Nurs 487 Final Study Guide Graded A+

Clinical Manifestations of hepatic encephalopathy {Ans: -Subtle changes in personality, memory loss, irritability, disinhibition, lethargy, and sleep disturbances are common initial manifestations of hepatic encephalopathy. -Symptoms then can progress to confusion, disorientation to time and space, flapping tremor of the hands (asterixis), slow speech, bradykinesia, stupor, convulsions, and coma. Coma is usually a sign of liver failure and ultimately results in death. -Variceal bleeding and ascites may develop concurrently. -Symptoms may be episodic, recurrent, or persistent. -Hepatic encephalopathy is often associated with bleeding varices and ascites.}Mechanisms of Jaundice {Ans: }Macrocytic-Normochromic Anemias {Ans: -characterized by unusually large stem cells (megaloblasts) in the marrow. These cells mature into erythrocytes that are unusually large in size (macrocytic), thickness, and volume. -These anemias are classified as normochromic because the hemoglobin content is normal. -They are the result of ineffective erythrocyte DNA synthesis, commonly caused by deficiencies of vitamin B12 (cobalamin) or folate (folic acid). -These defective erythrocytes die prematurely, which decreases their numbers in the circulation, causing anemia. -Defective DNA synthesis in megaloblastic anemias causes red blood cell growth and development to continue at unequal rates. DNA synthesis and cell division are blocked or delayed. However, RNA replication and protein (hemoglobin)