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 ["A","B","C"]

Explanation

A) PT is prolonged in cirrhosis due to impaired synthesis of clotting factors by the liver, making it important to monitor for bleeding risk.
B) Serum albumin levels decrease in cirrhosis due to impaired liver function, reflecting the client's nutritional status and liver synthetic function.
C) Elevated serum ammonia levels can indicate hepatic encephalopathy, a complication of cirrhosis characterized by altered mental status.
D) Troponin is not typically evaluated in cirrhosis assessment; it is a cardiac marker used to assess for myocardial infarction.
E) Serum lipase is not typically evaluated in cirrhosis assessment; it is a pancreatic enzyme used to diagnose pancreatitis.

A. Check blood glucose every 4 hours B. 2 gram sodium diet C. Bedrest D. Insert indwelling urinary catheter

Correct Answer is B

Explanation

A) Monitoring blood glucose is more relevant for diabetic care.

B) A sodium diet is appropriate for managing fluid retention associated with liver disease.
C) Bedrest may be prescribed but not as specific to the management of fluid retention.
D) Insertion of an indwelling urinary catheter is not a standard intervention without additional justification.

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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

The nurse should evaluate results of which laboratory tests while caring for a client who has cirrhosis of the liver? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

The nurse is admitting a client with liver disease who presents with dyspnea, weight gain and abdominal distention. Which order would the nurse anticipate?

Correct Answer is B

Explanation

The nurse is preparing discharge teaching for a client who has had a paracentesis. What information should be included in the education session?

The nurse is preparing to administer spironolactone (Aldactone) and furosemide (Lasix) at 0900 to a client diagnosed with ascites. Review of 0600 laboratory results shows serum sodium 130 mEq/L (136-145 mEq/L) and potassium 3.1 mEq/L (3.5-5.0 mEq/L). Which action should the nurse take first?

The nurse is providing care to a client admitted with chronic pancreatitis. Which items are appropriate to include in the discharge teaching for this client? Select all that apply.

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