A nurse is caring for a patient who continues to have issues with GERD (gastroesophageal reflux disease). Which of the following statements provides the best preventative health care education for this patient?

Choice A rationale

While an elevated serum ammonia level can indicate liver dysfunction, it is not typically a contraindication for liver biopsy. Ammonia is a byproduct of protein metabolism and is normally converted into urea by the liver, which is then excreted in the urine. Elevated levels can occur in liver disease, but they are not typically a direct concern in the context of a liver biopsy.
Choice B rationale
A hemoglobin level of 11 g/dL is slightly low, but it is not typically a contraindication for a liver biopsy. Hemoglobin is the protein in red blood cells that carries oxygen. While a low hemoglobin level can indicate anemia, it would not typically prevent a patient from undergoing a liver biopsy.
Choice C rationale
A white blood cell count of 14.2 x 103/uL is slightly elevated, indicating a possible infection or inflammation. However, this would not typically be a contraindication for a liver biopsy.
Choice D rationale
A prothrombin time of 32 seconds is significantly prolonged, indicating a potential problem with blood clotting. This would be a major concern for a nurse caring for a patient scheduled for a liver biopsy, as the procedure involves inserting a needle into the liver and could lead to bleeding. Patients with a prolonged prothrombin time are at an increased risk of bleeding complications.

Choice A rationale
Potassium levels are not directly affected by lactulose. Lactulose is used to treat hepatic encephalopathy, a complication of cirrhosis, by reducing levels of ammonia in the blood.
Choice B rationale
Glucose levels are not directly affected by lactulose. Lactulose is used to treat hepatic encephalopathy, a complication of cirrhosis, by reducing levels of ammonia in the blood.
Choice C rationale
Bicarbonate levels are not directly affected by lactulose. Lactulose is used to treat hepatic encephalopathy, a complication of cirrhosis, by reducing levels of ammonia in the blood.
Choice D rationale
In clients who have cirrhosis, lactulose is used to decrease levels of ammonia in the bloodstream. Lactulose works by changing the acidity of the gut, which helps trap ammonia in the colon and prevent it from being absorbed into the bloodstream.