A patient with liver failure has been admitted with hepatic encephalopathy and is prescribed lactulose every 2 hours. The patient is currently oriented and has had 6 loose, watery stools since 0700.
The 1400 dose of lactulose is due.
What should be the nurse’s next course of action?
No action is required as this is the desired therapeutic effect.
Withhold the dose and contact the doctor for daily stool count parameters.
Administer the medication since diarrhea is a common side effect.
Remove fall precautions due to changes in mental status.
The Correct Answer is A
Choice A rationale
Lactulose is used to treat hepatic encephalopathy, a condition that affects patients with liver failure. It works by reducing the absorption of ammonia in the gut. Having loose, watery stools is a desired therapeutic effect of lactulose. Therefore, no action is required if the patient is oriented and has had 6 loose, watery stools since 07007.
Choice B rationale
Withholding the dose and contacting the doctor for daily stool count parameters is not necessary in this situation. The patient is currently oriented, which suggests that the lactulose is effectively managing their hepatic encephalopathy.
Choice C rationale
Administering the medication because diarrhea is a common side effect is not the correct course of action. The presence of loose, watery stools is not merely a side effect, but a desired therapeutic effect of lactulose in the treatment of hepatic encephalopathy.
Choice D rationale
Removing fall precautions due to changes in mental status is not necessary in this situation. The patient is currently oriented, which suggests that the lactulose is effectively managing their hepatic encephalopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
T3 and T4 are thyroid hormones. While it’s important to monitor these levels in a patient on propylthiouracil therapy, they are not the most concerning lab value.
Choice B rationale
The white blood cell count should be the nurse’s primary concern. Propylthiouracil can cause agranulocytosis, a serious condition characterized by a decrease in the number of white blood cells, which can lead to infection.
Choice C rationale
Hemoglobin and hematocrit levels are important to monitor, but they are not the most concerning lab value in this context.
Choice D rationale
While it’s important to monitor platelet count in a patient on propylthiouracil therapy, it’s not the most concerning lab value.
Correct Answer is C
Explanation
Choice A rationale
Ibuprofen does not have a significant interaction with erythromycin18.
Choice B rationale
Diphenhydramine does not have a significant interaction with erythromycin18.
Choice C rationale
Loratadine should be avoided while on erythromycin. Erythromycin can increase the concentration of loratadine, which can lead to an increased risk of side effects, including heart rhythm abnormalities18.
Choice D rationale
Acetaminophen does not have a significant interaction with erythromycin18. Nystatin Nystatin Explore
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