A nurse is admitting a client. Review the exhibits to answer the question.

Exhibits

For each potential provider's prescription, click to specify if the prescription is anticipated or contraindicated.

Choice A rationale
Sorbitol is a type of sugar alcohol used as a sweetener in many diet foods. It is also used in certain medications as a laxative to relieve constipation. However, it is not typically associated with liver failure and would not likely be questioned by the nurse in this context.
Choice B rationale
Lactulose is a type of sugar that is broken down in the large intestine into mild acids that draw water into the intestine, which then helps soften the stools. It is often used to treat constipation and is also used to reduce high blood ammonia levels in patients with liver disease. It would not typically be questioned by the nurse for a patient with chronic liver failure.
Choice C rationale
Neomycin is an antibiotic that is used to reduce the amount of ammonia produced by bacteria in the intestines. High levels of ammonia can cause hepatic encephalopathy, a serious complication of liver disease. Therefore, neomycin can be beneficial for patients with chronic liver failure and would not likely be questioned by the nurse.
Choice D rationale
Acetaminophen, also known as paracetamol, is a common over-the-counter medication used to relieve pain and reduce fever. However, high doses or long-term use of acetaminophen can cause liver damage. In fact, acetaminophen overdose is a common cause of acute liver failure. Therefore, the nurse should question an order for acetaminophen for a patient with chronic liver failure.

Choice A rationale
Holding tube feeding 1 hour before and 2 hours after to avoid clumping is not a specific nursing intervention when administering Dilantin (phenytoin)1011.
Choice B rationale
Monitoring the patient for lethargy and drowsiness is important as these may indicate a high drug level of Dilantin (phenytoin), which can lead to toxicity.
Choice C rationale
Informing the patient that they may experience increased and large amounts of urinary output is not a specific nursing intervention when administering Dilantin (phenytoin)1011.
Choice D rationale
Advising the patient to use an extra soft toothbrush to avoid gum bleeding is a general recommendation for patients on anticoagulant therapy, not specifically for those taking Dilantin (phenytoin)1011.