A nurse is teaching a patient with hepatitis B about self-management. Which instructions should the nurse include in the teaching?

Choice A rationale
Monitoring for changes in the color of urine to maroon or red is not typically associated with peptic ulcers. This could be a sign of other conditions such as urinary tract infections, kidney stones, or certain medications.
Choice B rationale
Unintentional weight gain is not a common symptom of peptic ulcers. In fact, some people with peptic ulcers may experience weight loss due to discomfort while eating or a decrease in appetite.
Choice C rationale

The appearance of ecchymosis (bruising) on the sides of the abdomen or pelvic areas is not a typical symptom or concern with peptic ulcers. This could be a sign of trauma, certain medications, or other medical conditions.
Choice D rationale
One of the symptoms of a peptic ulcer can be changes in the color of the stool, particularly if it becomes dark or black. This can be a sign of bleeding in the gastrointestinal tract, which can occur with peptic ulcers. Therefore, patients should be advised to monitor for this symptom and seek medical attention if it occurs.

Choice A rationale

While an elevated serum ammonia level can indicate liver dysfunction, it is not typically a contraindication for liver biopsy. Ammonia is a byproduct of protein metabolism and is normally converted into urea by the liver, which is then excreted in the urine. Elevated levels can occur in liver disease, but they are not typically a direct concern in the context of a liver biopsy.
Choice B rationale
A hemoglobin level of 11 g/dL is slightly low, but it is not typically a contraindication for a liver biopsy. Hemoglobin is the protein in red blood cells that carries oxygen. While a low hemoglobin level can indicate anemia, it would not typically prevent a patient from undergoing a liver biopsy.
Choice C rationale
A white blood cell count of 14.2 x 103/uL is slightly elevated, indicating a possible infection or inflammation. However, this would not typically be a contraindication for a liver biopsy.
Choice D rationale
A prothrombin time of 32 seconds is significantly prolonged, indicating a potential problem with blood clotting. This would be a major concern for a nurse caring for a patient scheduled for a liver biopsy, as the procedure involves inserting a needle into the liver and could lead to bleeding. Patients with a prolonged prothrombin time are at an increased risk of bleeding complications.