Which of the following indicate to the nurse that lactulose is effective for an older adult who has advanced liver cirrhosis?
The client has at least one stool per day.
The client denies nausea and vomiting (N/V).
The client's bilirubin level decreases.
The client is alert and oriented (A&Ox4).
The Correct Answer is D
Choice A reason: While having at least one stool per day is a sign that lactulose is working, it does not directly indicate its effectiveness in reducing ammonia levels and improving mental status.
Choice B reason: Denial of nausea and vomiting is positive but is not a direct indicator of lactulose's effectiveness in treating hepatic encephalopathy.
Choice C reason: A decrease in bilirubin levels may be a positive sign, but it is not a direct indicator of lactulose's effectiveness in treating hepatic encephalopathy.
Choice D reason: The client being alert and oriented is a direct indicator that lactulose is effectively reducing ammonia levels and improving mental status, which is a key goal in treating hepatic encephalopathy associated with liver cirrhosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cleaning with an alcohol-based solution is not recommended as it can be irritating and does not prevent infection.
Choice B reason: Routine irrigation of the catheter is not recommended as it can introduce infection.
Choice C reason: Replacing the catheter routinely every three days is not recommended and can increase the risk of infection.
Choice D reason: Ensuring the catheter tubing is free of kinks, twisting, and dependent loops is important to maintain urine flow and prevent infection.
Correct Answer is D
Explanation
Choice A reason: While painful and red-tinged urination is a concern, it is not directly related to the intravenous pyelogram procedure.
Choice B reason: The end of the menstrual period is not relevant to the intravenous pyelogram procedure.
Choice C reason: Drinking fluids is generally encouraged but does not need to be reported unless it is restricted before the procedure.
Choice D reason: The client's allergy to shellfish is important to report because the contrast dye used in an intravenous pyelogram may contain iodine, which can cause a reaction in people with shellfish allergies.
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