Hepatic Encephalopathy with AMS

A 59-year-old Caucasian male with PMH of liver disease, T2DM, Hypertension, and Hypothyroidism was brought to the ER by his family, who states he’s had a change in mood the last day or so and now appears confused. The patient’s family reports he had just been treated for a UTI 2 weeks ago, but they never went for follow-up after completing the antibiotic. The patient’s family says he has been sleeping a lot and is more lethargic than normal, and does not have good oral intake. Positive Babinski’s sign, and hyperreflexia on assessment. The patient is jaundiced and presents with ascites along with bilateral lower extremity swelling.


Learning Objectives

Explain the nursing process and recognize critical thinking skills needed to deliver patient-centered, evidence-based care to patients associated with the gastrointestinal system, fluid and electrolytes disorders, acid-base balance disorders, and reproductive disorders

– Demonstrate essential nursing skills according to standards presented in the clinical lab evaluations

– Identify parameters that define a safe physical environment and psychosocial needs assessment adhering to the best current practices

– Demonstrate proficiency in guidelines for the Health Insurance Portability and Accountability Act (HIPAA)

– Recall knowledge and successfully complete written exam regarding standard precautions, infection control, and bloodborne pathogens

– Complete orientation to acute care facility procedures, including electronic health record management

– Recognize quality improvement measures to improve productivity and care of patients with medical-surgical conditions

Interested in this scenario?

Sign up to talk with a member of the SimX team today!


OS: Windows 10
Processor: Intel Core i5-2300 | AMD FX-4350
Memory: 4 GB RAM
Graphics: Nvidia GeForce GTX 2060
DirectX: Version 11
Storage: 12 GB available space


OS: Windows 10
Processor: Intel Core i7-2300 | AMD FX-4350
Memory: 8 GB RAM
Graphics: Nvidia GeForce GTX 3060
DirectX: Version 11
Storage: 12 GB available space