Patho Patho #17

Question

What is the pathophysiological process that leads to the development of hepatic encephalopathy in clients with severe liver failure?

Answers

  1. An overload of amino acids causing blood to be shunted away from the liver.
    • Rationale:

      This answer choice is not correct because hepatic encephalopathy is caused by the buildup of ammonia within the blood as opposed to blood being shunted away from the liver.

  2. The liver cannot convert amino acids into urea which causes large quantities of ammonia to accumulate in the blood.
    • Rationale:

      This answer is correct because hepatic encephalopathy is an altered mental status that is caused by the buildup of excess ammonia within the blood of clients with end stage liver disease.

  3. Proteins shift from the blood vessels into lymph space.
    • Rationale:

      This answer choice is not correct because the shifting of proteins out of the vessels leads to edema, not hepatic encephalopathy.

  4. The liver is unable to synthesize albumin.
    • Rationale:

      This answer choice is not correct because the inability of the liver to produce albumin leads to the development of edema as opposed to hepatic encephalopathy.

Overview

The focus of this question is asking the nurse to determine the pathophysiological processes leading to the development of hepatic encephalopathy. Hepatic encephalopathy is associated with end stage liver disease. In end stage liver disease, the liver is unable to convert ammonia which crosses the blood-brain barrier leading to symptoms of hepatic encephalopathy.

Explanation

Learning Outcomes

Hepatic encephalopathy causes an altered level of consciousness in clients with end stage liver disease. The underlying pathophysiological mechanism of hepatic encephalopathy is the buildup of excess ammonia within the blood as the liver becomes unable to convert amino acids to urea. Clients will experience significant mental status changes including, confusion, agitation, restlessness, lethargy and even coma if left untreated.

Test Taking Tip

Look at each answer choice carefully. Answers 3 & 4 are very similar and when this happens, those answers can usually be eliminated as possibilities.

Video Rationale