Author Question: The nurse is assessing the nutritional status of a patient who has cholelithiasis and a body mass ... (Read 39 times)

ahriuashd · **on:** Jun 25, 2018

The nurse is assessing the nutritional status of a patient who has cholelithiasis and a body mass index of 35. What action should the nurse take initially?

1. ask the patient to discuss typical daily menu choices
2. ask the patient to discuss strategies used to manage weight
3. ask if the patient takes daily supplemental vitamin C
4. ask if the patient has been skipping meals to reduce gallbladder pain

Question 2

The nurse is assessing a patient with liver cirrhosis. Which findings should the nurse relate to the patient's failed liver function?

Select all that apply.
1. The patient had two episodes of epistaxis.
2. The patient had toxic levels of a prescribed medication.
3. The patient is oriented to person and place but not to time.
4. The patient's urinary output has decreased.
5. The patient has cholelithiasis.

14vl19 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
The nurse begins by assessing nutritional status, particularly diet history, height and weight, and skinfold measurements. Even though often obese, patients with gallbladder disease may have an imbalanced diet or specific vitamin deficiencies, particularly of the fat-soluble vitamins. Vitamin C is a water-soluble vitamin. Discussing strategies used to manage weight may be important in assessing causes of cholelithiasis pain, as fluctuating weight gains and losses can contribute to cholelithiasis, but this is the not the priority when assessing the patient's nutritional status. Asking if the patient has been skipping meals is important, but not as important as the diet history and typical food choices.

Answer to Question 2

Correct Answer: 1, 2, 3
The liver produces clotting factors. Two episodes of epistaxis are likely related to the patient's liver failure. The liver metabolizes medications. Toxic levels of prescribed medication in the absence of other factors are likely related to liver failure. The patient who is disoriented may be experiencing high serum ammonia levels, an effect of liver failure. Decreased urinary output is not associated with liver failure, but with kidney failure. Cholelithiasis is not caused by liver failure.