Apply cold compresses for 30 minutes before bedtime.

Correct Answer is A

Explanation

A. Wearing braces or splints on both wrists at night helps to keep the wrists in a neutral position, preventing flexion that can worsen symptoms of carpal tunnel syndrome, particularly during sleep when the hands are more likely to be positioned in ways that exacerbate compression of the median nerve.

B. While notifying the healthcare provider is important if symptoms are severe, it is not the immediate teaching intervention the nurse should provide for symptom management.

C. Elevating the hands may help with swelling but is not the primary intervention for managing symptoms of carpal tunnel syndrome, especially pain and tingling.

D. Cold compresses may provide temporary relief but do not address the underlying issue of median nerve compression, which is better managed by using wrist braces.

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An older adult client with cirrhosis of the liver and hepatic failure is placed on a low sodium diet and is receiving periodic albumin infusions. Which assessment finding indicates progress toward the desired effect of this treatment plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

A client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling experienced worsens at night. Which client teaching should the nurse provide?

Correct Answer is A

Explanation

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