Medical Surgical Liver Cirrhosis #3

Question

A client with liver disease is admitted to the medical surgical unit. The nurse reviews the laboratory values and notices the ammonia level is elevated. The nurse contacts the health care provider and receives a prescription for lactulose 30 mL. After administration of the lactulose, the nurse expects which effect of the drug?

Answers

  1. Increased bowel movements.
    • Rationale:

      Lactulose is used to reduce the amount of ammonia in the blood of clients with liver disease. It works by drawing ammonia from the blood into the colon; in addition, it also increases intestinal motility thus increased bowel movements are expected.

  2. Increased urine output.
    • Rationale:

      Lactulose does not increase urine output; therefore, the nurse does not expect this effect after administering the medication

  3. Nausea and vomiting.
    • Rationale:

      Lactulose does not cause nausea and vomiting to remove ammonia from the body; therefore, the nurse does not expect this effect after administering the medication. Lactulose works by drawing ammonia from the blood into the colon; in addition, it also increases intestinal motility thus increased bowel movements are expected.

  4. Decreased ascites.
    • Rationale:

      Lactulose is not administered to treat ascites associated with liver disease; therefore, the nurse does not expect decreased ascites as a result of administering this medication. Lactulose works by drawing ammonia from the blood into the colon; in addition, it also increases intestinal motility thus increased bowel movements are expected.

Overview

Lactulose is a medication prescribed to reduce the amount of ammonia in the blood of clients with liver disease.

Explanation

Learning Outcomes

Cirrhosis is a late stage of scarring (i.e., fibrosis) of the liver caused by many different liver diseases and conditions (e.g., hepatitis, chronic alcoholism). Increased ammonia levels occur in cirrhosis of the liver. Lactulose works by drawing ammonia from the blood into the colon where it is removed from the body. It increases the intestinal motility which aids in trapping and expelling ammonia in the feces. Thus, an increase in bowel movements is expected. Lactulose is sometimes used for treatment of constipation. The other options are incorrect as Lactulose does not usually cause nausea and vomiting, increased urine output or affect ascites.

Test Taking Tip

Consider the mechanism of action for lactulose when it is administered to treat an elevated ammonia level to answer this question correctly.

Video Rationale