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.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
While a blood culture could be useful in diagnosing a systemic infection, it would not be the most appropriate intervention for a patient reporting watery diarrhea and abdominal cramps after 2 weeks of antibiotic therapy.
Choice B rationale
A stool sample should be collected to test for Clostridium difficile. This bacterium can overgrow in the gut during antibiotic therapy, leading to symptoms such as watery diarrhea and abdominal cramps.
Choice C rationale
Discontinuing the antibiotic immediately may not be the best course of action without confirming the cause of the symptoms.
Choice D rationale
Prescribing an antidiarrheal could alleviate discomfort, but it would not address the underlying cause of the symptoms.
Correct Answer is C
Explanation
Choice A rationale
Pyridoxine, also known as vitamin B6, does not prevent discoloration of body fluids. This is not a known side effect of isoniazid.
Choice B rationale
While isoniazid can potentially cause liver damage, pyridoxine does not prevent this side effect. Instead, regular liver function tests are typically performed to monitor for this potential complication.
Choice C rationale
Pyridoxine is prescribed alongside isoniazid to prevent peripheral neuropathy, which is a potential side effect of isoniazid. Peripheral neuropathy can cause symptoms such as numbness and tingling in the hands and feet.
Choice D rationale
Pyridoxine does not prevent drug-resistant tuberculosis. Drug resistance is a complex issue that is not prevented by vitamin supplementation. Prednisone Prednisone Explore
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