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","B","E"]

Explanation

Choice A reason: Placing the client in a side-lying position is beneficial for comfort and can help alleviate pain in clients with acute pancreatitis. This position can reduce pressure on the pancreas and improve circulation, helping to manage pain and discomfort effectively.

Choice B reason: Administering hydromorphone for pain as prescribed is essential in managing acute abdominal pain associated with acute pancreatitis. Pain control is a priority in the care of these clients because unmanaged pain can lead to increased stress and further complications. Hydromorphone, a potent opioid analgesic, helps to effectively manage severe pain.

Choice C reason: Obtaining daily weights is important for monitoring a client's nutritional status and fluid balance, but it is not directly related to the immediate management of acute abdominal pain in acute pancreatitis. While it is a relevant intervention, it is not as critical as the other measures listed.

Choice D reason: Maintaining a high-calorie, high-protein diet is not appropriate for a client with acute pancreatitis. In fact, clients with acute pancreatitis are often placed on a nil-per-os (NPO) status initially to rest the pancreas and reduce enzyme secretion. Once the inflammation subsides, a low-fat, bland diet may be introduced gradually.

Choice E reason: Monitoring the client's respiratory status is crucial because clients with acute pancreatitis are at risk for respiratory complications, such as pleural effusion, acute respiratory distress syndrome (ARDS), or atelectasis. Close monitoring ensures early detection and intervention for any respiratory issues that may arise.

A. Urine output increases to 35 mL/hr. B. Heart rate decreases to 105 beats/min. C. Systolic blood pressure increases to 85 mmHg. D. Right atrial pressure decreases.

Correct Answer is A

Explanation

Choice A reason: An increase in urine output to 35 mL/hr is the best indication of improved perfusion. Urine output is a direct measure of kidney function and perfusion. When the kidneys receive adequate blood flow, they are able to produce urine. An increase in urine output indicates that the patient's kidneys are being perfused more effectively, which is a reliable sign of overall improved perfusion status.

Choice B reason: A decrease in heart rate to 105 beats/min is a positive sign, as it indicates a reduction in the stress response and an improvement in hemodynamic status. However, it is not as direct an indicator of improved perfusion as urine output. Heart rate can be influenced by many factors, and while a lower heart rate is generally a good sign, it does not specifically indicate improved organ perfusion.

Choice C reason: An increase in systolic blood pressure to 85 mmHg is an indication of improved hemodynamic stability, but it is not as sensitive a measure of perfusion as urine output. Blood pressure provides information about the pressure within the arteries but does not directly indicate how well the organs and tissues are being perfused.

Choice D reason: A decrease in right atrial pressure is not typically an indicator of improved perfusion. Right atrial pressure reflects the pressure in the right atrium of the heart, which can be influenced by various factors, including fluid status and cardiac function. It is not a direct measure of perfusion to vital organs and tissues.

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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

When providing care for a client hospitalized with acute pancreatitis who has acute abdominal pain, which nursing interventions would be most appropriate for this client? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

A patient who is in hypovolemic shock has the following clinical signs: BP 80/55 mmHg, heart rate 120 beats/min, and urine output of 20 mL/hr. After administering an IV fluid bolus, which of these signs is the best indication of improved perfusion?

Correct Answer is A

Explanation

A nurse plans care for a patient with acute pancreatitis. Which intervention would the nurse include in this patient's plan of care to reduce discomfort?

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