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 B

Explanation

Choice A reason: A BUN level of 8 mg/dL and creatinine level of 0.7 mg/dL are within normal ranges and would not be expected in a client with CKD².

Choice B reason: Elevated BUN and creatinine levels, such as 45 mg/dL and 8 mg/dL respectively, are indicative of impaired kidney function, which is consistent with CKD².

Choice C reason: A BUN level of 10 mg/dL and creatinine level of 0.3 mg/dL are lower than the expected values for a client with CKD, indicating better kidney function than typically seen in CKD².

Choice D reason: A BUN level of 23 mg/dL and creatinine level of 1.0 mg/dL may be slightly elevated but are not as indicative of CKD as the values in choice B².

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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