A patient with a history of chronic alcohol abuse has been admitted to the unit with cirrhosis. Upon review of the patient's laboratory test results, the nurse notes that the patient's ammonia level is elevated at 218 mcg/dL. What medication should the nurse prepare to administer?
Lactulose
Polyethylene glycol (MiraLax)
0.9% NS
Docusate sodium (Colace)
The Correct Answer is A
Choice A reason:
Lactulose is the medication of choice for treating elevated ammonia levels, commonly seen in hepatic encephalopathy associated with cirrhosis. It works by reducing the absorption of ammonia from the intestines, converting ammonia to ammonium, which is then excreted. Administering lactulose helps in lowering blood ammonia levels and improving mental status in affected patients.
Choice B reason:
Polyethylene glycol (MiraLax) is a laxative used to treat constipation. It does not have any role in reducing ammonia levels or treating hepatic encephalopathy. Therefore, it is not appropriate for this patient's elevated ammonia condition.
Choice C reason:
0.9% NS (normal saline) is primarily used for fluid resuscitation and electrolyte balance. While essential in managing cirrhotic patients with fluid imbalances, it does not address the elevated ammonia levels directly. Therefore, it is not the treatment of choice for this specific situation.
Choice D reason:
Docusate sodium (Colace) is a stool softener used to treat constipation. It does not have any effect on ammonia levels or the treatment of hepatic encephalopathy. Thus, it is not appropriate for managing elevated ammonia in this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Decreased afterload due to vasodilation is not the primary cause of hypotension in acute myocardial infarction. While vasodilation can lower blood pressure, in the context of MI, the more direct and significant cause of hypotension is the reduced cardiac contractility leading to decreased cardiac output. Vasodilation and afterload reduction are not the primary mechanisms in this scenario.
Choice B reason:
A rapid heart rate, or tachycardia, can contribute to hypotension by reducing the time for the heart to fill with blood between beats. However, in the context of an acute myocardial infarction, the primary issue is the heart's ability to contract effectively. Therefore, while a rapid heart rate might exacerbate the condition, it is not the main cause of hypotension.
Choice C reason:
Decreased cardiac contractility, resulting in decreased cardiac output, is the primary cause of hypotension in acute myocardial infarction. The damaged heart muscle cannot pump effectively, leading to reduced blood flow and low blood pressure. This is a direct consequence of the myocardial damage caused by the infarction, making this the correct answer.
Choice D reason:
Increased capillary permeability is not a primary cause of hypotension in acute myocardial infarction. This condition is more associated with inflammatory responses, sepsis, or allergic reactions. The main cause of hypotension in MI is related to the heart's reduced pumping ability.
Correct Answer is ["A","B","D"]
Explanation
Choice A reason:
HIV can be transmitted through blood products. This mode of transmission occurs when contaminated blood, used in transfusions or other medical procedures, carries the virus to another person. It is one of the primary ways HIV spreads, especially before strict blood screening protocols were implemented.
Choice B reason:
Perinatal transmission refers to the transmission of HIV from a mother to her fetus during pregnancy, childbirth, or breastfeeding. This is a significant mode of transmission, particularly in regions with high HIV prevalence and limited access to antiretroviral therapy.
Choice C reason:
This choice is incorrect because HIV is not transmitted through airborne means. Unlike respiratory viruses, HIV requires direct contact with certain body fluids for transmission. Airborne transmission would imply that the virus could spread through the air, which is not the case with HIV.
Choice D reason:
Sexual transmission is a major route for HIV spread. The virus is present in bodily fluids such as semen, vaginal fluids, and rectal fluids. Unprotected sexual contact allows the virus to pass from one person to another, making this a crucial mode of HIV transmission.
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