A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as modifiable risk factors for this disorder? (Select all that apply.)

Choice A rationale
Liver cirrhosis is the most common cause of esophageal varices and portal hypertension. Cirrhosis leads to scarring of the liver, which impedes blood flow through the portal vein, causing increased pressure (portal hypertension) and the development of collateral blood vessels (varices) as the body attempts to bypass the blockage.

Choice B rationale
Throat lacerations are not related to the development of esophageal varices or portal hypertension. They are typically acute injuries and do not cause the chronic changes seen in the vasculature associated with these conditions.

Choice C rationale
Kyphosis, a curvature of the spine, does not cause esophageal varices or portal hypertension. It is a structural skeletal condition and does not affect the vasculature of the esophagus or the portal venous system.

Choice D rationale
While squamous cell cancer can occur in the esophagus, it is not a typical cause of portal hypertension or esophageal varices. These varices are usually a result of increased pressure in the portal vein, not directly from a malignancy.

Choice A rationale
Potassium levels are not directly affected by lactulose. While cirrhosis can lead to imbalances in electrolytes, including potassium, lactulose is not used to manage potassium levels in the bloodstream.

Choice B rationale
Ammonia is produced by the breakdown of proteins in the intestines and is normally processed by the liver. In cirrhosis, the liver's ability to convert ammonia to urea is impaired, leading to increased levels in the blood. Lactulose helps reduce blood ammonia levels by converting it into ammonium, which is then excreted.

Choice C rationale
Bicarbonate levels are related to the body's pH balance and are not the target of lactulose treatment. Cirrhosis does not typically result in bicarbonate imbalances that would be treated with lactulose.

Choice D rationale
Glucose levels are managed by insulin and other metabolic processes, not lactulose. While cirrhosis can affect overall metabolism, lactulose does not have a direct effect on blood glucose levels.