35 hours ago The nurse is assessing the abdomen of a patient with late portal cirrhosis. What is the most probable finding during palpation? ... Liver is nodular and enlarged The patient with late portal cirrhosis is likely to have an enlarged, nodular liver same with metastatic cancer or tertiary syphilis.The liver feels enlarged, smooth, and tender to ... >> Go To The Portal
The nurse is assessing the abdomen of a patient with late portal cirrhosis. What is the most probable finding during palpation? ... Liver is nodular and enlarged The patient with late portal cirrhosis is likely to have an enlarged, nodular liver same with metastatic cancer or tertiary syphilis.The liver feels enlarged, smooth, and tender to ...
The role of nurses in managing patients with cirrhosis is increasing due to the growing prevalence of the disease. This article reviews the pathophysiology, diagnosis, complications, and management of patients with cirrhosis, with an emphasis on interdisciplinary collaboration and evidence-based practice. In a review of best-practice strategies ...
Dark urine ANS: A, B, C, D, E, F All of these assessment findings are very common for a client who has late-stage cirrhosis due to biliary obstruction and poor liver function. The client has vascular lesions and excess fluid from portal hypertension. Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
Which would the nurse expect to find during an abdominal assessment on a patient with late portal cirrhosis? ... Which would the nurse suspect after assessing a patient who presents with sudden pain in the right upper quadrant (RUQ) that radiates to the scapula, nausea with vomiting, and who reports a recent fatty meal? ... Cholecystitis. While ...
Dullness along the flanks while in the supine position may indicate the presence of ascites. Various maneuvers can confirm this finding. The examiner should percuss from the midline laterally and if ascites is present, a change from the tympany of bowel gas to the dullness of fluids should exist.Dec 2, 2020
The abdomen should be auscultated before percussion or palpation to prevent production of false bowel sounds. When auscultating, ensure the exam room is quiet and auscultate over bare skin, listening to one sound at a time.
You should always auscultate the abdomen after inspection and before percussion or palpation so you do not produce false bowel sounds by percussion or palpation. Auscultation should begin in the right lower quadrant.
A DISTENDED ABDOMEN, bulging flanks, and a protruding, displaced umbilicus are signs of ascites, free fluid in the peritoneal cavity. Cirrhosis, heart failure, renal failure, portal hypertension, chronic hepatitis, and cancer are common causes. Shifting dullness and a fluid wave indicate ascites.
0:286:17Abdominal Examination (Exam) Nursing Assessment | BowelYouTubeStart of suggested clipEnd of suggested clipAnd remember we're switching our sequence. And how we assess we're going to do inspectionMoreAnd remember we're switching our sequence. And how we assess we're going to do inspection auscultation. And then percussion or palpation. So we're going to auscultation. Second.
Always follow this sequence: inspection, auscultation, percussion, and palpation. Changing the order of these assessment techniques could alter the frequency of bowel sounds and make your findings less accurate.
With abdominal assessment, you inspect first, then auscultate, percuss, and palpate. This order is different from the rest of the body systems, for which you inspect, then percuss, palpate, and auscultate.
The abdominal examination consists of four basic components: inspection, palpation, percussion, and auscultation. It is important to begin with the general examination of the abdomen with the patient in a completely supine position.Oct 15, 2021
Auscultation of the abdomen is performed for detection of altered bowel sounds, rubs, or vascular bruits. Normal peristalsis creates bowel sounds that may be altered or absent by disease. Irritation of serosal surfaces may produce a sound (rub) as an organ moves against the serosal surface.
Fluid can build up when: cancer cells irritate the lining of the abdomen and make it produce too much fluid. lymph glands in the abdomen get blocked and can't drain fluid properly. cancer has spread to the liver and raises the pressure in nearby blood vessels, which forces fluid out.
Don't percuss or palpate the abdomen before auscultation to avoid altering the frequency of bowel sounds. Don't palpate or percuss the abdomen if you've auscultated a bruit; notify the healthcare provider of a bruit immediately.
Assessment of the patient with cirrhosis should include assessing for: Bleeding. Check the patient's skin, gums, stools, and vomitus for bleeding. Fluid retention.Feb 11, 2021
Ascites, hepatic encephalopathy, and esophageal/gastric varices are the three most common complications seen in decompensated cirrhosis. However, there are several other possible complications that require monitoring (see Complications of cirrhosis ).
Ascites is the most common complication of cirrhosis, with almost one-half of patients with compensated cirrhosis developing it over a 10-year period. 13,19 Sometimes, the diagnosis of ascites is the first clue to prompt the identification of cirrhosis.
CIRRHOSIS IS ONE of the most challenging chronic conditions healthcare providers must manage, yet evidence suggests that primary care providers (PCPs) will take on more of the burden of care as the disease becomes more prevalent. 1 Nurses must understand the challenges and best practices of managing this common chronic disease.
