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:
Abdominal ultrasound and chest X-ray are not the first-line tests for a patient presenting with these symptoms. While they can be useful in assessing certain conditions, the priority in this case is to rule out cardiac causes, especially given the symptoms that could indicate a cardiac event.
Choice B reason:
Testing the acidity of gastric contents and assessing the throat is not relevant for the initial evaluation of these symptoms. While gastrointestinal issues can present with similar symptoms, the first step should be to rule out more serious cardiac causes.
Choice C reason:
Electrocardiogram (EKG) and serum troponin levels are the correct answer. These tests are critical in assessing cardiac function and identifying potential myocardial infarction or other cardiac issues. Given the patient's symptoms, which can be indicative of a cardiac event, these tests are prioritized to rule out any immediate cardiac threats.
Choice D reason:
Abdominal X-ray and colonoscopy are not appropriate first-line tests in this scenario. While they may be necessary later to investigate gastrointestinal issues, the primary concern given the patient's symptoms is to rule out cardiac events with an EKG and serum troponin levels.
Correct Answer is D
Explanation
Choice A reason:
Nonadherence to the antiviral regimen could result in suboptimal control of the HIV infection, but it is not typically associated with symptoms of increased hunger, thirst, and frequent urination. Therefore, this choice does not explain the patient's symptoms.
Choice B reason:
An allergic reaction might cause a variety of symptoms, such as rash, itching, or swelling, but it would not typically cause increased hunger, thirst, and frequent urination. This choice is incorrect as it does not align with the presented symptoms.
Choice C reason:
Pancreatic infiltration by HIV is a rare and serious condition that can lead to various metabolic complications, but it is not a common cause of the specific symptoms described (increased hunger, thirst, and frequent urination). This choice is not consistent with the patient's symptoms.
Choice D reason:
Hyperglycemia, or high blood sugar, can cause symptoms like increased hunger, thirst, and frequent urination. These symptoms are indicative of diabetes, which can be a side effect of some antiviral medications, particularly protease inhibitors used in HIV treatment. Therefore, this choice accurately reflects the patient's symptoms and is the correct answer.
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