A client with cirrhosis of the liver is having numerous, liquid, incontinent stools, and continues to be confused. In reviewing the client's laboratory studies, the nurse identifies an elevated serum ammonia level. Based on this finding, which prescription is most important for this client to receive?
Explanation & Rationale
A. Loperamide: Although it treats diarrhea, loperamide would worsen ammonia buildup by reducing bowel transit time. It doesn’t address the underlying hepatic encephalopathy causing confusion in cirrhosis. B. Furosemide: This loop diuretic is used to manage ascites or edema, not elevated ammonia. It doesn’t treat the neurological symptoms caused by hepatic encephalopathy or improve stool-based ammonia excretion. C. Lactulose: Lactulose lowers serum ammonia by trapping it in the colon and promoting its excretion through diarrhea. It directly treats confusion related to hepatic encephalopathy, making it the most important intervention here. D. Intravenous (IV) human albumin: Albumin helps restore oncotic pressure in cases of ascites or low serum protein but does not affect ammonia levels or mental status. It supports fluid balance, not toxin elimination.