2,3 It is the 12th leading cause of death in the US, causing at least 1 million deaths annually. 3,4 Underdiagnosis is common; over two-thirds of patients are unaware that they have liver disease.
As with any chronic illness, a thorough history, physical exam, and diagnostic evaluation is important. Healthcare providers (HCPs) should evaluate for signs and symptoms of cirrhosis, identify the underlying etiology of liver disease, and intervene for improved outcomes (see Signs and symptoms of cirrhosis and underlying pathophysiology ). Treatment of hepatitis C and abstinence from alcohol can improve patient outcomes and life expectancy. 8,13
8. Cirrhosis also alters the hepatic vasculature, which results in portal hypertension, a state of increased pressure in the portal venous system.
Cardiovascular disease is a common comorbidity that poses unique patient management concerns. Despite popular belief, statins can and should be continued during compensated cirrhosis. In fact, statins improve liver function by enhancing hepatic blood flow through intrahepatic vessel dilation. 15 Statins also partially reverse the endothelial dysfunction and fibrosis that is seen in portal hypertension. 15 The benefit of aspirin to prevent cerebrovascular events and/or myocardial infarction should be carefully balanced with the increased risk of azotemia or gastrointestinal bleeding seen in cirrhosis. Additionally, nonsteroidal anti-inflammatory drugs should be used with caution or avoided, if possible, due to decreased urinary sodium excretion and azotemia risks. 21
Nursing management for the patient with cirrhosis of the liver should focus on promoting rest, improving nutritional status, providing skin care, reducing risk of injury, and monitoring and managing complications .
Laboratory findings and imaging studies that are characteristic of cirrhosis include: Liver scan. Liver scan shows abnormal thickening and a liver mass. Liver biopsy. Liver biopsy is the definitive test for cirrhosis as it detects destruction and fibrosis of the hepatic tissue. Liver imaging.
Hepatic Cirrhosis. Hepatic cirrhosis is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells.
Various types of cirrhosis may occur in different types of individuals. The most common, Laennec’s cirrhosis, occurs in 30% to 50% of cirrhotic patients. Biliary cirrhosis occurs in 15% to 20% of patients. Postnecrotic cirrhosis occurs in 10% to 30% of patients.
The end-stage of liver disease is called cirrhosis. Hepatic cirrhosis is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. As necrotic tissue yields to fibrosis, this disease alters liver structure and normal vasculature, impairs blood and lymph flow, and ultimately causes hepatic ...
Complications. The complications of hepatic cirrhosis include the following: Portal hypertension. Portal hypertension is the elevation of pressure in the portal vein that occurs when blood flow meets increased resistance. Esophageal varices.
Fibrosis. There is diffuse destruction and fibrotic regeneration of hepatic cells. Alteration. As necrotic tissue yields to fibrosis, the disease alters the liver structure and normal vasculature, impairs blood and lymph flow, and ultimately causes hepatic insufficiency.
A patient with an enlarged spleen (splenomegaly) due to cirrhosis can experience thrombocytopenia (low platelet count), increased PT/INR (means it takes the patient a long time to stop bleeding), and leukopenia (low white blood cells). The spleen stores platelets and WBCs.
The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia. D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia . The answer is D. 9.
Inform the patient of restricted use of fluid, protein, and sodium intake. Inform the patient why these are essential in promoting prevention of the disease process. Inform the patient that adequate calorie consumption is vital to minimize weight loss. Eating a well-balanced diet with plenty of fruits, vegetables, and whole grains will help prevent malnutrition and provide the body with adequate energy. Stress that the body will not be able to process alcohol. If needed refer to therapy and local support groups.
Signs of jaundice – As the liver is less able to produce bile, or an inflamed liver bile flow is blocked, signs of jaundice will be observable. These signs include, yellowing skin and sclera. The urine will be much darker and the and stool will be clay-colored. Lab values may show increased bilirubin.
Restrict sodium and fluid intake as ordered – This will aid on prevention of edema and fluid retention. Restrict protein intake – Protein break down in the liver may lead to increased serum ammonia level, which could cause hepatic encephalopathy.
Administer diuretics – This will help remove excess fluid being stored in the body such as edema. Monitor Potassium Level and Administer Electrolytes as needed – Potassium levels may drop due to the use of diuretics, diarrhea, vomiting, or low dietary intake of potassium.
Eating a well-balanced diet with plenty of fruits, vegetables, and whole grains will help prevent malnutrition and provide the body with adequate energy. Stress that the body will not be able to process alcohol. If needed refer to therapy and local support groups.
Teach the patient about the need for soft tooth brushes, electric razors, careful flossing, and other possible activities to reduce the risk of bleeding. Provide education on over the counter medications, herbs, and supplements which can result in further damage to the liver.
Because cirrhosis is a chronic disease, managing exacerbations of fluid retention in an outpatient setting decreases rehospitalizations and is more cost-effective than admission to an acute care facility. (White, A.)”. Talk with your doctor about routine follow up appointments and the importance of attending them.