A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the drug?
Stool color and character.
Serum electrolytes and ammonia.
Serum hepatic enzymes.
Fingerstick glucose.
The Correct Answer is B
Choice A reason: This is not the best assessment for the nurse to use to evaluate the client's therapeutic response to lactulose. Stool color and character may change as a result of lactulose administration, as it is a laxative that lowers the pH of the colon and promotes the excretion of ammonia. However, these changes are not indicative of the effectiveness of lactulose in reducing the ammonia levels in the blood, which is the main goal of the therapy.
Choice B reason: This is the best assessment for the nurse to use to evaluate the client's therapeutic response to lactulose. Serum electrolytes and ammonia are directly affected by lactulose administration, as it lowers the blood ammonia levels by converting it to ammonium and facilitating its elimination in the stool. The nurse should monitor the serum electrolytes and ammonia levels regularly to assess the efficacy and safety of lactulose therapy, as well as to adjust the dosage as needed.
Choice C reason: This is not the best assessment for the nurse to use to evaluate the client's therapeutic response to lactulose. Serum hepatic enzymes are markers of liver function and damage, and they may be elevated in clients with hepatic encephalopathy due to cirrhosis or other liver disorders. However, lactulose does not affect the hepatic enzymes directly, and it does not reverse the underlying liver disease. The nurse should monitor the serum hepatic enzymes to assess the progression and severity of the liver condition, but not to evaluate the response to lactulose.
Choice D reason: This is not the best assessment for the nurse to use to evaluate the client's therapeutic response to lactulose. Fingerstick glucose is a measure of blood glucose levels, and it may be altered in clients with hepatic encephalopathy due to impaired glucose metabolism by the liver. However, lactulose does not affect the blood glucose levels directly, and it does not improve the liver's ability to regulate glucose. The nurse should monitor the fingerstick glucose to assess the risk of hypoglycemia or hyperglycemia, but not to evaluate the response to lactulose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Priming the inhaler with 7 pumps is an incorrect action, as it wastes the medication and reduces the number of doses available. The nurse should teach the client that ipratropium inhaler only needs to be primed once when it is first used, or if it has not been used for more than 3 days. To prime the inhaler, the client should spray it into the air away from the face until a fine mist appears.
Choice B reason: Rinsing the mouth after each use is a correct action, as it prevents dry mouth and irritation caused by the medication. Ipratropium is an anticholinergic drug that blocks the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and mucus. The nurse should teach the client to rinse the mouth with water or mouthwash after using the inhaler, and to drink plenty of fluids to stay hydrated.
Choice C reason: Storing the medication at room temperature is a correct action, as it preserves the quality and effectiveness of the medication. The nurse should teach the client to store the ipratropium inhaler at room temperature, away from heat, moisture, and direct sunlight. The nurse should also instruct the client to check the expiration date and the dose counter of the inhaler, and to replace it when it is empty or expired.
Choice D reason: Attaching spacer device to the inhaler is a correct action, as it improves the delivery and absorption of the medication. A spacer is a device that attaches to the mouthpiece of the inhaler and creates a chamber that holds the medication until the client inhales it. The nurse should teach the client to use a spacer with the ipratropium inhaler, as it can reduce the risk of side effects, such as coughing, throat irritation, and hoarseness. The nurse should also teach the client how to clean and maintain the spacer device.
Correct Answer is A
Explanation
Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.
Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.
Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.
Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.
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