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When your patient is in liver failure

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GENERAL PURPOSE To familiarize nurses with the causes, treatment, and complications of liver failure.

LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to:

  1. Describe liver anatomy and function and the causes and types of liver failure.
  2. Identify signs and symptoms of liver failure and its complications.
  3. Identify appropriate treatment for patients with liver failure.

1. Blood is supplied to the liver from the

a. hepatic artery and internal jugular vein.

b. hepatic vein and internal jugular vein.

c. hepatic artery and portal vein.

d. hepatic vein and portal vein.

2. The liver is responsible for

a. cleaning blood, storing nutrients, and making bile.

b. coagulating blood, storing bile, and making nutrients.

c. conjugating carbohydrates, excreting bile, and making blood.

d. converting bile, storing blood, and making glycogen.

3. The two main categories of liver disease are

a. fulminant and chronic.

b. hepatocellular and cholestatic.

c. viral and biliary.

d. acute and end stage.

4. Cholestatic liver disease may be caused by

a. tumor.

b. alcohol abuse.

c. drug overdose.

d. hepatitis C.

5. Which of the following contributes to development of ascites?

a. low serum sodium

b. low serum albumin

c. low portal pressure

d. low hemoglobin

6. Fever, hypotension, and abdominal pain in a patient with ascites may indicate

a. steatorrhea.

b. cirrhosis.

c. peritonitis.

d. acute fatty liver.

7. All of the following may be GI-associated signs of liver failureexcept

a. steatorrhea.

b. fetor hepaticus.

c. asterixis.

d. clay-colored stools.

8. Which signs and symptoms would lead you to suspect liver failure?

a. increased urine bilirubin and polyuria

b. decreased blood urea nitrogen and decreased libido

c. decreased serum creatinine and amenorrhea

d. elevated unconjugated bilirubin levels and jaundice

9. Impaired ability of the liver to metabolize bilirubin at the cellular level is best described as which type of jaundice?

a. prehepatic

b. parenchymal

c. obstructive

d. posthepatic

10. The accumulation of bile acids under the skin may cause

a. petechiae.

b. spider angiomas.

c. xanthomas.

d. pruritus.

11. The definitive test to assess the cause and severity of liver dysfunction is

a. an ERCP.

b. a computed tomography scan.

c. a liver biopsy.

d. an ultrasound.

12. The best approach for liver biopsy in a patient with uncorrected coagulopathy is

a. transjugular.

b. percutaneous.

c. open surgical.

d. laparoscopic.

13. Which therapy for bleeding esophageal varices involves injecting a strong irritating agent into the area to cause scarring?

a. sclerotherapy

b. balloon tamponade

c. endoscopic electrocautery

d. banding

14. The initial treatment for a pleural effusion in a patient with ascites is

a. I.V. diuretics.

b. thoracentesis.

c. paracentesis.

d. transjugular intrahepatic portosystemic shunt.

15. The best way to prevent hepatorenal syndrome is to

a. administer I.V. diuretics every 2 hours.

b. monitor closely for low serum sodium.

c. administer nonsteroidal anti-inflammatory drugs.

d. administer potassium-sparing diuretics.

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© 2005 Lippincott Williams & Wilkins, Inc.