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Clinical Manifestations and Symptoms

- The signs and symptoms of liver cirrhosis depend on the severity and stage of the disease.

- In the early stages, patients may be asymptomatic or have nonspecific symptoms such as:

  • fatigue
  • Weakness
  • Anorexia
  • weight loss
  • nausea
  • abdominal pain
  • pruritus.

- As the disease progresses, patients may develop more specific symptoms such as:

  • spider angiomas
  • palmar erythema
  • jaundice
  • gynecomastia
  • ascites
  • peripheral edema
  • splenomegaly
  • caput-medusae
  • esophageal varices
  • hematemesis
  • melena
  • hepatic encephalopathy
  • asterixis
  • coagulopathy
  • hypoalbuminemia
  • hypoglycemia.

 

Questions on Clinical Manifestations and Symptoms

Correct Answer is A

Explanation

<p>Monitoring serum calcium levels is not directly related to the use of spironolactone in liver cirrhosis. Spironolactone does not significantly impact calcium levels in the blood.</p>

Correct Answer is C

Explanation

<p>This statement is incorrect. The client should not consume any type of alcoholic beverage. All forms of alcohol can be harmful to the liver, and complete abstinence is necessary for individuals with liver cirrhosis.</p>

Correct Answer is C

Explanation

<p>Deep breathing exercises can be helpful for clients with liver cirrhosis, but they are not the priority for managing ascites. The focus should be on diuretic therapy and addressing the fluid retention in the abdomen.</p>

Correct Answer is D

Explanation

Chronic hepatitis C infection is a well-established risk factor for liver cirrhosis. The hepatitis C virus causes persistent inflammation in the liver, leading to liver cell damage and scarring (fibrosis). Over time, this fibrosis can progress to cirrhosis, which is the advanced stage of liver damage.

Correct Answer is A

Explanation

Primary biliary cholangitis is an autoimmune liver disease that primarily affects the small bile ducts within the liver. While it can lead to liver damage and cirrhosis, it is not associated with elevated iron levels.

Correct Answer is C

Explanation

Hepatic encephalopathy, a neuropsychiatric complication of advanced liver disease, is also a later manifestation of liver cirrhosis and is not an early sign of the condition.

Correct Answer is D

Explanation

Hepatopulmonary syndrome is a complication of liver cirrhosis characterized by the development of pulmonary vascular dilation and arteriovenous shunting. This results in impaired oxygenation of blood, leading to difficulty breathing (dyspnea), especially while lying down (orthopnea). Clients with hepatopulmonary syndrome often experience frequent awakenings due to shortness of breath during sleep.

Correct Answer is D

Explanation

Varices are dilated and tortuous veins that can develop in various locations, including the esophagus (esophageal varices) and the abdomen and chest wall (caput medusae). In liver cirrhosis, portal hypertension causes increased pressure in the portal vein, leading to the development of these enlarged veins. Esophageal varices can be life-threatening if they rupture and cause severe bleeding.

Correct Answer is B

Explanation

No explanation

Correct Answer is D

Explanation

Altered mental status and confusion in a client with liver cirrhosis can indicate hepatic encephalopathy, a serious complication of advanced liver disease. Hepatic encephalopathy results from the accumulation of toxic substances in the blood due to impaired liver function. The nurse should prioritize notifying the healthcare provider immediately to initiate appropriate interventions and prevent further deterioration of the client's condition.

Correct Answer is D

Explanation

In liver cirrhosis, impaired liver function leads to reduced clearance of bilirubin, resulting in elevated total bilirubin levels in the blood. Elevated bilirubin is a common finding in liver cirrhosis and can contribute to jaundice.

Correct Answer is C

Explanation

An electroencephalogram (EEG) is a test used to record electrical activity in the brain. It is not used to assess the liver's size, shape, or structure in clients with liver cirrhosis.

Correct Answer is A

Explanation

Splenomegaly (enlargement of the spleen) can occur in liver cirrhosis due to portal hypertension. However, splenomegaly itself is not the cause of the decreased platelet count; it is the hypersplenism resulting from the splenomegaly that causes thrombocytopenia.

No explanation

Transient elastography is not used to identify hepatic encephalopathy. Hepatic encephalopathy is a neuropsychiatric complication of advanced liver disease, and its diagnosis is based on clinical assessment, mental status evaluation, and laboratory tests. Transient elastography is not involved in ide

For a client with liver cirrhosis, the most crucial dietary modification is to restrict alcohol consumption completely. Alcohol is a major contributing factor to liver damage and can exacerbate cirrhosis. Abstinence from alcohol is essential to prevent further liver injury and improve the client's o

Spironolactone is a diuretic used to manage fluid retention and ascites in clients with liver cirrhosis. Like furosemide, it is not effective in reducing ammonia levels or treating hepatic encephalopathy.

Pericardiocentesis is a procedure to drain fluid from the pericardial sac surrounding the heart. It is not used to treat ascites.

Propranolol is a beta-blocker commonly used to reduce the risk of bleeding from esophageal varices in clients with liver cirrhosis. Propranolol helps decrease portal hypertension by reducing the pressure in the portal vein, thereby reducing the likelihood of variceal rupture and bleeding.

Encouraging a high-protein diet is not appropriate for a client with hepatic encephalopathy. High-protein diets can exacerbate hepatic encephalopathy by increasing ammonia production in the intestines. Instead, the client should be prescribed a controlled-protein diet and, in some cases, given lactu

Encouraging the client to avoid straining during bowel movements is essential in the care of a client at risk of developing esophageal varices. Straining during bowel movements can increase intra-abdominal pressure, which may lead to increased pressure in the portal vein, potentially exacerbating po

Diuretics are used in the management of ascites to promote urine output and reduce fluid retention. However, paracentesis is a more immediate intervention for relieving discomfort and removing a large volume of ascitic fluid.

Lactulose is not known to significantly affect blood glucose levels, and there is no specific need for the client to monitor blood glucose levels while taking this medication.

<p>While it is important to administer intramuscular injections cautiously in clients with clotting disorders, this intervention is not the most essential for preventing bleeding episodes. Clients with liver cirrhosis are at risk of bleeding primarily due to the liver&#39;s decreased synthesis of cl

<p>Autoimmune hepatitis is an immune-mediated liver disease that can lead to chronic inflammation and cirrhosis if not properly managed. While it is a risk factor for cirrhosis, alcohol abuse remains the leading cause of the condition.</p>
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