The nurse is caring for a client who has ascites and hepatic encephalopathy. Which of the following prescriptions should the nurse clarify with the primary healthcare provider (PHCP)?
Rifaximin
Lactulose
Spironolactone
Alprazolam
The Correct Answer is D
Choice A rationale: Used in the management of hepatic encephalopathy by reducing the production of ammonia in the gut.
Choice B rationale: Often prescribed to reduce ammonia levels in hepatic encephalopathy by promoting bowel movements and aiding ammonia excretion. Choice C rationale: Typically used in managing ascites by reducing fluid retention and treating edema.
Choice D rationale: This medication can potentially worsen hepatic encephalopathy due to its sedative effects and impact on mental function. It's crucial to clarify its use in a patient with hepatic encephalopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Peptic ulcer disease doesn't typically present with ecchymosis around the umbilicus (Cullen's sign) or significantly elevated amylase and lipase levels.
Choice B rationale: Gastroenteritis is less likely given the specific symptoms, physical exam findings, and laboratory results indicating pancreatic involvement.
Choice C rationale: Acute pancreatitis fits the clinical picture with epigastric pain after heavy alcohol use, persistent nausea/vomiting, tenderness, and elevated amylase and lipase levels.
Choice D rationale: Diverticulitis typically presents with symptoms more localized to the lower abdomen and doesn't cause the characteristic findings seen in this scenario.
Correct Answer is C
Explanation
Choice A rationale: Typically associated with potassium depletion rather than elevated levels.
Choice B rationale: Furosemide, a loop diuretic, can cause potassium depletion leading to hypokalemia, but it might also cause transient elevations in potassium levels initially. Choice C rationale: Addison disease can cause hyperkalemia, or high potassium, due to decreased renal excretion of potassium and increased retention of sodium and water.
Choice D rationale: Cushing disease can cause hypokalemia, or low potassium, due to increased renal excretion of potassium and decreased reabsorption of sodium and water.
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