A client diagnosed with end-stage liver disease is prescribed Lactulose. Which assessment finding indicates that this medication is effective?
The client has less itching.
The client is having less bowel movements.
The client's ammonia levels have decreased.
The client has less pain and less jaundice.
The Correct Answer is C
A. The client has less itching.: Itching in liver disease is caused by bile salt accumulation under the skin and is not directly affected by lactulose. Improvement in pruritus is more closely related to bile acid–binding agents rather than ammonia-reducing therapy.
B. The client is having less bowel movements.: Lactulose works by increasing bowel movements to promote the excretion of ammonia from the body. Fewer bowel movements would actually suggest reduced medication effectiveness in managing hepatic encephalopathy.
C. The client's ammonia levels have decreased.: Lactulose reduces blood ammonia levels by trapping ammonia in the colon and enhancing its excretion through feces. A decrease in serum ammonia reflects improved hepatic encephalopathy control.
D. The client has less pain and less jaundice.: Pain and jaundice in end-stage liver disease result from liver inflammation and bile obstruction, not elevated ammonia. Lactulose does not directly influence bilirubin metabolism or liver pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Bacteriostatic.: Bacteriostatic antibiotics inhibit bacterial growth and reproduction but do not directly kill the organisms. They allow the immune system to eliminate the remaining bacteria, which may not be sufficient for severe infections like sepsis.
B. Bactericidal.: Bactericidal antibiotics destroy bacteria by interfering with essential cellular functions such as cell wall synthesis or DNA replication. These agents are preferred in life-threatening infections like sepsis because they rapidly reduce bacterial load and prevent further toxin release.
C. Disinfectant.: Disinfectants are chemical agents used on non-living surfaces to kill microorganisms. They are not used internally or systemically in humans due to their toxicity, making them inappropriate for treating infections such as sepsis.
D. Bacterial resistant.: The term “bacterial resistant” refers to microorganisms that have developed mechanisms to survive exposure to antibiotics. It describes a bacterial trait, not a type of antibiotic, and therefore cannot classify the drug prescribed.
Correct Answer is B
Explanation
A. They block histamine H2 receptors on parietal cells.: H2 receptor blockers, such as ranitidine or famotidine, work by inhibiting histamine-stimulated acid secretion. PPIs target the final step of acid production rather than receptor activity.
B. They inhibit the H+/K+ ATPase enzyme in gastric parietal cells.: Proton pump inhibitors block the H+/K+ ATPase (proton pump) in the parietal cells of the stomach. This action irreversibly prevents the secretion of hydrogen ions into the gastric lumen, leading to a profound and long-lasting reduction in gastric acid production.
C. They neutralize gastric acid directly.: Antacids, not PPIs, act by chemically neutralizing existing stomach acid. PPIs do not have an immediate neutralizing effect but reduce acid secretion over time.
D. They increase gastric mucus production: PPIs do not directly increase gastric mucus secretion. Protective mechanisms like mucus production are enhanced by other agents, such as prostaglandin analogs, but are not the primary action of PPIs.
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