Elevated serum ammonia level causes which complication of cirrhosis?

Hepatic encephalopathy

Jaundice

Ascites

Peripheral neuropathies

Answer and Explanation

The Correct Answer is A

Choice A reason: Hepatic encephalopathy is a severe complication of cirrhosis caused by elevated serum ammonia levels. When the liver is unable to effectively remove ammonia from the blood due to cirrhosis, ammonia accumulates and crosses the blood-brain barrier, leading to neurological symptoms such as confusion, altered mental status, and even coma. This condition is directly related to the liver's impaired ability to detoxify the blood, making it the most consistent complication associated with elevated serum ammonia levels.
Choice B reason: Jaundice is a common symptom of cirrhosis, but it is not directly caused by elevated serum ammonia levels. Jaundice occurs due to the liver's inability to process bilirubin, a byproduct of red blood cell breakdown, leading to its accumulation in the blood and tissues. While jaundice is a sign of liver dysfunction, it is not specifically linked to ammonia levels.
Choice C reason: Ascites is the accumulation of fluid in the abdominal cavity and is a common complication of cirrhosis. It occurs due to portal hypertension and hypoalbuminemia, which result from liver dysfunction. Although ascites is a significant complication, it is not directly caused by elevated serum ammonia levels.
Choice D reason: Peripheral neuropathies are nerve damage that can occur in various conditions, but they are not typically associated with elevated serum ammonia levels in cirrhosis. Peripheral neuropathies can result from nutritional deficiencies, metabolic disorders, or other underlying conditions, but they are not a direct consequence of ammonia accumulation.

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Correct Answer is ["B","C","D","E"]

Explanation

Choice A reason: Asking the nursing assistant to determine if Marvin can safely sit in a bedside chair is not appropriate. Safety assessments, especially for patients with recent neurological events, should be done by a registered nurse or a physical therapist. This ensures that any nuanced clinical signs indicating instability or risk are recognized and addressed promptly.
Choice B reason: Passive range of motion (ROM) exercises are essential for patients with hemiplegia to prevent complications such as muscle atrophy, joint contractures, and decreased circulation. Regularly performing these exercises can maintain the health of the muscles and joints, promote better blood flow, and help in maintaining some degree of flexibility in the affected limbs.
Choice C reason: Assessing neurologic status is crucial in patients who have had a recent stroke and received tPA treatment. Frequent neurologic assessments help in monitoring for any changes or signs of deterioration. This includes checking consciousness, pupil response, motor function, and sensory perception. Changes in these parameters can indicate complications or the need for immediate medical interventions.
Choice D reason: Coordinating with speech therapy for a swallowing evaluation is essential because Marvin has dysphagia. Swallowing assessments by a speech therapist can determine the patient's ability to swallow safely and the appropriate dietary modifications needed to prevent aspiration, a common risk in patients with dysphagia. This is vital to prevent pneumonia or other respiratory complications.
Choice E reason: Using pillows and positioning devices to maintain proper body alignment is important in preventing complications such as pressure ulcers, muscle contractures, and discomfort. Proper positioning can also assist in maintaining better respiratory function and overall comfort. It also prevents the development of deformities and promotes functional posture, which is especially important for patients with hemiplegia.
Choice F reason: Pulling on his arm to position him on his side is inappropriate and can cause injury, especially in a patient with hemiplegia. This technique can lead to shoulder dislocations or increased pain. Instead, proper repositioning techniques using assistive devices and help from additional staff members should be employed to ensure safe and effective movement of the patient.

Correct Answer is ["133"]

Explanation

Step 1: First, we need to determine how many mL per hour the IV is administering. We know that 100 mL is administered over 45 minutes.

Step 2: Convert 45 minutes to hours. 45 minutes ÷ 60 minutes = 0.75 hours

Step 3: Calculate the flow rate in mL per hour. 100 mL ÷ 0.75 hours

Step 4: Perform the division. 100 ÷ 0.75 = 133.33

Step 5: Round to the nearest whole number. 133.33 rounds to 133.

Answer: The flow rate is 133 mL per hour.

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Elevated serum ammonia level causes which complication of cirrhosis?

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Naxlex Comprehensive Predictor Exams

Marvin is transferred from the ICU to the Tele/Neuro unit 24 hours after receiving tPA. He has left sided hemiplegia with some dysphagia. What nursing interventions should be part of his plan of care? Select all that apply.

Correct Answer is ["B","C","D","E"]

Explanation

Determine the flow rate in mL per hour for the following IV being administered by infusion pump: Ampicillin 1.5g in 100 mL 0.9% NS over 45 minutes: Round to the whole number.

Correct Answer is ["133"]

Explanation

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