A nurse is teaching a client measures to help relieve sleeplessness. Which would be the highest priority teaching point during the instructional session?

A. Decreased ascites

Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels.

B. Decreased ammonia level

Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood.

C. Decreased jaundice

Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy.

D. Decreased blood pressure

Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.

A. Depression:

CNS stimulants are generally not indicated for depression. In fact, they can exacerbate symptoms and are not considered a first-line treatment for depressive disorders.

B. Opiate overdose:

CNS stimulants are not indicated for treating opiate overdose. In cases of overdose, other medications like naloxone are commonly used to reverse the effects of opioids.

C. Poor appetite:

CNS stimulants may be used to increase alertness and decrease fatigue, but they are not typically prescribed to address poor appetite. Appetite stimulation is often managed through other approaches.

D. Narcolepsy:

This is the correct answer. CNS stimulants, such as modafinil or methylphenidate, are commonly prescribed to manage symptoms of narcolepsy. These medications help improve wakefulness and reduce excessive daytime sleepiness.