A client with cirrhosis of the liver is being cared for by the healthcare team. Which clinical manifestation indicates that the client has developed hepatic encephalopathy?

Correct Answer: A

Rationale: The correct answer is A: Asterixis. Hepatic encephalopathy is a neuropsychiatric syndrome associated with liver dysfunction. Asterixis, also known as liver flap, is a key clinical manifestation characterized by a flapping tremor of the hands when extended. This occurs due to impaired ammonia metabolism in the liver leading to neurotoxicity. Jaundice (B) is a sign of liver dysfunction but not specific to hepatic encephalopathy. Ascites (C) is the accumulation of fluid in the peritoneal cavity, common in liver cirrhosis but not indicative of hepatic encephalopathy. Splenomegaly (D) is enlargement of the spleen, which can occur in cirrhosis but is not a direct sign of hepatic encephalopathy.

Correct Answer: A

Rationale: The correct answer is A: Increase your intake of high-calcium foods. Osteoporosis is a condition characterized by low bone density, and calcium is essential for bone health. Increasing calcium intake can help strengthen bones and prevent further bone loss. Foods high in calcium, such as dairy products, leafy green vegetables, and fortified foods, are beneficial for individuals with osteoporosis. Summary of other choices: B: Limiting intake of vitamin D-rich foods is not advised, as vitamin D plays a crucial role in calcium absorption and bone health. C: Avoiding foods high in phosphorus is not necessary, as phosphorus is also important for bone health and overall body function. D: Increasing intake of high-sodium foods is not recommended, as high sodium intake can lead to calcium loss from the bones, worsening osteoporosis.

Correct Answer: C

Rationale: The correct answer is C: Crepitus around the insertion site. Crepitus suggests subcutaneous emphysema, which can indicate a pneumothorax or air leak. Immediate intervention is needed to prevent further complications. A: Intermittent bubbling in the water seal chamber is expected and indicates a functioning chest tube system. B: Drainage of 75 ml in the first hour post-insertion is within the normal range and should be monitored. D: Fluctuation of the water level in the water seal chamber with respiration is a normal finding indicating the chest tube is functioning correctly.

Correct Answer: B

Rationale: The correct answer is B: Serum potassium of 6.2 mEq/L. Hyperkalemia is a life-threatening condition in AKI. High potassium levels can lead to cardiac arrhythmias and must be addressed immediately. Choice A is concerning but not as critical as hyperkalemia. Choice C, elevated blood pressure, needs monitoring but does not require immediate intervention. Choice D, elevated serum creatinine, indicates kidney dysfunction but does not pose an immediate threat compared to hyperkalemia.

Correct Answer: D

Rationale: The correct answer is D: Potassium level of 6.5 mEq/L. High potassium levels (hyperkalemia) in CKD patients receiving hemodialysis can lead to serious complications like cardiac arrhythmias or even cardiac arrest. Therefore, it is crucial to report this finding immediately to the healthcare provider for prompt intervention. Explanation for other choices: A: Blood pressure of 150/90 mm Hg - While elevated, this blood pressure reading is not an immediate concern unless accompanied by symptoms like chest pain or shortness of breath. B: Weight gain of 2 pounds since the last dialysis session - While weight gain may indicate fluid retention, it is not an urgent issue unless it is rapid and significant. C: Blood glucose level of 120 mg/dl - A blood glucose level of 120 mg/dl is within the normal range and does not require immediate action in this context.