Lactulose is ordered for a patient with liver disease. What would indicate the medication is exerting a positive therapeutic effect on the patient?
Decreased ascites
Decreased ammonia level
Decreased jaundice
Decreased blood pressure,
The Correct Answer is B
A. Decreased ascites
Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels.
B. Decreased ammonia level
Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood.
C. Decreased jaundice
Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy.
D. Decreased blood pressure
Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Ask a colleague what the order says:
This option involves seeking assistance from a colleague to interpret the illegible handwriting. While collaboration among healthcare professionals is important, relying on a colleague to interpret unclear handwriting may introduce the risk of miscommunication or misinterpretation.
B. Contact the prescriber to clarify the order:
This is the recommended and safest option. Contacting the prescriber directly to seek clarification ensures accurate information and reduces the risk of misinterpretation or errors related to illegible handwriting.
C. Wait until the prescriber makes rounds again to clarify the order:
This option involves delaying clarification until the prescriber is available during rounds. Waiting may not be ideal if the patient requires prompt intervention or if there is an urgency in administering the medication. Timely communication is crucial for patient safety.
D. Ask the patient what medications he takes at home:
This option is unrelated to the issue of illegible handwriting on the prescription. While obtaining a patient's medication history is important for comprehensive care, it does not address the immediate need to clarify the unclear order.
Correct Answer is A
Explanation
A. Misoprostol (Cytotec)
The patient complaining of gastric distress from NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) like aspirin or indomethacin may benefit from the administration of misoprostol (Cytotec). Misoprostol is a prostaglandin analog that helps protect the stomach lining and reduce the risk of NSAID-induced gastric ulcers.
B. Lansoprazole (Prevacid)
Lansoprazole is a proton pump inhibitor (PPI) that reduces stomach acid production. While PPIs can be used for certain acid-related conditions, they do not directly protect against NSAID-induced gastric distress.
C. Magaldrate (Riopan)
Magaldrate is an antacid that neutralizes stomach acid. It may provide relief from symptoms of indigestion but does not specifically address the gastric distress caused by NSAIDs.
D. Magnesium trisilicate (Gaviscon)
Magnesium trisilicate is an antacid that helps neutralize stomach acid. Like magaldrate, it may alleviate symptoms of indigestion but does not target the underlying issue of NSAID-induced gastric distress.
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