The patient in the icteric phase of hepatitis asks the nurse, Why ...

[roselinechinyere27m]

The patient in the icteric phase of hepatitis asks the nurse, Why are my stools no longer brown? How should the nurse respond?
 
  1. Your liver isn't making any of the substance that makes stools brown.
  2. The pigment is backing up into your blood and turning your skin yellow.
  3. It is being released into your bloodstream and turning your blood darker red.
  4. The answer is not known. More research is needed regarding this question.

Question 2

The nurse is teaching a patient about the effects of liver failure. The nurse knows the patient understands when the patient identifies which manifestations as related to liver failure?
 
  Select all that apply.
  1. My abdomen is becoming very large.
  2. My blood sugar is sometimes too high and sometimes too low.
  3. My left lower leg is red and swollen.
  4. My menstrual cycle has become very irregular.
  5. My skin appears yellow.

[pikon]

Answer to Question 1

Correct Answer: 2
The icteric (jaundiced) phase usually begins 5 to 10 days after the onset of symptoms. It is heralded by jaundice of the sclera, skin, and mucous membranes. Inflammation of the liver and bile ducts prevents bilirubin from being excreted into the small intestine. As a result, the serum bilirubin levels are elevated, causing yellowing of the skin and mucous membranes. The stools are light brown or clay colored because bile pigment is not excreted through the normal fecal pathway. Instead, the pigment is excreted by the kidneys, causing the urine to turn brown. The liver continues to make bilirubin, even during hepatitis. The blood does not become darker when bilirubin levels are elevated. The cause of this phenomenon is known.

Answer to Question 2

Correct Answer: 1, 2, 4, 5
Ascites occurs during liver failure due to low oncotic pressure related to a deficiency of serum albumin. The liver's ability to use glycogen is impaired by liver failure, leading to difficulty controlling hypoglycemia and/or hyperglycemia. Impaired metabolism of steroid hormones interferes with the menstrual cycle. Impaired ability to metabolize and excrete bilirubin leads to a buildup of bilirubin in skin, causing a jaundiced appearance. The patient is describing symptoms of a blood clot. This is not associated with liver failure. Excessive bleeding is associated with liver failure.

[roselinechinyere27m]

TYSM

[kishoreddi]

Excellent