Adult Chronic Exam 2 Office Hours, Answered Update

Adult Chronic Exam 2 Office Hours, Answered Update

Adult Chronic Exam 2 Office Hours, Answered
Bolded answer = said in office hours
Yellow highlight = getting more detail
Cirrhosis- 7 questions
● What is the best confirmatory test to diagnose cirrhosis?
â—‹ Liver biopsy is the gold standard
● What are physical exam findings for hepatic encephalopathy?
â—‹ Hepatic encephalopathy is the neuropsychiatric manifestation of liver disease w
neurotoxic effects of pneumonia that can result in
â–  asterixis - flapping tremors
â–  Apraxia- inability to construct simple figures, perform tasks when asked
â–  Fetor hepaticus- musty sweet odor of the patient's breath
● What treatments would be used for hepatic encephalopathy and why?
â—‹ Lactulose to trap ammonia in the gut and cause a laxative effect resulting in
removal of ammonia from the body
â—‹ Antibiotics if pt is unresponsive to lactulose (don't think we need to know this tho)
● What behavioral changes might we see in a patient with hepatic encephalopathy?
â—‹ Change in neurologic or mental status, inappropriate behavior, sleep
disturbances, coma
● What are nursing interventions that we would incorporate for a pt who has esophageal
varices and got a balloon tamponade, what do we need at the bedside?
â—‹ Esophageal varices are a complex of tortuous, enlarged veins at the lower end of
the esophagus and/or stomach. If we require a balloon tamponade we need…
â–  Scissors at the bedside to cut it in case it blocks the airway
â–  Suction & oral care if on ventilator in ICU