A nurse is admitting a client with a history of duodenal ulcer. To determine if the client's current symptoms are related to this information, the nurse should assess the client for which manifestations of a duodenal ulcer?

Choice A reason: A fractured femur, while a serious injury, does not inherently contraindicate the use of lipid emulsions. These patients may require additional nutrition if they are unable to eat adequately by mouth, and lipid emulsions can be part of their parenteral nutrition regimen if needed.

Choice B reason: Severe anorexia nervosa is a condition that can lead to malnutrition and may necessitate the use of parenteral nutrition, including lipid emulsions, to provide essential nutrients. However, care must be taken to avoid refeeding syndrome, a potentially fatal condition that can occur when malnourished patients begin to refeed too quickly.

Choice C reason: Gastrointestinal obstruction is a condition that could be exacerbated by the administration of lipid emulsions. In cases of obstruction, enteral or parenteral nutrition may need to be carefully managed or avoided until the obstruction is resolved to prevent further complications. While lipid emulsions are a valuable component of parenteral nutrition, their use must be carefully considered in the context of the patient’s overall clinical condition. In the case of gastrointestinal obstruction, the nurse would be most concerned about the prescription of a lipid emulsion due to the potential for exacerbating the obstruction and complicating the patient’s condition.

Choice D reason: Chronic diarrhea and vomiting can lead to dehydration and electrolyte imbalances, but they do not directly contraindicate the use of lipid emulsions. However, the underlying cause of these symptoms should be addressed, and fluid and electrolyte balance should be carefully monitored.

Title: Choice A reason: Beta-blocking agent Beta-blocking agents are often used in the management of cirrhosis of the liver. They are particularly useful in managing portal hypertension, a common complication of cirrhosis. Beta-blockers lower elevated portal pressure and protect against variceal hemorrhage, a serious complication of portal hypertension. Therefore, a beta-blocking agent may be ordered for a client with cirrhosis of the liver.

Title: Choice B reason: Diuretic Diuretics are commonly used in the management of fluid retention, a frequent complication in patients with cirrhosis. Fluid retention can lead to conditions such as ascites (abdominal fluid accumulation) and edema (swelling in the legs, feet, or ankles)2. Diuretics help to remove excess fluid from the body, thereby managing these symptoms. Therefore, a diuretic may be ordered for a client with cirrhosis of the liver.

Title: Choice C reason: Opioid analgesic While opioid analgesics are powerful pain relievers, they should be used with caution in patients with cirrhosis of the liver. Opioids can precipitate hepatic encephalopathy, a condition characterized by altered mental status and neuromuscular dysfunction, which is a serious complication of cirrhosis. Therefore, an opioid analgesic may not be the best choice for a client with cirrhosis of the liver.

Title: Choice D reason: Lactulose Lactulose is a non-absorbable sugar that is widely used in the treatment of hepatic encephalopathy, a common complication in patients with cirrhosis. It works by reducing the absorption of ammonia in the gut, thereby lowering blood ammonia levels and improving symptoms of hepatic encephalopathy. Therefore, lactulose may be ordered for a client with cirrhosis of the liver.

Title: Choice E reason: Sedative Sedatives should be used with caution in patients with cirrhosis of the liver. Like opioids, they can precipitate hepatic encephalopathy. Therefore, a sedative may not be the best choice for a client with cirrhosis of the liver.