A client with advanced cirrhosis has been admitted to the medical-surgical unit. The nurse is assessing the client and identifies which of the following findings as indicators of hepatic encephalopathy? (Select all that apply).

Asterixis

Change in orientation

Anorexia

Ascites

Fetor hepaticus

Answer and Explanation

Correct Answer : A,B,E

Choice A reason: Asterixis, also known as "liver flap," is a tremor of the hand when the wrist is extended, often seen in hepatic encephalopathy as a result of altered brain function.

Choice B reason: A change in orientation, including confusion and altered consciousness, is a hallmark of hepatic encephalopathy, reflecting the brain's impaired ability to process information.

Choice C reason: Anorexia may be present in cirrhosis, but it is not a specific indicator of hepatic encephalopathy.

Choice D reason: Ascites is a common complication of cirrhosis due to portal hypertension but is not a direct indicator of hepatic encephalopathy.

Choice E reason: Fetor hepaticus, a musty odor of the breath, is a distinctive symptom of hepatic encephalopathy caused by the presence of mercaptans in the breath as the liver fails to break down sulfur-containing amino acids.

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Correct Answer is A

Explanation

Choice A reason: Hematemesis Hematemesis, or vomiting blood, is a serious symptom that usually indicates bleeding in the upper gastrointestinal tract. This could be due to a severe peptic ulcer, among other conditions1. The blood may appear red or black, and the condition can cause a person to go into hypovolemic shock, which can lead to organ failure and death if not treated immediately. Therefore, hematemesis should be identified as the priority symptom in this case. While all these symptoms can be associated with peptic ulcer disease, hematemesis is the most serious and should be prioritized due to the risk of significant blood loss and potential for hypovolemic shock.

Choice B reason: Abdominal bloating Abdominal bloating is a symptom that can be caused by various conditions, including indigestion, overeating, and certain medical conditions. While it can be uncomfortable, it is generally not as immediately life-threatening as hematemesis.

Choice C reason: Epigastric discomfort Epigastric discomfort refers to pain or discomfort in the upper abdomen, below the ribs. It can be caused by conditions such as acid reflux, GERD, overeating, lactose intolerance, and others. While it can be a symptom of a peptic ulcer, it is not typically as urgent as hematemesis.

Choice D reason: Dyspepsia Dyspepsia, also known as indigestion, can cause symptoms such as bloating, heartburn, and feeling full too quickly8910. It can be caused by a variety of factors, including certain foods, overeating, and medical conditions like GERD. While it can be a symptom of a peptic ulcer, it is generally not as immediately life-threatening as hematemesis.

A. Increased serum amylase B. Decreased WBC count C. Increased serum calcium D. Decreased serum lipase

Correct Answer is A

Explanation

Choice A reason:Increased serum amylase is a common finding in acute pancreatitis as it is released from the inflamed pancreas[^10^].

Choice B reason:A decreased WBC count is not typically associated with acute pancreatitis; an increased count may indicate infection or inflammation.

Choice C reason:Serum calcium is often decreased in acute pancreatitis due to fat saponification and hypoalbuminemia.

Choice D reason:Decreased serum lipase would not be expected; increased levels are indicative of acute pancreatitis, similar to amylase[^10^].

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A client with advanced cirrhosis has been admitted to the medical-surgical unit. The nurse is assessing the client and identifies which of the following findings as indicators of hepatic encephalopathy? (Select all that apply).

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Correct Answer is A

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Correct Answer is A

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