A 50-year-old woman has a long history of hospital admissions related to alcohol abuse and consequent liver failure. During this present admission, the patient has been diagnosed with hepatic encephalopathy and prescribed lactulose (Cephulac).
During morning report, the nurse learns that the previous nurse withheld the patient's latest dose of lactulose because the patient had two loose bowel movements during the shift. How should the nurse interpret the previous nurse's action?
A) The previous nurse acted correctly because loose bowel movements present a threat to the patient's fluid and electrolyte balance.
B) The previous nurse should have obtained an order for a stool softener to replace the scheduled lactulose.
C) The previous nurse should have administered the lactulose because it is necessary to remove excess ammonia.
D) The previous nurse should have administered a partial dose of the lactulose in spite of the patient's bowel movements.
Question 2
A 49-year-old man with a history of heavy alcohol use and liver cirrhosis has been admitted to the hospital's medical unit due to an exacerbation of his health problems that has resulted in massive ascites.
The nurse should be prepared to implement which of the following interventions in an effort to resolve the patient's ascites?
A) High Fowler's positioning and fluid restriction
B) Low-sodium diet and administration of diuretics
C) Peritoneal massage and administration of hypertonic IV solutions
D) Low-protein diet and administration of IV albumin
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