NCLEX Style Study Question
Lactulose (Chronulac) has been prescribed for a client with advanced liver disease. Which of the following assessments would the nurse use to evaluate the effectiveness of this treatment?
- An increase in appetite
- A decrease in fluid retention
- A decrease in lethargy
- A reduction in jaundice
April 25th, 2005 at 6:14 pm
4
April 28th, 2005 at 12:23 am
3
This will eliminate toxic levels of drugs which are metabolized by the liver and with excess build up may lead to lethargy. It also can reduce ammonia levels in the body which can lead to encephalopathy.
April 28th, 2005 at 6:53 am
The correct answer is number: 3
Due to physiological changes in the elderly, as well as conditions such as dehydration, hyperthermia, immobility and liver disease, the metabolism of drugs may decrease. As a result, drugs can accumulate to toxic levels and cause serious adverse reactions.
Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition). Philadelphia: F.A. Davis Company.
Delaune, S & Lander, P. (2002). Fundamentals in Nursing: Standards and Practice. (2nd ed). Clinton Park, New York: Delmar.
April 28th, 2005 at 10:10 am
#2 what a question! Lactulose helps because it causes
ammonia to be converted to ammonium ions which are not reaborbed into the body like ammonia is.
I too, think in time, the appetite would increase, and lethargy would decrease.
I’m GUESSING AGAIN: I think FLUID RENTENTION would be decreased if the liver functions more normally, and that would be easier to assess, Therefore I guess #2.
April 28th, 2005 at 4:26 pm
Lactulose binds to ammonia and also causes heavy diarrhea, eliminating further ammonia as well as fluids.
April 30th, 2005 at 4:26 am
#3
although it is true that lactulose has a laxative effect, it’s main use in treating advanced liver disease is to get rid of the ammonia (cerebral toxin) and somehow increase the patient’s energy level
April 30th, 2005 at 5:08 pm
#3
May 5th, 2005 at 10:39 am
I was suprised that the answer was #3. I was thinking #4 because since Lactulose causes severe diarrhea, the frequent stooling would decrease the jaundice.