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The nurse has reviewed the laboratory results day 1 at 1800.

Exhibits

Complete the following sentence by using the lists of options.

The client is at risk for

due to

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Rationale:

  • Hepatic encephalopathy: This is caused by the buildup of neurotoxins, particularly ammonia, due to impaired liver function. The client’s elevated ammonia level and history of chronic alcohol use and jaundice support this diagnosis. Early signs may include confusion and lethargy, progressing to coma if untreated.
  • Uremic encephalopathy: This condition is caused by accumulation of urea and toxins due to kidney failure. There is no evidence in the case of renal impairment, such as elevated BUN or creatinine levels, making this diagnosis unlikely in the current context.
  • Hypoglycemia: Low blood glucose can cause confusion or altered mental status, but this client’s symptoms and labs do not indicate hypoglycemia. There is no mention of a low glucose level, and the focus of concern is more aligned with liver failure than endocrine causes.
  • Abdominal pain: Although abdominal pain is a relevant symptom in liver disease, it is nonspecific and not directly responsible for hepatic encephalopathy. It reflects general liver inflammation or ascites but does not cause neurologic symptoms on its own.
  • Albumin 3.0 g/dL: Low albumin indicates reduced liver synthetic function and contributes to fluid shifts like ascites, but it is not neurotoxic. It does not directly cause hepatic encephalopathy or altered mental status.
  • Ammonia 150 mcg/dL: This is a critically elevated value, more than double the normal upper limit. High ammonia levels are the most direct biochemical cause of hepatic encephalopathy and require immediate treatment to prevent worsening neurological decline.
  • Total Bilirubin 2.0 mg/dL: While elevated bilirubin suggests cholestasis and impaired liver clearance, it leads to jaundice rather than mental status changes. It reflects liver dysfunction but is not the key factor in encephalopathy development.


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Related Questions

Correct Answer is ["0.5"]

Explanation

Calculation:

Calculate the total desired dose in mg:

Desired dose (mg) = Weight (kg) x Ordered dose (mg/kg)

Desired dose (mg) = 69.9 kg x 0.75 mg/kg

Desired dose (mg) = 52.425 mg

Determine the volume to administer using the available concentration:

Volume to administer (mL) = Desired dose (mg) / Available concentration (mg/mL)

First, find the concentration in mg/mL:

60 mg / 0.6 mL = 100 mg/mL

Now, calculate the volume:

Volume to administer (mL) = 52.425 mg / 100 mg/mL

Volume to administer (mL) = 0.52425 mL

Round the answer to the nearest tenth:

0.52425 mL rounded to the nearest tenth is 0.5 mL.

Correct Answer is B

Explanation

Rationale:
A. Coronary artery disease: This is a macrovascular complication of diabetes caused by atherosclerosis affecting large blood vessels, leading to reduced blood flow to the heart and increased risk of myocardial infarction. It does not involve small vessel damage.

B. Retinopathy: Diabetic retinopathy is a classic microvascular complication resulting from damage to the small blood vessels of the retina due to chronic hyperglycemia. Over time, it can lead to vision impairment and blindness if not managed appropriately.

C. Cerebrovascular accident: A stroke is considered a macrovascular complication involving large arteries that supply the brain. Diabetes increases the risk through mechanisms such as endothelial dysfunction and accelerated atherosclerosis.

D. Hypertension: Hypertension is a common comorbidity in people with diabetes and contributes to both micro- and macrovascular complications, but it is not itself classified as a direct microvascular complication of diabetes.

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