Liver cirrhosis and failure Flashcards
define liver cirrhosis
- Characterised by diffuse hepatic
fibrosis surrounding nodules of
liver tissue → permanent
alteration of hepatic blood flow
and liver function - Extensive fibrosis → distorts
liver architecture → formation
of regenerative nodules - HIGH degree of nodular regeneration- significant
“risk” for primary liver neoplasm- Hepatocellular carcinoma
Madam Wong Si Ling is 72-year-old retiree who is HBsAg (+), HBeAg (+),anti-HBc (+), anti-HBsAg (-) and has an elevated serum alaninetransaminase (ALT). Her hepatitis B virus (HBV) DNA is 18000international units/mL. Madam Wong also has ascites and known esophageal varices. She has Liver Cirrhosis.
What information could be derived from Madam Wong’s Hepatitis B virusmarkers at this point? She has:
A. Chronic Hepatitis B infection with low viral load.
B. Chronic Hepatitis B infection with viral replication
C. Chronic Hepatitis B infection with non-actively replicating viral replication
D. no chronic hep B infection
B
Madam Wong Si Ling is 72-year-old retiree who is HBsAg (+), HBeAg (+),anti-HBc (+), anti-HBsAg (-) and has an elevated serum alaninetransaminase (ALT). Her hepatitis B virus (HBV) DNA is 18000international units/mL. Madam Wong also has ascites and known esophageal varices. She has Liver Cirrhosis.
Madam Wong developed Liver Cirrhosis as a result of her ChronicaHepatitis B Infection. Based on her presentation, what is Madam WongMOST at-risk of?
A. Dehydration
B. Allergic reaction
C. Haemorrhage
D. Septicemia
C
Madam Wong Si Ling is 72-year-old retiree who is HBsAg (+), HBeAg (+),anti-HBc (+), anti-HBsAg (-) and has an elevated serum alaninetransaminase (ALT). Her hepatitis B virus (HBV) DNA is 18000international units/mL. Madam Wong also has ascites and knownesophageal varices. She has Liver Cirrhosis..
Which of the following is/are the next step(s) in the management of Madam Wong?
I. Obtain ammonia levels
II. Stop all drugs that are suspected to cause drug-induced liver injury
III. Administer N-acetylcysteine as antidote
A. I only
B. I, II and III
C. II & III only
D. I & II only
C
Madam Wong Si Ling is 72-year-old retiree who is HBsAg (+), HBeAg (+),anti-HBc (+), anti-HBsAg (-) and has an elevated serum alaninetransaminase (ALT). Her hepatitis B virus (HBV) DNA is 18000international units/mL. Madam Wong also has ascites and knownesophageal varices. She has Liver Cirrhosis.
The nurse is serving lactulose 20 mL to Madam Wong. The nurse observes that Madam Wong has become more confused and hasdeveloped asterixis. Which of following is the MOST APPROPRIATE nursing action to do next? The nurse should:
A. increase protein in the diet from her next meal.
B. monitor serum bilirubin levels closely.
C. withhold the lactulose and re-serve the medication to her tomorrow moming.
D. assess her for gastrointestinal bleeding.
D
Madam Wong Si Ling is 72-year-old retiree who is HBsAg (+), HBeAg (+),anti-HBc (+), anti-HBsAg (-) and has an elevated serum alaninetransaminase (ALT). Her hepatitis B virus (HBV) DNA is 18000international units/mL. Madam Wong also has ascites and known esophageal varices. She has Liver Cirrhosis.
The nurse is establishing nursing care to reduce the risks for impairedskin integrity for Madam Wong who has ascites and peripheral oedema.1o prevent skin breakdown, which of following is the MOST APPROPRIATE nursing action? The nurse should:
A. keep her nails clean.
B. assist her to re-position every 2-4 hours.
C. conduct range-of motion (rom) exercise with her every 2-4 hours.
D. massage her abdomen every 2-4 hours.
B
Build-up of bile salts may cause the systemic symptom of:
(a) hypotension.
(b) pruritis (itching).
(c) ecchymosis (bruising).
(d) urticaria (hives)
B
