The client has fallen off his mountain bike and sustained multiple abrasions to both of his knees. Which would be appropriate medication(s) for pain management for this client? (Select All That Apply)

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.

A. Dietary restriction while taking hydrocodone

There are no specific dietary restrictions associated with hydrocodone use. This option is not relevant to hydrocodone therapy.

B. Instructions not to exceed recommended dosage

It is crucial to emphasize to the patient not to exceed the recommended dosage of hydrocodone. Exceeding the prescribed dose can lead to adverse effects, including respiratory depression.

C. Instructions not to use alcohol or CNS depressants while taking hydrocodone

Hydrocodone is a central nervous system (CNS) depressant. Combining it with alcohol or other CNS depressants can increase the risk of respiratory depression and sedation. Patients should be advised to avoid alcohol and other drugs that depress the CNS.

D. Instructions on how to prevent constipation

Opioid medications, including hydrocodone, can cause constipation. Patients should receive instructions on how to prevent constipation, such as increasing fluid and fiber intake and incorporating regular physical activity.

E. Side effects to report

Patients should be educated about potential side effects of hydrocodone and instructed to report any unusual or severe side effects to their healthcare provider promptly. This may include symptoms such as respiratory distress, severe drowsiness, or allergic reactions.