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jean
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The decreased serum oncotic pressure is caused by?
decreased albumin production.
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Fluid sequestering in the peritoneal cavity results in ________ vascular volume. __________ blood return to the heart, and __________ cardiac output.
decreased
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The change in CO results in decreased _______ ________ and secretion of ___________ and ________.
- kidney perfusion
- aldosterone
- ADH
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Aldosterone and ADH increase _________ __________
Fluid retention
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Retained fluid has low oncotic colloidal pressure, and it escapes into the interstitial spaces, causing _________ ______.
peripheral edema
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Excessive fluid continues to be reabsorbed from the kidney because of the altered kidney perfusion and because __________ is not metabolized by the impaired liver.
aldosterone
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The changes in laboratory test results that relate to ascites are?
- hypoalbuminemia
- hypokalemia
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Why does a pt with cirrhosis and ascites need bedrest?
helps promote diuresis and fluid excretion
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Why does a pt with ascites need salt-poor albumin?
increases plasma colloid osmotic pressure and maintains intravascular volume & kidney profusion.
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Why does a pt with ascites need diuretic therapy?
increase fluid loss thru the kidneys & mobilize peritoneal fluid
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____________ blocks effects of excess aldosterone.
Spironalactone
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Why does a pt with ascites need low-sodium diet?
decrease intake of fluid-retaining sodium
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Why does a pt with ascites need paracentesis?
to relieve impaired respiration or pain of severe ascites
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Why does a pt with ascites need peritoneovenous shunts?
shunts peritoneal fluid from the abd to the venous system decrease ascites & improving hemodynamic factors.
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An early sign of hepatic encephalopathy?
irritability and lethargic
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Why use Lactulose (Cephulac) in pt with hepatic encephalopathy?
it reduces ammonia formation by decreasing absorption of ammonia in bowel
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Why use Neomycin in pt with hepatic encephalopathy?
reduces ammonia formation by reducing bacterial flora that produce ammonia
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Why eliminate blood from GI tract in pt with hepatic encephalopathy?
reducing ammonia formation by removing RBC as a source of protein
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What is an appropriate snack for a pt with advanced cirrhosis with a nursing diagnosis of imbalanced nutrition: < requirement?
a fresh tomato sandwich with salt-free butter. Needs high calorie, high carb foods
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