A nurse is caring for a patient with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the patient has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease?
Asterixis
Fetor hepaticus
Palmar erythema
Constructional apraxia
The Correct Answer is A
Choice A reason:
Asterixis is a characteristic sign of hepatic encephalopathy, characterized by a flapping tremor of the hands. It is associated with liver dysfunction and is indicative of impaired ammonia metabolism in the brain.
Choice B reason:
Fetor hepaticus refers to a musty, sweet odor of the breath that is associated with severe liver disease. It is not related to the flapping tremor observed in this case.
Choice C reason:
Palmar erythema is a reddening of the palms and is associated with various conditions, including liver disease. However, it is not the sign described in the scenario.
Choice D reason:
Constructional apraxia is a neurological deficit characterized by difficulty in copying or constructing simple drawings or designs. It is not related to the flapping tremor seen in hepatic encephalopathy.
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Related Questions
Correct Answer is D
Explanation
- A: This response minimizes the client's feelings and may make them feel unheard. It's important for healthcare providers to acknowledge a patient's feelings and provide reassurance in a more empathetic manner.
- B: This response delays addressing the client's concerns and may increase his anxiety. Consent is important, but it should not be a barrier to discussing care and addressing concerns.
- C: This response is factual but does not address the client's immediate concern about pain. It's crucial to address the client's fears directly rather than deflecting to the procedure's necessity.
- D: This response directly addresses the client's concern about pain by informing him of the sedative, which is a common practice to reduce discomfort during a colonoscopy. It provides reassurance and factual information about the procedure's process.
Correct Answer is D
Explanation
Choice A reason:
Taking metronidazole with food can help reduce stomach upset. It is not typically recommended to take on an entirely empty stomach.
Choice B reason:
Metronidazole can cause drowsiness, but taking it at bedtime specifically for this reason is not a standard recommendation. It's more important to focus on avoiding alcohol.
Choice C reason:
Taking an extra dose without specific medical advice is not recommended. It's important to follow the prescribed dosing regimen.
Choice D reason:
Avoiding alcohol while taking metronidazole is crucial. The combination of metronidazole and alcohol can cause severe reactions, including nausea, vomiting, abdominal cramps, headache, and flushing. This interaction can occur for several days after discontinuing metronidazole, so it's essential to abstain from alcohol throughout the course of treatment.
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