The nurse is caring for a patient with an increasing ammonia level because of acute hepatic dysfunction. Which of the following can the nurse do to help prevent the ongoing accumulation of ammonia?
1. physical therapy consult for bedside therapy to prevent muscle breakdown due to bedrest
2. consult with a dietitian regarding the amount of protein to provide in the patient's diet
3. encourage patient to conduct most self-care activities
4. measure the patient for anti-embolism stockings
2
Rationale: One measure to reduce serum ammonia levels is to reduce dietary protein to reduce the formation of ammonia. To do this, the nurse can consult with a dietitian regarding the amount of protein the patient should be ingesting through the diet. A physical therapy consult could be done for bedside therapy in efforts to reduce muscle breakdown because of the patient's bedrest status however this is not going to impact the patient's production of ammonia. Encouraging the patient to conduct most self-care activities also is not going to reduce the production of ammonia. Measuring the patient for anti-embolism stockings will not reduce the production of ammonia.
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