Patrick who is diagnosed with liver cirrhosis is experiencing symptoms of hepatic encephalopathy. The physician ordered 50 ml of Lactulose p.o. every 2 hours. Patrick suddenly develops diarrhea. The nurse best action would be:
A. “I’ll see if your physician is in the hospital”.
B. “Maybe you’re reacting to the drug; I will withhold the next dose”.
C. “I’ll lower the dosage as ordered so the drug causes only 2 to 4 stools a day”.
D. “Frequently, bowel movements are needed to reduce sodium level”.
Correct Answer: C. “I’ll lower the dosage as ordered so the drug causes only 2 to 4 stools a day”.
Lactulose is given to a patient with hepatic encephalopathy to reduce absorption of ammonia in the intestines by binding with ammonia and promoting more frequent bowel movements. If the patient experiences diarrhea, it indicates overdosage and the nurse must reduce the amount of medication given to the patient. The stool will be mushy or soft. Lactulose is also very sweet and may cause cramping and bloating.
Option A: The nurse may inform the physician so that he may order a lower dosage.
Option B: Withholding the next dose is unnecessary; the nurse may lower the dosage as ordered.
Option D: Lactulose, in this case, is given to reduce absorption of ammonia in the intestines.