A client is refusing to take lactulose (Heptalac) because of diarrhea. Which is the nurse's best response to this client?
a. "Diarrhea is expected; that's how your body gets rid of ammonia."
b. "You may take Kaopectate liquid daily for loose stools."
c. "Do not take any more of the medication until your stools firm up."
d. "We will need to send a stool specimen to the laboratory."
A
The purpose of administering lactulose to this client is to help ammonia leave the circulatory system through the colon. Lactulose draws water into the bowel with its high osmotic gradient, thereby producing a laxative effect and subsequently evacuating ammonia from the bowel. The client must understand that this is an expected and therapeutic effect for him or her to remain compliant. The other statements are inaccurate.
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The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the patient asks the nurse why she must take both hormones, the best reply is: 1. "Hot flashes respond better when replacement includes both hormones." 2. "You are having very severe symptoms, so you need more hormones replaced." 3. "There is an increased risk of tissue abnormality inside the uterus if only one is given." 4. "Your blood pressure can become elevated if only one hormone is used."
A client with a subarachnoid bleed refuses to use a bedpan and becomes angry when denied permission to walk to the bathroom. While waiting to hear from the health care provider (HCP), which action should the nurse take?
a. Help the patient to get up on a bedside commode b. Wait for the neurosurgeon to call back with orders c. Page security to restrain the patient from harming the nurse d. Administer an as-needed dose of a sedative that is ordered
When is healing by primary intention expected?
a. When the wound is left open and is allowed to heal b. When a surgical wound is left open for 3 to 5 days c. When connective tissue development is evident d. When the edges of a clean incision remain close together
A client who was reported missing 5 days prior is admitted to the critical care unit. A nurse notes that the client is cachectic and dehydrated, but otherwise without notable disease. The nurse understands that the client is likely experiencing which of the following?
A) Wasting syndrome B) Uncomplicated starvation C) Sepsis D) Multisystem organ failure