NURS 414 Final Exam Test

NURS 414 Final Exam Test The physician orders Lactulose 30 mL by mouth per day for a client with cirrhosis. What finding below demonstrates the medication is working effectively? A. Improvement in level of consciousness B. Presence of asterixis C. Decreased albumin levels D. Absence of fruity breath A. Improvement in level of consciousness A patient with cirrhosis may experience a complication called hepatic encephalopathy. This will cause the patient to become confused (they may enter into a coma), have pungent, musty smelling breath (fetor hepaticus), asterixis (involuntary flapping of the hands). This is due to the buildup of ammonia in the blood, which affects the brain. Lactulose can be prescribed to help decrease the ammonia levels. Therefore, if the medication is working properly to decrease the level of ammonia the patient would have improving mental status, decreased ammonia blood level, decreasing or absence of asterixis, and decreased ammonia blood level. Fruity breath is associated with DKA not hepatic encephalopathy. During the morning assessment of a client with cirrhosis, you note the client is disoriented to person and place. In addition, while assessing the upper extremities, the client's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings? A. Ammonia level of 68 µ/dL B. Creatinine level of 2.9 mg/dL C. Potassium level of 3.7 mmol/L D. Calcium level of 10.9 mg/dL A. Ammonia level of 68 µ/dL Based on the assessment findings and the fact the client has cirrhosis, the client is experiencing hepatic encephalopathy. This is due to the buildup of toxins in the blood, specifically ammonia. The flapping motion of the hands is called "asterixis". Therefore, an increased ammonia level would confirm these abnormal assessment