The client is brought to the emergency department with a reported overdose of morphine. Which drug does the nurse anticipate will be prescribed?

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. Avoid caffeine-containing beverages before sleep

The highest priority teaching point to help relieve sleeplessness would be to advise the client to avoid caffeine-containing beverages before sleep. Caffeine is a stimulant that can interfere with the ability to fall asleep and maintain a restful sleep.

B. Perform strenuous exercise before bedtime

Strenuous exercise close to bedtime can actually stimulate the body and make it more difficult for the individual to relax and fall asleep. It is generally recommended to engage in exercise earlier in the day.

C. Drink lots of fluids before bedtime

Drinking excessive fluids before bedtime may lead to disrupted sleep as it can increase the need to wake up for bathroom trips during the night. It's advisable to limit fluid intake close to bedtime.

D. Eat a heavy meal before bedtime

Consuming a heavy meal before bedtime can cause discomfort and indigestion, potentially disrupting sleep. It is recommended to have a light, easily digestible meal if eating close to bedtime.