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To prevent the spread of hepatitis A virus (HAV) infection, the nurse is especially careful when:

A.

Changing an IV

B.

Disposing of food trays

C.

Emptying bed pans

D.

Taking an oral temperature

Answer and Explanation

The Correct Answer is C

A. Changing an IV: This procedure involves standard precautions to avoid bloodborne infections, not primarily fecal-oral infections like hepatitis A. It is more relevant to viruses such as hepatitis B and C.

B. Disposing of food trays: While hygiene in food service is important, the nurse’s direct role in disposing of trays does not significantly contribute to HAV prevention. HAV is transmitted primarily through the fecal-oral route rather than leftover food on trays.

C. Emptying bed pans: Hepatitis A is spread via the fecal-oral route. Handling feces, especially without strict hand hygiene and appropriate protective equipment, poses a high risk for transmission. Therefore, careful attention is needed during this activity to prevent spread.

D. Taking an oral temperature: This involves mucosal contact but carries minimal risk of spreading hepatitis A, especially when using disposable covers and practicing standard precautions. It is not a primary concern for fecal-oral transmission.


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Related Questions

Correct Answer is A

Explanation

A. Esophageal: Esophageal variceal bleeding is the most common and serious complication of portal hypertension. Increased pressure in the portal venous system leads to the formation of varices in the esophagus, which can rupture and cause life-threatening hemorrhage.

B. Intestinal: While portal hypertension can cause changes in intestinal blood flow, it is not the most common site for clinically significant bleeding. Intestinal bleeding related to portal hypertension is much less frequent than esophageal variceal bleeding.

C. Duodenal: Duodenal bleeding is more commonly associated with peptic ulcer disease rather than portal hypertension. It is not a typical manifestation of increased portal venous pressure.

D. Rectal: Rectal bleeding may occur due to hemorrhoids or portal hypertensive colopathy, but it is less common and less life-threatening compared to esophageal varices in portal hypertension.

Correct Answer is []

Explanation

Potential Condition: Hepatic Encephalopathy

  • The client has very high ammonia levels (236 mcg/dL), elevated liver enzymes, and low albumin, all pointing toward hepatic encephalopathy. Additional signs include a history of alcohol abuse, cirrhosis, and altered liver function, which commonly contribute to ammonia accumulation and neurotoxicity.

Actions to Take:

  • Administer lactulose: Helps lower serum ammonia by promoting its excretion via the GI tract.

  • Assess for asterixis: A classic sign of hepatic encephalopathy characterized by a flapping tremor of the hands.

Parameters to Monitor:

  • Neurologic status: To detect changes in mental status or worsening encephalopathy.

  • Safety measures: Clients with hepatic encephalopathy are at high risk for confusion, falls, and injury, necessitating close supervision and safety interventions.

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