After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas.
What action should the nurse take?

Choice A rationale

If a patient is experiencing increasingly frequent oily stools and gas after taking orlistat for one week, the nurse should ask the patient to describe her dietary intake history for the last

several days. Orlistat works by inhibiting the absorption of dietary fats, which are then excreted in the stool. Consuming a diet high in fat can increase the side effects of orlistat, which include oily or fatty stools and gas.

Choice B rationale

Advising the patient to stop taking the drug and contact her healthcare provider is not the first step. The nurse should first assess the patient’s dietary habits as the side effects may be due to a high-fat diet.

Choice C rationale

Instructing the patient to increase her intake of saturated fats over the next week is not advisable. A high-fat diet can increase the side effects of orlistat.

Choice D rationale

Obtaining a stool specimen to evaluate for occult blood and fat content is not necessary in this case. The symptoms described by the patient are common side effects of orlistat and can often be managed by adjusting the diet.

Choice A rationale

While changes in stool color and character can be indicative of various health conditions, they are not the best indicators of a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice B rationale

Fingerstick glucose monitoring is important in managing conditions like diabetes, but it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice C rationale

Lactulose is used in the management of hepatic encephalopathy, a condition that can occur in patients with severe liver disease. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction. Therefore, monitoring serum electrolytes and ammonia levels can help evaluate the effectiveness of lactulose therapy.

Choice D rationale

While monitoring serum hepatic enzymes can provide valuable information about liver function, it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.