A nurse is providing education to the partner of a client who has hepatic encephalopathy about a prescription for lactulose. Which of the following statements should the nurse make to the client’s partner?
A.
“There should be a decrease in the number of bowel movements with this medication.”
B.
“IV administration is the preferred route to give this medication.”
C.
“This medication will treat the infection that is causing the confusion.”
D.
“We will monitor the serum ammonia level to help determine if the medication is effective.”
The correct answer and Explanation is :
The correct answer is:
D. “We will monitor the serum ammonia level to help determine if the medication is effective.”
Explanation:
Lactulose is commonly prescribed for clients with hepatic encephalopathy, a condition caused by liver dysfunction, which leads to a buildup of toxins in the blood, particularly ammonia. Ammonia is normally processed by the liver and excreted, but when the liver fails to function properly, ammonia levels rise, leading to neuropsychiatric symptoms such as confusion, disorientation, and even coma.
Lactulose works by promoting the conversion of ammonia into ammonium, a form that cannot be absorbed into the bloodstream. It also increases bowel movements, helping to expel the ammonium from the body. The effectiveness of lactulose is monitored by checking the client’s serum ammonia levels. If the ammonia levels decrease, the medication is working effectively to reduce the symptoms of hepatic encephalopathy. Therefore, monitoring serum ammonia levels is a key aspect of determining the efficacy of the treatment, making Option D the most accurate statement.
Now, let’s review the other options:
- A. “There should be a decrease in the number of bowel movements with this medication.” This statement is incorrect because lactulose actually works by increasing the number of bowel movements to facilitate the excretion of ammonia.
- B. “IV administration is the preferred route to give this medication.” Lactulose is typically administered orally or via enema, not intravenously.
- C. “This medication will treat the infection that is causing the confusion.” Lactulose does not treat infections. It addresses the elevated ammonia levels, which are the primary cause of the confusion in hepatic encephalopathy, not an infection.