A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?

Breath with fecal odor

Increasing confusion

Serum ammonia level 72 mcg/dL (15-45 mcg/dL)

Diarrhea

Answer and Explanation

The Correct Answer is D

A)   Breath with fecal odor could indicate hepatic encephalopathy, for which lactulose is indicated.
B)   Increasing confusion is a symptom of hepatic encephalopathy suggests a need for lactulose.
C)   Elevated ammonia levels indicate hepatic encephalopathy hence the need for lactulose.
D)   If the client already has diarrhea, additional doses of lactulose (which acts as a laxative) could exacerbate this condition and might need to be adjusted or halted based on clinical judgment.

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Correct Answer is B

Explanation

A) Monitoring intake and output (I&O) is crucial for understanding the patient's fluid balance, especially after 24 hours of vomiting, which could lead to dehydration. However, it is important for fluid balance but not the immediate next step.
B) Checking blood pressure can provide immediate information on the patient's hemodynamic status and potential hypovolemia due to fluid loss; thus, it should be assessed immediately.
C) Assessing pain level is important for comfort, but stabilization of vital signs takes precedence.
D) Measuring oxygen saturation is useful but less critical than assessing for potential hypotension due to dehydration.

A. Fatty stools may result B. Administer prior to antacids C. Do not take with food D. Rinse mouth after taking

Correct Answer is A

Explanation

A) Pancrelipase is an enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates, and its use may lead to steatorrhea (fatty stools) as a common side effect.
B) Pancrelipase is typically administered with meals or snacks to aid in digestion; there is no need to administer it prior to antacids.
C) Pancrelipase is taken with meals or snacks to assist in digestion, so this statement is incorrect.
D) There is no need to rinse the mouth after taking pancrelipase; it is a medication designed for oral ingestion.

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A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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