A client with a history of cirrhosis has a new prescription for lactulose 30 mL four times a day. What does the nurse explain to the client about this medication?

Question

A client with a history of cirrhosis has a new prescription for lactulose 30 mL four times a day.  What does the nurse explain to the client about this medication?

Quizplus · Accepted Answer

Lactulose is a syruplike liquid that decreases intestinal ammonia absorption in clients with liver disease and hepatic encephalopathy. Hepatic encephalopathy occurs when the failing liver does not adequately detoxify ammonia in the body, leading to changes in mental status and death if not adequately and promptly treated. The lactulose dosing frequency should be adjusted to ensure 2-3 soft stools per day with no confusion or lethargy. (Option B) Spironolactone, an aldosterone inhibitor and potassium-sparing diuretic, is typically used in a client with liver failure, ascites, and edema to promote diuresis and to prevent fluid retention. If more diuresis is needed, then intravenous furosemide is used, often in combination with albumin infusion. (Option C) Lactulose does not promote renal excretion of bilirubin. (Option D) A TIPS (transjugular intrahepatic portosystemic shunt) procedure and beta blockers (propranolol) are used to reduce portal pressure in the client with liver failure and esophageal varices. Educational objective: Lactulose controls ammonia levels in hepatic encephalopathy by reducing intestinal absorption of ammonia with excretion in the stool.

A Client with a History of Cirrhosis Has a New