A patient with hepatic encephalopathy is receiving lactulose.
Which assessment provides the nurse with the best information to evaluate the patient’s therapeutic response to the drug?

Choice A rationale

While changes in stool color and character can be indicative of various health conditions, they are not the best indicators of a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice B rationale

Fingerstick glucose monitoring is important in managing conditions like diabetes, but it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice C rationale

Lactulose is used in the management of hepatic encephalopathy, a condition that can occur in patients with severe liver disease. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction. Therefore, monitoring serum electrolytes and ammonia levels can help evaluate the effectiveness of lactulose therapy.

Choice D rationale

While monitoring serum hepatic enzymes can provide valuable information about liver function, it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice A rationale

St. John’s Wort is known to interact with many prescription drugs, including cyclosporine, a medication often given to transplant patients to prevent organ rejection. St. John’s Wort can decrease plasma concentrations of cyclosporine, thus endangering the success of organ transplantations.

Choice B rationale

There is no evidence to suggest that consumption of St. John’s Wort can reduce the patient’s sodium intake.

Choice C rationale

Adding the herb does not decrease the need for corticosteroids. In fact, it can interact with many medications and cause serious complications.

Choice D rationale

While St. John’s Wort is often used to treat depression, in the context of a patient who has undergone a renal transplant, the most significant information is its potential to interact with cyclosporine and endanger the success of the transplant.