A client diagnosed with end-stage liver disease is prescribed Lactulose. Which assessment finding indicates that this medication is effective?

A. The client has less itching.: Itching in liver disease is caused by bile salt accumulation under the skin and is not directly affected by lactulose. Improvement in pruritus is more closely related to bile acid–binding agents rather than ammonia-reducing therapy. B. The client is having less bowel movements.: Lactulose works by increasing bowel movements to promote the excretion of ammonia from the body. Fewer bowel movements would actually suggest reduced medication effectiveness in managing hepatic encephalopathy. C. The client's ammonia levels have decreased.: Lactulose reduces blood ammonia levels by trapping ammonia in the colon and enhancing its excretion through feces. A decrease in serum ammonia reflects improved hepatic encephalopathy control. D. The client has less pain and less jaundice.: Pain and jaundice in end-stage liver disease result from liver inflammation and bile obstruction, not elevated ammonia. Lactulose does not directly influence bilirubin metabolism or liver pain.