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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: A hemoglobin level of 12.0 g/dL is slightly below the normal range for men but is not the most critical concern preoperatively. It indicates mild anemia, which should be monitored but does not present an immediate high risk.

Choice B reason: A serum creatinine level of 1.3 mg/dL is slightly elevated and indicates mild renal impairment. While this should be considered, it is not as immediately concerning as a significantly abnormal coagulation value.

Choice C reason: A Blood Urea Nitrogen (BUN) level of 24 mg/dL is slightly above normal, indicating some renal function impairment or dehydration. However, it does not pose the most significant immediate risk compared to a high INR value.

Choice D reason: An INR of 3.5 is significantly elevated and indicates a high risk of bleeding. For a surgical patient, this is the most concerning pre-op lab value because it suggests that the patient's blood is not clotting properly. This increases the risk of excessive bleeding during and after surgery, making it a priority to address before proceeding with the operation.

A. Inform the patient that the pain medication is contraindicated and offer to dim the room lights. B. Monitor the patient closely after administering the ibuprofen for pain. C. Consult the healthcare provider about ordering a different pain medication. D. Administer the ibuprofen as ordered since ibuprofen is used to treat headaches.

Correct Answer is C

Explanation

Choice A reason: Informing the patient that the pain medication is contraindicated and offering to dim the room lights addresses the immediate concern but does not provide an effective solution for pain management. While it's important to inform the patient, alternative pain relief should be pursued.

Choice B reason: Monitoring the patient closely after administering ibuprofen for pain does not ensure patient safety, especially since ibuprofen can worsen kidney function in patients with acute renal failure. Administering ibuprofen is contraindicated in this case.

Choice C reason: Consulting the healthcare provider about ordering a different pain medication is the safest first step. This ensures that the patient receives an appropriate pain reliever that does not further compromise their renal function. The healthcare provider can prescribe a medication that is safe for patients with acute renal failure.

Choice D reason: Administering ibuprofen as ordered since it is used to treat headaches is not appropriate in this scenario. Ibuprofen is nephrotoxic and can worsen renal function in patients with acute renal failure, making it unsafe to administer.

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Identify two causes of ascites related to liver cirrhosis:

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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