20. A client with intractable ascites from liver failure has a transjugular intrahepatic portosystemic shunt (TIPS). For which common complication should a nurse assess the client?
20. A client with intractable ascites from liver failure has a transjugular intrahepatic portosystemic shunt (TIPS). For which common complication should a nurse assess the client?
Test-Taking Tip
Choose the option that is different from the others. Three of the choices would be complications of cardiac dysfunction.
Content Area: Adult Health, Gastrointestinal; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Complications of Diagnostic Tests/Treatments/Procedures
.
Answer 1 is incorrect because the ascites would pull protein from the vascular system, and fluid will move from the vascular system into the peritoneal space. Answer 2 is incorrect because there is a decrease in circulating volume, and the work of the heart will decrease. Answer 3 is incorrect because with liver failure there is portal hypertension, but not systemic hypertension. Answer 4 is correct because the purpose of the shunt is to reduce portal hypertension. TIPS is a procedure in which a stent carries blood from the portal vein to the hepatic vein. Consequently, toxic substances reach the brain without being detoxified by the liver.
