Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:
Hyperbilirubinemia and jaundice
Fluid and electrolyte imbalances
Decreased cerebral blood flow
Impaired ammonia metabolism and increased ammonia levels in the blood
The Correct Answer is D
Choice A reason: Hyperbilirubinemia and jaundice are common manifestations of chronic liver disease, but they are not the primary cause of hepatic encephalopathy. These conditions result from the liver's inability to process and clear bilirubin effectively, leading to its accumulation in the blood and subsequent yellowing of the skin and eyes. While these symptoms indicate liver dysfunction, they do not directly cause the neurological impairments seen in hepatic encephalopathy.
Choice B reason: Fluid and electrolyte imbalances are often associated with chronic liver disease and can contribute to various complications, including ascites and edema. However, these imbalances are not the primary cause of hepatic encephalopathy. While electrolyte disturbances, particularly hyponatremia, can exacerbate encephalopathy, the condition itself is more directly linked to the liver's inability to detoxify certain substances, such as ammonia.
Choice C reason: Decreased cerebral blood flow can lead to neurological impairments, but it is not the primary mechanism underlying hepatic encephalopathy. Hepatic encephalopathy primarily results from the accumulation of neurotoxic substances that the liver can no longer effectively process, rather than reduced blood flow to the brain.
Choice D reason: Impaired ammonia metabolism and increased ammonia levels in the blood are the main causes of hepatic encephalopathy. In chronic liver disease, the liver's ability to convert ammonia, a byproduct of protein metabolism, into urea for excretion is compromised. As a result, ammonia accumulates in the blood and crosses the blood-brain barrier, leading to neurotoxicity and the characteristic symptoms of hepatic encephalopathy, such as confusion, altered consciousness, and asterixis (flapping tremor).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Nonadherence to the antiviral regimen could lead to a resurgence of HIV symptoms and a higher viral load, but it is not typically associated with the symptoms of increased hunger, thirst, and frequent urination described by the patient.
Choice B reason: Pancreatic infiltration by HIV is a rare complication and would not be the first suspicion in this scenario. While HIV can affect multiple organs, the symptoms described are more suggestive of metabolic issues rather than direct infiltration of the pancreas.
Choice C reason: An allergic reaction to the medication would more likely present with symptoms such as rash, itching, swelling, or difficulty breathing rather than the metabolic symptoms described. Allergic reactions typically do not cause increased hunger, thirst, or frequent urination.
Choice D reason: Hyperglycemia (high blood sugar levels) is the most likely cause of the symptoms described. Protease inhibitors can lead to metabolic side effects, including insulin resistance and hyperglycemia. Symptoms of hyperglycemia include increased hunger (polyphagia), increased thirst (polydipsia), and frequent urination (polyuria). These findings are consistent with the patient's complaints and should be investigated further to manage the side effects of the medication.
Correct Answer is A
Explanation
Choice A reason: Cirrhosis of the liver is the most common cause of portal hypertension. Cirrhosis involves the scarring of liver tissue, which obstructs blood flow through the liver and increases pressure in the portal vein. This increased pressure can lead to complications such as varices (enlarged veins) that can rupture and cause bleeding, such as vomiting blood (hematemesis). The liver's inability to properly manage blood flow due to scar tissue buildup is central to the development of portal hypertension.
Choice B reason: Left ventricular failure can lead to pulmonary hypertension (increased pressure in the pulmonary arteries) but is not a common cause of portal hypertension. Portal hypertension specifically refers to increased pressure in the portal vein system, which is most often due to liver disease. Left ventricular failure affects the heart and lungs, not the liver or its blood vessels, thus not leading to the observed condition of portal hypertension.
Choice C reason: Renal stenosis refers to the narrowing of the arteries that supply blood to the kidneys, which can lead to hypertension (high blood pressure) but not portal hypertension. Portal hypertension is related to the liver and its blood flow, not the renal arteries. Renal stenosis primarily causes problems in the kidney's function and systemic blood pressure rather than affecting the portal vein system.
Choice D reason: Thrombosis in the spleen can cause localized issues but is not a common cause of portal hypertension. Portal hypertension is typically related to liver conditions, such as cirrhosis, which affect the blood flow through the liver and portal vein system. Thrombosis in the spleen might complicate portal vein blood flow but is not a primary cause like liver cirrhosis is.
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