A nurse cares for a patient who is prescribed lactulose (Heptalac). The patient states, "I do not want to take this medication because it causes diarrhea." How would the nurse respond?

Diarrhea is expected; that's how your body gets rid of ammonia.

You may take Kaopectate liquid daily for loose stools.

Do not take any more of the medication until your stools firm up.

We will need to send a stool specimen to the laboratory.

Answer and Explanation

The Correct Answer is A

Choice A reason: Explaining that diarrhea is expected and that it is how the body gets rid of ammonia is accurate. Lactulose is often prescribed for patients with hepatic encephalopathy, and its purpose is to reduce blood ammonia levels by promoting bowel movements. Diarrhea is a common and anticipated side effect, as it helps eliminate ammonia from the body.

Choice B reason: Recommending Kaopectate for loose stools is not appropriate in this context. Kaopectate is an anti-diarrheal medication, and using it would counteract the effect of lactulose, which aims to promote bowel movements to reduce ammonia levels.

Choice C reason: Instructing the patient to stop taking the medication until stools firm up is incorrect. Lactulose should be continued as prescribed to maintain its therapeutic effect of reducing blood ammonia levels. Stopping the medication would negate its benefits and potentially worsen the patient's condition.

Choice D reason: Suggesting to send a stool specimen to the laboratory is unnecessary in this scenario. Diarrhea is an expected side effect of lactulose, and there is no indication that a stool specimen needs to be analyzed unless there are signs of infection or other complications.

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Correct Answer is ["A","C","D","E"]

Explanation

Choice A reason: Providing at least 5000 kcal/day is essential for a patient with burn injuries. Burns significantly increase the body's metabolic rate and caloric needs to support the healing process and prevent catabolism. Ensuring an adequate caloric intake helps meet the energy demands required for tissue repair and recovery.

Choice B reason: Starting an oral diet on the first day may not be appropriate for all burn patients, particularly those with extensive burns or those who are not yet stable. Nutrition needs should be carefully assessed, and feeding may begin via alternative methods such as enteral nutrition until the patient is ready for oral intake.

Choice C reason: Administering a diet high in protein is crucial for burn patients, as protein is essential for wound healing, maintaining lean body mass, and supporting the immune system. Protein intake should be increased to help repair damaged tissues and promote recovery.

Choice D reason: Collaborating with a registered dietitian is important to create an individualized nutrition plan that meets the specific needs of the burn patient. A dietitian can provide expertise in calculating caloric and protein requirements, recommending appropriate supplements, and monitoring the patient's nutritional status.

Choice E reason: Offering frequent high-calorie snacks helps ensure that the patient meets their increased caloric needs. Small, frequent meals and snacks can be more manageable for patients with reduced appetite or those who have difficulty consuming large meals. High-calorie snacks provide additional energy to support healing and recovery.

A. An electrician who suffered external burn injuries a month ago and is asking the nurse to contact the healthcare provider immediately about discharge plans. B. Older adult client admitted yesterday with partial- and full-thickness burns over 40% of the body who is receiving IV fluids at 250 mL/hr. C. Adult client admitted a week ago with deep partial-thickness burns over 35% of the body who is reporting pain. D. Firefighter with smoke inhalation and facial burns who has just arrived on the unit.

Correct Answer is D

Explanation

Choice A reason: The electrician who suffered external burn injuries a month ago is stable enough to be concerned with discharge plans. This indicates that his burns have been managed and he is in a phase of recovery where he is preparing for discharge. Although his request is important, it is not an immediate priority compared to more acute conditions.

Choice B reason: The older adult client admitted yesterday with partial- and full-thickness burns over 40% of the body is in a critical condition and needs continuous monitoring, especially with high fluid administration. However, their condition is currently being managed with IV fluids. While this client requires close observation, there is no immediate indication of a life-threatening change that demands immediate intervention compared to the firefighter's situation.

Choice C reason: The adult client admitted a week ago with deep partial-thickness burns over 35% of the body who is reporting pain is also in need of pain management and ongoing care. However, pain, while significant and requiring treatment, does not take precedence over the potential airway compromise and respiratory distress posed by smoke inhalation and facial burns in the firefighter.

Choice D reason: The firefighter with smoke inhalation and facial burns who has just arrived on the unit must be assessed first due to the immediate risk of airway compromise and respiratory distress. Smoke inhalation can lead to rapid swelling of the airways, making it a critical emergency. Facial burns also increase the risk of airway obstruction. Prompt assessment and intervention are essential to ensure the firefighter's airway remains patent and to provide necessary respiratory support.

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A nurse cares for a patient who is prescribed lactulose (Heptalac). The patient states, "I do not want to take this medication because it causes diarrhea." How would the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse plans care for a patient with burn injuries. Which interventions would the nurse include in this patient's plan of care to ensure adequate nutrition? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

The nurse on a burn unit has just received a change-of-shift report about these clients. Which client does the nurse assess first?

Correct Answer is D

Explanation

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