Identify two causes of ascites related to liver cirrhosis:
Poor nutrition related to alcoholism results in abdominal obesity.
Portal hypertension pushes proteins from the blood vessels, causing leakage into the peritoneal cavity.
Osmoreceptors in the hypothalamus stimulate thirst, which causes the patient to take in excessive fluids orally.
There is decreased colloid oncotic pressure from the liver's inability to synthesize albumin.
Correct Answer : B,D
Choice A reason: Poor nutrition related to alcoholism can lead to abdominal obesity, but it is not a direct cause of ascites in liver cirrhosis. Ascites is primarily due to factors like portal hypertension and decreased colloid oncotic pressure.
Choice B reason: Portal hypertension is a significant cause of ascites in liver cirrhosis. The increased pressure in the portal vein causes proteins to leak from the blood vessels into the peritoneal cavity, leading to fluid accumulation.
Choice C reason: Osmoreceptors in the hypothalamus stimulating thirst can lead to excessive fluid intake, but this is not a direct cause of ascites related to liver cirrhosis. Ascites is more directly linked to portal hypertension and decreased colloid oncotic pressure.
Choice D reason: Decreased colloid oncotic pressure due to the liver's inability to synthesize albumin is a key factor in the development of ascites. Albumin helps maintain fluid balance in the blood vessels, and its deficiency leads to fluid leakage into the peritoneal cavity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Anticipating obtaining a throat swab for rapid streptococcus testing is not immediately related to the use of a budesonide inhaler. This test is typically done when there is a suspicion of a streptococcal infection, not specifically for managing asthma medication side effects.
Choice B reason: Offering reassurance that the symptoms are common with budesonide use may not fully address the patient’s concern or prevent potential complications. It is more effective to provide actionable advice that can help manage the symptoms.
Choice C reason: Suggesting that the patient stop using the spray until the symptoms are resolved could potentially worsen asthma control. Budesonide is an important medication for managing asthma, and discontinuing it without alternative treatment may lead to exacerbation of symptoms.
Choice D reason: Teaching the patient to gargle with water after using the budesonide inhaler is the most appropriate action. This practice helps to reduce the risk of developing oral thrush, a common side effect of inhaled corticosteroids like budesonide. Gargling with water removes any residual medication in the mouth, thereby minimizing the risk of infection.
Correct Answer is C
Explanation
Choice A reason: Administering Furosemide (Lasix) 40 mg IV is important for reducing fluid overload, but the immediate priority is to address the patient's low oxygen saturation levels.
Choice B reason: Assessing lung sounds and peripheral edema is important for ongoing monitoring, but the immediate action should focus on stabilizing the patient's oxygen levels.
Choice C reason: Placing the patient on oxygen to titrate to oxygen saturations 94% or greater is the most immediate and critical intervention. The patient's oxygen saturation is significantly low at 86%, and addressing this ensures adequate oxygenation and reduces the risk of hypoxia.
Choice D reason: Educating the patient on lifestyle modifications is important for long-term management but is not the immediate priority in an acute situation.
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